Games and cash: The best motivators for staying active, according to trial

Are you struggling to maintain a consistent workout regimen? You’re not alone. In the digital age, the battle to stay active is increasingly challenging but critically important, especially for those at risk for cardiovascular disease. 

A compelling study known as the BE ACTIVE trial offers fresh insights into how combining technology, gamification, and financial incentives can turn the tide in this ongoing battle.

How effective are gamification and financial incentives in promoting physical activity?

The BE ACTIVE trial, a comprehensive study involving over 1,000 adults at risk of cardiovascular disease, provides a groundbreaking look into how behavioral strategies can effectively increase physical activity [1]. 

Participants, ranging from those with atherosclerotic cardiovascular conditions to others with a heightened 10-year risk for severe heart issues, experienced significant improvements in their daily activity levels thanks to innovative motivational strategies.

The power of financial incentives

Participants who were offered financial incentives showed remarkable improvements in their daily steps

With a setup that rewarded $14 weekly for meeting set goals, and penalized $2 for each day they didn’t, this approach not only motivated immediate action but also sustained it over time. 

The trial noted a 1700 step increase per day, translating to an increase in life expectancy by approximately 1.2 years based on extrapolations from related observational studies [1].

Gamification as a tool for engagement

Similarly, gamification, which involved earning points for meeting daily step goals, proved to be a strong motivator. 

Participants in this arm of the trial were allocated 70 points weekly, which they could lose if they failed to meet their activity goals [1]. 

This playful, competitive element made physical activity more engaging and helped participants significantly boost their daily steps.

Combining forces for maximum impact

Interestingly, the most robust results came from the combination of both financial incentives and gamification. 

This group saw the highest increase in daily steps during the trial period, underscoring the potential of integrated approaches to tackling physical inactivity among at-risk populations [1].

Long-term engagement and practical considerations

Despite the successes, the trial also highlighted challenges in maintaining these improvements over time, with a slight decline in activity observed after the initial 12-month intervention period [1]. 

This raises important questions about the sustainability and long-term effectiveness of such programs, especially in a real-world setting.

Are these strategies practical for widespread use?

The scalability and automation of these interventions make them an attractive option for broader implementation. 

The trial utilized an automated patient communication platform linked to a Fitbit device, facilitating easy monitoring and interaction without intensive manual oversight [1]. 

However, questions remain about who will fund these incentives and how they will be integrated into standard healthcare practices.

The role of self-motivation

While external motivators like cash and points significantly impact activity levels, the intrinsic motivation to stay active remains crucial. 

Cathleen Biga, MSN, incoming ACC President and a specialist in cardiac rehabilitation, emphasizes that ultimately, the decision to stay active falls on the individual. 

This sentiment highlights the need for a balanced approach that combines external motivators with strategies to enhance personal commitment to health.

What’s next?

As healthcare systems and insurers evaluate the potential benefits of these programs, further research is necessary to confirm their impact on long-term health outcomes, including mortality and cardiovascular events. 

The promising results of the BE ACTIVE trial suggest that with the right incentives, significant improvements in population health are within reach, potentially paving the way for new standards in preventive care.

By adopting these innovative strategies, healthcare providers can not only enhance patient engagement but also potentially reduce the incidence of cardiovascular diseases, making a significant impact on public health.


Photograph: YuriArcursPeopleimages/Envato
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