Would you exercise (more) if someone paid you to?

Inactivity… It’s a major issue

The WHO lists physical inactivity as a global public health problem. In some regions (namely the Americas & Eastern Mediterranean regions), 50% of the population are classified as sedentary.

To combat this problem, and to (literally) decrease the associated morbidity and mortality, people are trying to find ways to get people moving.

The Study in Question

I’m not saying I agree with this premise of this study (in fact I think it’s ridiculous) but it was recently published in The Lancet Diabetes & Endocrinology, and involved 800 Singaporeans being randomised to 4 groups:

1. Fitbit only
2. Fitbit + cash ($20 per week for meeting daily step goals)
3. Fitbit + charitable incentive
4. Control (no Fitbit, no reward)

With these interventions, it was found that Group 2 (cash) had 30 minutes more of moderate-vigorous activity per week (compared with controls) and group 3 (charitable reward) had 20 minutes more per week than controls.

After incentives were removed, physical activity levels dropped (to only 10 minutes more per week than control – er, that’s only 1.4 minutes per day?!).  Additionally, neither body weight nor blood pressure improved post intervention.

Their Conclusion

The researchers concluded that:

  • This study calls into question the value of these devices for health promotion (actually, studies are showing that physical activity trackers (such as Fitbits) are not having their intended effects (“improve your health by tracking your activity, exercise, food, weight and sleep”), and that
  • “Incentives would probably need to be in place long-term to avoid any potential decrease in physical activity resulting from discontinuation”.

(NB:  Spellcheck for ‘Fitbit’ brings up ‘nitwit’. Not judgin’. Just sayin’.)

fitbit

My Conclusion (infinitely more insightful)

I have differing conclusions:

  • The list of reasons for inactivity is extensive and varied (see below), and a measly $20 a week ain’t gonna help people overcome these hurdles (aka excuses);
  • The suggestion that these incentives could be in place for long-term indicates a lack of insight into the reasons for inactivity, and also opens up the potential danger of a policy being developed at governmental level (this study was funded by the Ministry of Health after all) that is completely useless (I know, I know… It wouldn’t be the first time a government has done this…);
  • Finally, and most importantly, why should anyone be PAID to exercise? Unless there are really valid reasons for an inability to exercise (I would hazard a guess that these would be mostly lacking in this study population:  English-speaking, adult, full-time employees of some 13 organisations in Singapore) why perpetuate the dangerous ideal that they are owed something for doing what they should be doing anyway – ie. getting up off their asses and moving.

funeralforfat

Top 10 Barriers to Physical Activity (constructive suggestions in brackets)

1. No time (make some)
2. Inconvenient (but yet you will drive 1 hour to a shopping outlet)
3. No motivation (find some – less obesity/ disease/ DEATH. Oh you don’t care? How about ‘look hot naked’?)
4. Unenjoyable (you clearly have issues, and shouldn’t have made it through to the Industrial Revolution ‘ Oh I just find walking for life-sustaining food and water so, like, unenjoyable – can’t I wait in the village and get a mani/pedi instead?’ #naturalselection)
5. Boring (pick another type of activity – perhaps one that ISN’T boring)
6. Low self-efficacy (this is a real one. Lack of confidence with activity from early childhood does carry over into adulthood, but still this can be overcome – find a caring and physically attractive personal trainer to gently ease you into an exercise programme. They will praise you for simply breathing. Well done!)
7. Fear of injury (well, the longer you wait to exercise, the heavier and less agile you’ll be, so you’d better get started now)
8. Lack of self-management skills (#1 actually comes under this one – in short, you need to get your shizzle together)
9. Lack of encouragement from others (if family and friends aren’t holding your hand enough (and I am crying you a river), get some encouraging emails/ banners/ robots that will remind you to do what you know you should already be doing)
10. Lack of safe space near home or work (oh that’s RIGHT! I forgot that no-one in Central America or Africa is active. I also forgot that no-one exercises at home. My bad.)
(Sallis and Hovell, 1990; Sallis et al., 1992)

pilates

REFERENCES
Finkelstein EA, Haaland BA, Bilger M, Sahasranaman A, Sloan RA, Nang E, Evenson KR. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. Lancet Diabetes Endocrinol. 2016 Oct 3. pii: S2213-8587(16)30284-4.
Jakicic JM, Davis KK, Rogers RJ, King WC, Marcus MD, Helsel D, Rickman AD, Wahed AS, Belle SH. Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial. JAMA. 2016 Sep 20;316(11):1161-1171. doi: 10.1001/jama.2016.12858.

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