Astute and observant readers might have noticed a subtle change on the site under the "Who are the sports scientists" section on the right column. Namely, my employment status has changed from the University of Illinois at Chicago to The Vitality Group. The departure was sudden, not planned in advance at all, and the process went very quickly, taking only about five weeks to finalize the details. Officially my first day in my new position---Director of Clinical Development---was Monday, 14 March, and I am happy to say I have hit the ground running and very excited about what lies ahead. It is actually an interesting story---both how the move came about and who is The Vitality Group, but we will spare you the soap opera for now and talk about the new company!
I think we can all agree that as a population, we could exercise more and make better choices regarding nutrition. In fact people who are overweight, obese, or inactive will probably even admit to knowing that they should, in fact, make changes to their lifestyle, and they might even know that they are at higher risk for many things because of their inactivity or weight. Yet the story remains---as a population, at least here in the USA, we are overweight and inactive. The mean BMI is 27 (overweight) and the general population does not exercise. At all.
And I will not need to convince you of this one, either, but more active people who have a BMI below 25 spend less on medical care each year. So promoting health and exercise becomes a win-win: the insurer pays out less in claims, and the individual benefits from lower premiums as well as better quality of life as a result of engaging in healthier and more active behaviours.
The incentive: Part of human nature?
The evolutionary psychologists or perhaps the behavioural economists in the audience can debate why we respond to incentives, but the fact is we do. I recall a story from the Freakonomics movie, in which Steven Levitt talks about using an incentive program to toilet train their daughter. It worked, although the point about his story was that people learn how to beat the program! Which is why verification and sophistication are important parts of any rewards program that will reduce the amount of cheating, and therefore Vitality invests heavily in these characteristics of the program. But many scientists spend lots of time and money trying to figure out when incentives work best, why they work, and the magnitude of their effect, and as I learn this area of the scientific literature I will be writing more about the findings, because they are really quite fascinating.
So it seems a no-brainer to provide a reward for people to exercise and eat better, but no one has really done it on any scale that Discovery and Vitality has. The crux is that the rewards and incentive system must be "meaningful" and sophisticated. That is is a difficult nut to crack, which is probably why no one has executed it to the same level as Discovery and Vitality.
Translating science to application
One of the primary reasons we started this site nearly four years ago (attention shoppers, our birthday is 28 April!) was to apply science to the every-day athlete. One of our favourite quotes around here is, "Science without application is stamp collecting," and so we strive to translate the science and apply it to everything we are passionate about. And now I find myself at the very edge of application, even on the level of taking simple validated lab tools such as step tests to predict VO2max, and attempting to implement them in a meaningful and accurate way to tens of thousands of people.
Discovery Health has always been based solidly in actuarial science, and with the growth and expansion of Vitality they have added exercise and behavioural science. The really important questions around Vitality (now written on the white board in my office!) include, "How can we continue to innovate new ways to measure and verify activity, and not just how much someone did but how hard, and also how do we reward them based on the data we can collect?" These are key pieces of the puzzle as we try to make exercising and logging (verifying) those results as easy as possible so that the barriers to getting active and remaining active are as low as possible.
The journey continues
So it is happy trails to life in academics, which is an exciting thing because this new position is ripe with possibilities to engage in outstanding science. There are numerous questions we can ask about the role and efficacy of incentives in changing (health) behaviours. The area of :behavioural economomics" is key to this, and I am consuming many papers day by people in that field that are trying to understand how incentives produce action and can drive behaviour change.
This will also be an ongoing journey, because in science there are no absolute truths. The "truth," that final conclusion, is always a moving target as we develop new methods and design more elegant scientific models to explain what we observe. We cannot reduce anything down to one point, but the models we develop try to connect the many points that exist.