My eyes glistened with excitement when I read last line:
“If you complete both the biometric screening and the online Health Assessment by the campaign deadlines, you’ll receive a $100 cash incentive award.”
Yes, bolded just like that. As if the writer imagined I might miss those magic words – incentive award. It almost seemed too good to be true. According to my employer, all I needed was 20 minutes to get my blood pressure, blood sugar, and cholesterol levels tested and BOOM! I’ld get paid for it. As you can imagine, I was all over this like white on rice. I scheduled the screening and began daydreaming of the true happiness that $100 might bring. Perhaps, I’ld go shopping or better yet, buy groceries. Regardless of how I decided to use the money, I knew it would be valuable. The day finally arrived. I went during my lunch break to get my biometric screening. There was a short wait, but I was seen very quickly and it was all over. A few months later, I completed the required online assessment and became $100 richer. This was April 2014.
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Two months ago, I received the same email, and as you can imagine, I was like, Yes, bring on the money! Today, I was reminded of this experience because of a few things:
1. A class I started today at the Wharton School. I decided to entertain my curiosity and sign up for a health care management course called “Clinical Issues in Health Care Management- Doctors, Patients, and Managers in Modern Society.” To be honest, I am VERY excited about the course. One of the articles we had to read for today was: “Incentivize Your Way to Good Health in 2011.” My heart did a flip!
2. An online-first piece was published last week in JAMA: “Wearable Devices as Facilitators, Not Drivers, of Health Behavior Change.” I received a new release about the paper this morning and was reminded of the saga with my bootleg pedometer aka my iPhone.
3. An article published yesterday on KevinMD: “What a medical student learned from using a fitness band.” I read this and couldn’t help shaking my head, preach on sir!
From my perspective, it seems a no brainer. Sure, I’ll get healthy if you pay me! It might be an inconvenience as my professor pointed out, but I believe the money is worth the inconvenience in time and effort. For me, it was a $100! That was the main focus. I’ll say it again, that was the main focus.
And therein lies the problem.
It would be nice to know what my cholesterol levels were but to be frank, I didn’t care about my health numbers. I knew I was moderately healthy and even if some numbers ended up being at risk, it couldn’t be THAT bad. I simply cared about the money.
Early last year, I received another email. If I enrolled in a study with a few other individuals and formed a team, we would get paid to (1) enroll in the study, (2) stay in the study for a certain period of time, and (3) if we reached a certain number of steps a day, individually and as a team, we could win more money via lottery. And yet again, I was like FREE MONEYYYY! I rounded up my coworkers and we enrolled in the study. I thought it would be easy, but boy was I wrong. Using a device – an iPhone or android phone, meant each of us had to have one or the other. It also meant we had to REMEMBER to have it on our body each and every moment to accurately count our steps. Lastly, it meant the app had to be on at AT ALL times. This was a problem. We’re talking battery drain. Major battery drain.
My team and I didn’t last long. Once we got our money, we checked out.
Therein lines a key problem with behavioral economics. Staying motivated. I like the idea of it. Although, I completely understand the opposing views. Ordinarily an individual should care about their health without the promise of financial incentives, but alas, as we can see from our country’s state of health, a significant part of the population do not. When I counted my steps, I was motivated. At one point, I even forgot about the money. I just wanted to meet my goal each day – 7,000 steps. This was however short-lived; the combination of battery drain, making sure my team stayed motivated, and having to carry my phone everywhere I went, slowly decreased my interest. Once I received the money for staying in the program for a period of time, I checked out. Changing health behaviors is hard. I’ll admit, I’m speaking as a healthy, and physically active individual, but from my interactions with others, it IS hard.
Incentives can be a great catalyst towards that healthy change. However, from my experience, it cannot sustain a behavioral change. What can keep that momentum going are “nudges.” Constant reminders and feedback that “hey, you’re on target to reach your goal.” It helps if you’re on a “team” or have a few other friends with similar health goals and it definitely helps if your wearable device isn’t bulky and doesn’t need a lot of battery life.
So yes, I’ll get healthy if you pay me, but I’ll stay healthy if I have the right tools.