How to motivate heart disease patients to exercise? Pay them.

A Penn study finds financial incentives and wearable devices leads to increased exercise for high-risk patients


Exercise is a proven factor in decreasing the risk of a heart attack, but convincing at-risk patients with heart disease to commit to regular exercise programs is a challenge. Researchers at Penn Medicine have published the results of a clinical trial in the Journal of the American Heart Association, which show that offering payment up front, and taking money away if exercise goals aren’t met, increases physical activity.

Researchers were aware that participation in exercise programs like cardiac rehab is extremely low, due to lack of motivation or access to classes and facilities. Neel Chokshi, medical director of the Penn Sports Cardiology and Fitness Program and assistant professor of clinical medicine in cardiology, was interested in finding creative ways to engage patients in exercise, combining wearable fitness trackers with motivational techniques. 

“In this clinical trial, we tested a scalable approach combining wearables and principles from behavioral economics to show significantly increased activity levels even after incentives were stopped,” says Chokshi.

Researchers found that while wearable devices can motivate high-risk patients, wearables alone did not increase physical activity levels. “However, framing rewards as a loss—a technique from behavioral economics—led to a meaningful difference in behavior,” says Mitesh Patel, an assistant professor of medicine and health care management, and director of the Penn Medicine Nudge Unit.

The study enrolled 105 patients. Those in the intervention group were given personalized goals and $14 at the beginning of each week for 16 weeks. For each day a goal was not met, $2 was taken away.

Read more at Penn Medicine News.