“Our findings suggest that coupling the incentives to daily steps may not be the way to go. However, tying them to MVPA (moderate-to-vigorous physical activity) or aerobic steps is worth considering, as these are the type of steps most likely to improve health. Yet, the results also suggest that any incentive strategy would need to be in place for a longer period of time to generate any noticeable improvements in health benefits and to avoid undermining effect from their removal,” he added.

The researchers also pointed out that about 40% of participants stopped using the tracker during the first 6 months and only about 10% were still wearing the tracker at 12 months.


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“We saw a large drop-off in usage as the study went on,” study co-author Robert Sloan, PhD, of Kagoshima University Graduate School of Medical and Dental Sciences in Japan, explained in the press release. “People use these devices for a while, but with time the novelty wears off—this is consistent with how people use trackers in real life.”

The researchers cited several study limitations. Notably, participants volunteered for the study and therefore may have been healthier or more interested in being physically active than the general population. They also stated that the control group’s decrease in physical activity may have resulted from baseline physical activity that was “artificially high as a result of joining the study or wearing the accelerometer for the first time.” There was also potential for contamination, as participants within worksites but in different study groups may have interacted with each other.

In a related commentary, Courtney M. Monroe, PhD, of the University of South Carolina in Columbia, stated that the “timely” trial fills gaps in the scientific literature about the combined effect of financial incentives and use of these new wearable devices. She underscored the relevance of the findings as well as opportunities for more research.6

“Future incentive-based studies targeting physical activity should include measures of motivation and examine how different aspects of these approaches (eg, incentive distribution patterns, reward intervals, and incentive amount) can be manipulated to positively affect intrinsic motivation and physical activity in a cost-effective manner,” she wrote.

“Testing the use of financial incentives, wearables, or both, in conjunction with other financial incentives, wearables, or both, in conjunction with other technologies and strategies that have great potential as components of physical activity promotion (eg, mobile phone features, gamification, and social media) is a logical future step.”

Disclosures: The researchers report no conflicts of interest. Dr Monroe reports no conflicts of interest.

References

  1. Finkelstein EA, Haaland BA, Bilger M, et al. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomized controlled trial. Lancet Diabetes Endocrinol. 2016 Oct 4. doi:10.1016/S2213-8587(16)30284-4 [Epub ahead of print]
  2. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT; for the Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380: 219–229. doi:10.1016/S0140-6736(12)61031-9.
  3. Ledger D, McCaffrey D. Inside wearables: how the science of human behaviour change offers the secret to long-term engagement. Endeavour Partners, 2014. http://endeavourpartners.net/assets/Endeavour-Partners-Wearables-White-Paper-20141.pdf. Accessed September 6, 2016.
  4. Zulman DM, Damschroder LJ, Smith RG, et al. Implementation and evaluation of an incentivized Internet-mediated walking program for obese adults. Transl Behav Med. 2013;3:357–369. doi:10.1007/s13142-013-0211-6.
  5. Even with charity or cash incentives, activity trackers do not appear to improve health [news release]. New York, NY: Lancet Journals Press Office; October 4, 2016. Accessed October 13, 2016.
  6. Monroe CM. Valuable steps ahead: promoting physical activity with wearables and incentives. Lancet Diabetes Endocrinol. 2016 Oct 4. doi:10.1016/S2213-8587(16)30264-9 [Epub ahead of print].