Financial incentives motivate sedentary adults to exercise

Lead author Marc Mitchell, University of Toronto PhD candidate and Cardiac Rehabilitation Supervisor at Toronto Rehab, worked under the leadership of University of Toronto exercise psychologist Guy Faulkner and exercise physiologist Jack Goodman to publish these findings in the September online publication of the American Journal of Preventive Medicine.

The review study looked at 1,500 patients.

“The time commitment and discomfort of exercise prevents many adults from starting regular exercise,” said Mitchell. “For those who do start, most drop out within six months.”

Financial incentive-based public health strategies have gained popularity in North America in recent years, with smoking and weight loss being the more popular targets.

“People's actions tend to serve their immediate self-interest at the expense of long-term wellbeing,” said Mitchell. “This is often the case for exercise, where the costs are experienced in the present and the benefits are delayed. Because of this, many adults postpone exercise.”

This study was mainly done at Toronto Rehab's Cardiovascular Prevention and Rehabilitation Program to help understand the conditions which might increase cardiac rehab adherence for patients who have had a cardiovascular event or are at risk of cardiovascular disease.

“Our research shows that people who participate in cardiac rehab programs after experiencing a major heart event cut their risk of dying from another cardiac event by as a much as 50 per cent,” said Dr. Paul Oh, Medical Director, Cardiovascular Prevention and Rehabilitation Program, Toronto Rehab. “One of our concerns is there are people who need cardiac rehab, but are not receiving it or sticking with the program over the long term. The financial-incentives model gives us an additional strategy to help more people fully engage with the life-saving care we provide.”

Toronto Rehab will be conducting a financial incentive-based pilot study in the Cardiovascular Prevention and Rehabilitation Program in fall 2013 targeting patients who did not complete the program for various reasons as well as recent graduates.

“We want people to continue their exercise regimen after graduating from cardiac rehab,” said Mitchell. “Our research suggests that providing incentives in the short-term increases the amount of exercise people do – there is also potential to drive long-term change, but that will need to be studied further. The sustained behaviour change we are seeking could save our health system millions by preventing repeat heart events.”

This research study was funded by CIHR and the Ontario Centres of Excellence. The financial incentives for Toronto Rehab's pilot program have been donated by Cookson James Loyalty.

About Toronto Rehabilitation Institute

One of North America's leading rehabilitation sciences centres, Toronto Rehabilitation Institute is revolutionizing rehabilitation by helping people overcome the challenges of disabling injury, illness or age related health conditions to live active, healthier, more independent lives. It integrates innovative patient care, groundbreaking research and diverse education to build healthier communities and advance the role of rehabilitation in the health system. Toronto Rehab, along with Toronto Western, Toronto General and Princess Margaret Hospitals, is a member of the University Health Network and is affiliated with the University of Toronto. http://www.uhn.ca

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