January 18, 2017 / 8:32 PM / 7 months ago

Paying people to walk more may work until the money runs out

(Reuters Health) - Handing out prize money for exercise might get people moving, but a new study suggests the increased activity only lasts as long as the cash keeps coming.

In an experiment, researchers gave 94 older adults daily walking goals and pedometers to track their progress. They randomly sorted participants into four groups to get different types of weekly motivation for meeting the walking goals: $20 to keep for themselves, $20 to donate to a charity of their choice, $20 to keep or donate or a control group that got no cash at all.

During the 16-week experiment, people who had the chance to get cash were more than three times as likely to meet daily walking goals as the group that had no way to win money, the study found.

Over another 16 weeks of follow-up after payments ended, however, there wasn’t a meaningful difference between the groups in how often people met their walking goals.

“I think that people don't continue their changed behavior of walking more because they are not getting that immediate incentive or reinforcement from the money,” said senior study author Karen Glanz, a researcher at the University of Pennsylvania in Philadelphia.

“We've seen that, in order to maintain behavior change, people have to ‘internalize’ the reward – that could be by focusing on how walking more makes them feel better, such as having more energy or easier everyday activities, or helps them get off medication,” Glanz added by email.

Adults should get at least 150 minutes of moderate to vigorous physical activity a week, according to the U.S. Centers for Disease Control and Prevention.

All of the people in the study lived in retirement communities, and they were 80 years old on average.

At the start of the study, they walked an average of 4,556 steps a day. This amounts to a bit more than two miles at a comfortable pace for most people, and might take a total of 30 to 40 minutes to complete.

Every participant had the same daily goal – to walk 50 percent more than they did at the beginning of the experiment. This translated into a daily goal of about 6,379 steps on average, or more than three miles, extending walking time to about 45 to 60 minutes.

Both financial incentives and opportunity to donate to charity increased walking, by 2,348 steps and 2,562 steps per day, respectfully, researchers report in the American Journal of Preventive Medicine.

There wasn’t a statistically meaningful difference in the number of days people met goals based on the type of financial incentive they could get.

After the payouts went away, all of the groups that had been offered money walked less, dropping down to about the same level seen in the control group that didn’t have a chance to win money.

The study was small, making it hard to spot statistically meaningful differences among the groups, the authors note. The experiment was also too short to see how payouts might influence long-term changes in physical activity levels.

Financial incentives may work well to trigger motivation and to increase walking during the time they are handed out, said Dr. Per Ladenvall, a researcher at the University of Gothenburg in Sweden who wasn’t involved in the study. Long-term behavior change, however, may require counseling or other efforts to motivate people to stick with their exercise programs, Ladenvall said by email.

“I think financial incentives can serve a purpose of helping people increase their physical activity over a short-term,” said Lucas Carr, a physiology researcher at the University of Iowa in Iowa City who wasn’t involved in the study.

“In terms of maintaining activity long-term, I think we need to focus on designing work, school and neighborhood environments that sustainably nudge everyone to be more active,” Carr added by email.

SOURCE: bit.ly/2jLy5Tz American Journal of Preventive Medicine, online January 3, 2017.

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