A new study supports the daily nudge approach to healthier habits. Supported by the National Institutes for Health, this study was designed to assess the impact of daily reminders on step count. Steps offer a simple way to measure activity, especially in older populations. The researchers also added a twist, comparing financial incentives and/or gamification through a points-based system. What’s more, this study targeted a group of people who already had markers of poor heart health, so they had a lot to gain from successful fitness improvements! 
Helping older individuals who do not lead active lives is a major challenge. Yet the rising cost of health care and longer lifespans are sparking a sense of urgency in finding interventions that work. Researchers selected study participants who had several established risk factors for heart disease. This disease takes decades to manifest, though symptoms don’t arise till late in the course of disease. It is important to interrupt behaviors that accelerate the disease course, and inactivity is a prime target. In a study lasting over a year, researchers used daily nudges to help these individuals make healthier choices. Would these brief daily interruptions be enough to motivate movement?
As the study results developed, the outcomes provided evidence that yes, daily nudges help participant increase their daily physical activity. Using additional studies, the authors emphasize that this 10% boost in step count as a result of nudges or financial incentives influences life expectancy. Based on prospective studies, the boost found in the step study can reduce risk of premature death by 6% and cardiovascular-related death by 10%.
Reframing these findings, the outcomes show that daily nudges in support of activity goals significantly improved heart health, helping them stay healthier for longer. The step improvements were able to change the course of their disease. We know from other research that even for those with heart disease, more daily activity reflects a lowering of your heart failure risk. The study participants who received daily nudges took the steps necessary to protect their heart function.
With more than 1,000 adult participants at elevated risk for major cardiovascular events, researchers were able to test four groups. All wore wearable fitness devices to track daily step count, and they were randomized into one of the following: A control group, daily nudge reminders, financial incentives for activity ($2/day, with loss-framing), and a group receiving both daily nudge reminders and financial incentives.
While a simple daily reminder was effective on its own, the experience was enhanced by offering additional financial incentives (by earning up to $14 per week which was lost if step count was not achieved) and/or point-based gamification. The points-only gamification successfully increased steps by more than 530 per day. There was even greater support for earning money combined with gamification, with an increase in steps exceeding 860 per day.
Fitness facilities and forward-thinking employers know that support matters when it comes to physical activity and creating healthy habits. Few may have the financial support necessary to reward their members or employees to achieve higher step counts. Nonetheless, research like this helps us understand that in addition to money, gamified reward systems influence behavior. Studies like these can help us better support physical activity for all, even if financial rewards are not possible.
The authors address this in their conclusions. “There were no significant differences in physical activity outcomes between gamification and financial incentives. A formal cost-effectiveness analysis is forthcoming, but gamification may be preferable in many contexts for financial reasons and because there are no additional costs to continuing it indefinitely, potentially mitigating the risk of challenges with maintaining gains in physical activity after intervention withdrawal. Engagement remained high over the 12-month intervention, suggesting the feasibility of an indefinite intervention.”
The study’s findings highlight the importance of support for physical activity, even if individuals are older or already have chronic conditions. It is daily support that is needed, because many are future-oriented upon receiving their diagnosis. They may think about the inevitable outcomes of staying on their current disease course, and it is often disheartening. Instead of focusing far into the future, activity support that has a daily nudge can help individuals stay focused on the present. This helps them make smaller, sustainable changes in their activity, because they exert control day-by-day. They choose how to get those steps in. This idea aligns closely with Treo’s Supported Autonomy model of health support. When it comes to daily nudges and gamification, Treo motivates healthier daily habits using the same strategy.
Much like the formal study, Treo has provided evidence that daily nudges are effective strategies for promoting healthier habits. With diverse daily habits, personalized interests can be customized for every individual. This includes eating choices, stress management, physical activity, and more. With a gamified experience, and no wearable required, habit tracking delivers an immediate sense of reward. Interested in learning more? Let’s get in touch to find out how Treo can support your organization. Schedule a demo here: Schedule Demo or contact Treo Wellness at info@treowellness.com
As Treo’s Global Wellness Researcher, Karlie uses recent research findings to support healthier daily habits. Karlie earned her doctorate in Neuroscience and Behavior and bachelors in Health and Exercise Science.
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