A recent study supported by the National Institutes of Health found that adults at risk for heart disease who were given daily reminders or rewards to be more active increased their daily steps by over 1,500 within a year, and many of them were still continuing with this new habit six months later. The study was published in Circulation.
This article was previously presented as new research at the American College of Cardiology’s Annual Session.
The improvements, which also led to an additional 40 minutes of moderate exercise each week, were linked to a 6% lower risk of premature death and a 10% lower risk of cardiovascular-related deaths compared to previous studies. The Department of Health and Human Services suggests that most adults should aim for at least 150 minutes of moderate aerobic exercise per week, such as brisk walking, or 75 minutes of vigorous exercise, like fast cycling, or a combination of the two, along with strength training twice a week.sessions.
Researchers discovered that a simple daily reminder was effective in motivating people to increase their physical activity. However, offering financial incentives or point-based rewards, similar to those in a game, proved to be even more effective. The most effective method, though, was combining the two incentives. Even after the rewards stopped, participants who received both incentives continued to show improvements in their activity levels six months later.
“Even modest exercise can significantly reduce the risk of heart disease, so finding affordable ways to encourage people to be more active and maintain a fitness routine that they can do at home is a major win for public health,” explained Alison Brown, Ph.D., R.D., a program officer at.the National Heart, Lung, and Blood Institute (NHLBI), which is a part of the NIH, conducted the study. The study took place from 2019 to 2024 and involved tracking more than 1,000 adults at high risk for major cardiovascular events. Each participant was given a wearable fitness tracker that connected to an online health portal, allowing researchers to monitor their baseline daily step count. Participants were then given a goal to increase their daily steps by 33%, 40%, 50%, or any amount greater than 1,500 steps from their starting point. Once they set their goals, the participants were randomly assigned to one of four groups. In the study, participants were divided into two groups: the game group and the financial group. In the game group, participants earned points by meeting their daily step goals and lost points on days they did not meet their goals. Those with enough points moved up a level, while those who did not meet their goals moved down a level. Participants could also enlist a family member or friend as a “support crew” to receive progress updates. At the end of the study, adults who reached the highest levels received trophies. In the financial group, participants received $14 each week.The second group faced a penalty of $2 per day if they failed to achieve their step goals, while the third group was given game-like rewards and financial incentives. In contrast, the fourth group, which served as the control group, did not receive any incentives but were provided with a fitness tracker and received daily messages acknowledging their step count. Each intervention lasted for 12 months followed by a six-month follow-up period where all participants received the same information as controls.
Before the study, all groups had an average of around 5,000 daily steps, equivalent to 2.4 miles. After 12 months, they managed to increase their daily step count by over 1,500 steps.group that received both game and financial incentives showed the most significant increase in daily steps, maintaining this improvement even six months later. The adults in the single intervention groups also saw an increase in physical activity, but this did not differ significantly from the control group after 18 months. Overall, the findings suggest that these incentives had a positive and immediate impact on the participants.Dr. Alexander C. Fanaroff, a study author and expert in behavior change, emphasized the importance of focusing on the present when trying to make changes. Whether it’s exercising for better heart health or saving for future goals, research shows that immediate rewards can be more motivating than long-term benefits. By applying the same principles used in the study, individuals looking to change their exercise habits can create immediate benefits or rewards for movement.Exercise apps can provide daily reminders and rewards for achieving personal health goals. People can also seek support from family and friends, and even create scenarios where they risk losing money if they don’t meet their targets. Healthcare systems and organizations can employ similar tactics to help patients increase their physical activity levels. The research was funded by NHLBI grant R61/R33HL141440.
