“Sooner or later, we sell out for money”
— Tony Randall
Definition
Incentivized wellness, or promoting health with rewards, is a technique that is used to motivate people to make healthier lifestyle choices and improve their behaviour by offering emotional or financial rewards. It is a type of prevention that attempts to prevent people from becoming ill. For example, through a healthier diet, more physical activity or giving up smoking.
Applications & benefits
Rewarding people really works, as described by Victor Vroom in 1964 in his expectancy theory, which was redefined by Porter and Lawler in 1968 [1]. His theory drew a connection between motivation, performance and reward. Reward strategies are often used in other sectors, such as the mobile applications industry [2]. Users receive a reward for behaviour such as downloading another app, watching a video or frequently using the app. The rewards often consist of virtual currency, game items, an upgrade or discount for a particular product or service. As a healthy lifestyle is associated with better health [3], the benefits of incentivized wellness should be clear. In addition to a healthier lifestyle, the person receives a reward (emotional or financial). Ultimately, incentivized wellness scan result in lower healthcare costs..
Driving forces
Developments in incentivized wellness are taking place at various levels. Health insurers reward clients by charging lower premiums if they live a healthy lifestyle [4-6]. In the interest of business continuity, ‘healthy employees’ are becoming more important to employers. They set up health programmes that reward employees for having a healthy lifestyle [8]. In the United States, employers are encouraged to make progress in this area via the Affordable Care Act (ACA) [8]. One way in which they do this is by investing in wearables and apps to track employees. When there are (financial) rewards for healthy living, the participation in health programmes increases by 60% [9]. These investments lead to a healthier workforce, which in turn results in fewer visits to the doctor and lower medical costs due to illness [9].
The rise of mobile health applications that inform, educate and motivate users also drives the growing impact of incentivized wellness [10]. More and more people have a smartphone and there is a growing awareness of the importance of a healthy lifestyle. Due to improved and renewed designs more and more people apply this to their daily lives.
Growing investments in healthcare technology
Increased awareness and growing acceptance
New technological capabilities
Hindering forces
Lack of awareness and reluctance among potential users
Limiting guidelines, legislation and regulations
Ethical considerations
Although many people are aware that they need to change their lifestyle, research shows that there are several barriers that prevent lasting lifestyle changes. These are both aversion of ‘have-to’s’ and dreading the necessary changes [11]. Incentivized wellness scan break down such barriers. However, the question is whether it is better to reward a healthy lifestyle or to punish unhealthy behaviour? An example of a ‘punishment’ could be withholding a reward or using a financial incentive, as some American employers do [8,12]. Research shows that when it comes to behavioural change, people tend to be more responsive to negative incentives than to positive ones, which makes punishment a more effective way to promote a healthy lifestyle. There are still many questions to be answered about the effectiveness of Incentivized wellness [8]. Much of this is due to the design of the interventions and experiments with this instrument. It is important that both the reward and the activity that contribute to behavioural change suit the user [8,10]. On which behaviour lies the focus? Which reward or punishment is used? And when is this reward earned or punishment given?
Conclusion
Healthcare is going through a transformation from ‘disease and healthcare‘ to ‘health and behaviour’. Incentivized wellness applications ft in this shift and are expected to accelerate and make positive contributions to this transformation.
References
- Fred C. Lunenburg. Expectancy Theory of Motivation: Motivating by Altering Expectations. International Journal of Management, business and administration. 2011;15:1
- What’s Better? Incentivized Or Non-Incentivized App-Install Campaigns | TechCrunch [Internet]. [cited 2016 Aug 24]. Available from: https://techcrunch.com/2015/09/10/whats-better-incentivized-or-non-incentivized-app-install-campaigns/
- WHO Regional office for Europe. Behaviour change strategies of health systems: the role of health systems. 2008
- Raad voor Volksgezondheid: “Stel beloning in voor gezonde levensstijl” | De Volkskrant [Internet]. [cited 2016 Aug 24]. Available from: https://www.volkskrant.nl/nieuws-achtergrond/raad-voor-volksgezondheid-stel-beloning-in-voor-gezonde-levensstijl~baa74c33/
- Menzis beloont gezonde leefstijl | Gezond | AD.nl [Internet]. [cited 2016 Aug 24]. Available from: https://www.ad.nl/gezond/menzis-beloont-gezonde-leefstijl~aacf9049/
- Aon Nederland | Risico-, pensioen- en gezondheidsoplossingen [Internet]. [cited 2016 Aug 24]. Available from: https://www.aon.com/netherlands/default.jsp
- Elenko E., et al. Defining digital medicine. Nature biotechnology. 2015l 33:5
- Meredith SE., et al. The ABCs of incentive-based treatment in health care: a behavior analytic framework to inform research and practice. Psychol Res Behav Manag. 2014; 7:103-114
- Marketwatch. You may be forced to wear a health tracker at work. 2015
- Mathews J., et al. Persuasive technology in mobile applications promoting \ physical activity: a systematic review. Journal of medical systems. 2016; 40:72
- Fitbit. Fitbit healthy futures report. 2013
- Patel, MS., et al. Framing financial incentives to increase physical activity among overweight and obese adults: a randomized controlled trial. Ann intern med. 2016;164(1);385-394