In her study, Dr. Losina says subjects were divided into one of four different groups, including an attention control group, which received phone calls conveying general health messages and had conversations based on general aspects of recovery and rehabilitation.
The second intervention focused on telephonic health coaching (THC), in which staff trained in motivational interviewing techniques made periodic calls. The THC calls were intended to focus on patients’ short- and long-term physical activity goals.
“It’s important for us to advise patients on what they need to do to increase their physical activity and to offer them support,” Dr. Losina says. “Even modest increases in physical activity have been shown to markedly reduce the risk of mortality.”
Dr. Losina’s findings are supported by evidence found in Exercise Is Medicine, a global health initiative that encourages healthcare providers to assess every patient’s level of activity at every clinic visit, provide patients with brief counseling to help them meet the guidelines and refer patients to either healthcare or community-based resources for further physical activity counseling and guidance.
The third intervention was financial incentives (FI), designed to provide study participants with both smaller and larger financial rewards for completing exercise logs. Each participant was assigned an escrow account containing $105, and they received $5 for completing at least five out of seven daily exercise logs.
The fourth (and most successful) intervention combined THC and FI. Participants received $5 from their escrow account for completing at least five out of seven daily exercise logs. They were also able to view the amount of money “lost” due to missed reporting.
Dr. Losina notes that many workplace wellness programs also offer financial incentives to get employees to increase their physical activity levels. A 2016 study published in the Annals of Internal Medicine found that 80% of large employers are now using some form of financial incentive to increase their employees’ physical activity levels.2
Use a Combined Approach
Investigators used the Fitbit Zip to measure exercise activity and duration. By combining THC and FI, study investigators found both the amount and duration of exercise increased. After six months, Dr. Losina says the average daily step count ranged from 5,619 in the patients who received only THC compared to 7,152 steps in those who received THC and FI. In addition, physical activity, as measured by total minutes per day, increased by 14 minutes in the THC-only group compared to 39 minutes in the THC plus FI group.