As anyone who’s tried to eat healthier or start exercising will know, changing health behaviour is hard. But it’s particularly important to target children and young people in policy and programs because unhealthy patterns/habits of behaviour starts in their period of life, is likely to continue into adulthood and have serious impact on lifelong health.
Which is why I was interested to read about a new research project from HopeLab, who developed the highly successful and innovative Re-Mission game to help young people manage their cancer. Their new project is Zamzee, which again uses the intrinsic motivation of a game, and tracking technology, to motivate young people to exercise more.
However, they also use cash payment to reward behaviour (intervention group received either no case, $5 or $20 – it’s not exactly clear how much an individual received but seems like it was reward for hitting specific targets). Their research found a 59% increase in exercise over the 6 month study period – and improvements in biological measures such as cholesterol and blood sugar. Those who received cash incentives showed the most improvements in exercise.
While $20, and even $5, might be effective motivation for children and young people, what about adults? Well, the research seems to suggest that yes, it does work. A systematic review published in 2004 analysed 47 randomised control trials and found that cash incentives are effective for motivating people to engage in preventive health behaviours, at least in the short term.
But how much? And for how long? Well, this is unclear. My initial reaction to cash incentives is to resist this idea (‘people need to take responsibility for their own behaviour!’). However given the millions of dollars spent on treating people with preventable chronic illnesses – not to mention the insidious and persistent negative influences constantly shaping our behaviour (fast-food/gambling ads, our largely sedentary work), it may actually end up being a smart investment in health.
It’s also interesting to read Hopelab are targeting GPs to prescribe this game as prevention which I think is very clever. There is certainly a real opportunity for GPs to integrate new technology into their practice – particularly tracking devices – to help provide a much richer understanding of patients. And a need to evaluate its effectiveness in this setting.