The World Health Organisation (WHO) set ambitious targets in its Global Action Plan to reduce physical inactivity by 10% by 2025 and 15% by 2030. Progress against these targets is lacking, with over a third of the UK population remaining physically inactive.

In our study, we investigated the impact of using weekly, ongoing, short-term incentives to achieve positive and persistent changes in physical activity that were verified using gym membership card swipes, wearable tracker activity or parkruns. We followed up almost 12,000 vitality members for two years prior to and two years following introduction of short-term incentives.

We found a very dramatic rise in levels of physical activity in all members, but particularly in those who were least active at the outset as shown in the figure. At follow-up compared with baseline, annual number of active days had increased by 56% overall (from 60.8 to 94.8 days) but by a surprising 554% in the least active group (from 8.5 to 47.1 days). The impact was sustained and continued to increase two years following introduction of the intervention. 

Figure. Relative change in Active Days before and after VAR Activation by Baseline Activity Level Note: VAR Phase 1: Starbucks hot drinks reward, Phase 2: cinema tickets

This study is also one of the first to monitor progress against the WHO physical activity targets using verified data. Those who were least active increased their weeks of meeting WHO physical activity recommendations by more than three-fold.

In this large real-world intervention, the use of ongoing short-term incentives led to a dramatic improvement in physical activity, particularly in those with most to gain, the least physically active. Few other examples of real-world interventions for physical activity have shown this magnitude of  sustained. 

Further work is required to identify triggers for people to participate incentives-based programmes, with a view to being able to offer similar initiatives at population level.