Physical activity behaviour change driven from engagement with an incentive-based app : evaluating the impact of Sweatcoin

Background Now the fourth leading cause of death, physical inactivity is a primary element of non-communicable diseases. Despite a great number of attempts, there is still a lack of effective approaches that can motivate sedentary populations to increase their levels of physical activity over a sustained period. Financial and non-financial incentives for exercise can provide an immediate reward for increasing activity levels, but due to limited funding to provide rewards, previous programmes using this approach have only shown short-term changes in behaviour. Sweatcoin, a UK-based technology company, has developed a digital platform that tracks and verifies physical movement to convert it into virtual currency. The currency can subsequently be exchanged for goods and services on their marketplace, providing a continuous incentive to be active. This study investigates the physical activity behaviour change observed in Sweatcoin users over a 6-month period of app usage. Objective To investigate the change in physical activity (measured using daily step-count) of Sweatcoin users following registration with the app, the longevity of the change and whether this change can be predicted through and driven by demographic and other lifestyle variables. Methods Activity data from a sample of 5,406 Sweatcoin users was used to analyse daily step count. Activity change was measured in terms of the percentage change in average daily step count for each month after registration, relative to that in the 3 months prior to the app being used. A subset of over 800 users completed a questionnaire capturing demographic and activity information. Change in activity behaviour following app download was calculated and users were grouped according to having no/negative, moderate or high activity change. Differences between groups in terms of activity and demographic status were investigated using regression analyses. Seasonal effects were also investigated and accounted for. Results Analyses show an overall average increase in daily step count of 19.5% over the 6-months following registration, in comparison to 3-months prior to registration (P<.001). Of the questionnaire respondents, 678 were valid responses. Of those, 34% were identified to have shown high levels of behaviour change following app registration. The logistic regression identified the key drivers of high activity behaviour change. There was an obvious impact of seasonality, with those registering the app in winter (OR, 6.89, p<.001) or spring (OR, 5.87, p=.002) were more likely to show high activity behaviour change than those registering in summer. More striking were the results identifying those classified as overweight (measured through body mass index (BMI); OR, 2.22, p=.014) and less active (based on self-report scale of physical activity; OR, 0.85, p=.037), being most likely to show high levels of physical activity change following registration with app. Conclusions The results highlight that an incentives-based app can induce significant sustainable physical activity behaviour change. Importantly, the results suggest that those typically lacking motivation to exercise (sedentary and high BMI) are most likely to be incentivised to increase their activity levels