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Behaviour change study on physical activity

How technology-based incentives drive healthier lives

This study outlines findings of the largest behavioural change study on physical activity - based on verified data.

Conducted by RAND Europe, a not-for-profit global research institute, this study is the largest yet to measure the effectiveness of financial rewards coupled with wearable technology to make people more active over time.

"Our study suggests that incentivising physical activity can lead to better activity levels and the Vitality Active Rewards with Apple Watch benefit bears that finding out. Given RAND Europe’s fact-driven, evidenced-based research and analysis, we are pleased that our work has helped to deepen understanding of what works in designing health-promotion programmes.”

Hans Pung, President, RAND Europe

Study statistics

  • Total participants


  • Study period

    3 years

  • Countries covered


  • Tracked activities

    man running on a treadmill

    Steps, heart rate, calories and gym visits

The physical activity study in a nutshell

Research focused on Vitality Active Rewards with Apple Watch and how it works to make people more active.

Vitality Active Rewards is grounded in the principles of behavioural economics – goal setting, loss aversion and immediate rewards.

Linked to the sophisticated technology capabilities of Apple Watch, it personalises physical activity goals and rewards activity recorded with Apple Watch.

There are more than five million people using Vitality Active Rewards globally.

The Antidote to Inactivity

How Vitality Active Rewards work with Apple Watch

  • Get Apple Watch

    Apple watch icon

    Members could get Apple Watch with Vitality for an upfront fee and then pay nothing more if they stay active and track their activity to earn Vitality points.

  • Get Active

    Heart beat icon

    Members need to track activity and heart rate workouts to earn 160 Vitality activity points per month to reduce Apple Watch payments to nothing.

  • Be Rewarded

    Rewards icon

    Members are then also rewarded with handcrafted drinks and cinema tickets at ODEON or Vue.

Vitality has responded to global trends

By combining technology, behavioural science, and Vitality Shared-Value, Vitality Active Rewards with Apple Watch is easy to use and offers the opportunity to drive good health behaviour for more desirable outcomes in health systems:

Has mass appeal

People who are active or inactive, have high health risks or chronic health conditions, engage.

A foundation in behavioural economics

Micro goals, loss aversion and rewards as motivation help to change and maintain positive behaviour.

Funded through shared value

Profits generated from improved health and activity, lowers risks and are shared with members. Society benefits from healthier populations.

Why this study is important

More than one in four adults globally are physically inactive

That’s 28% of the global population, or 1.4 billion people!

Moving is important - for better health and longer life expectancy. The World Health Organization Global Action plan on physical activity stresses the societal impact of physical inactivity.

The action plan suggests creating environments that promote physical activity to reduce various health risks and the rise of NCDs (non-communicable diseases).

Results of the study

People with Vitality Active Rewards – through goal structure and loss aversion with Apple Watch – become more active and stayed active over time.

They were 34% more active, which is the equivalent of an extra 4.8 days' physical activity per month.

They were also 34% more active than members engaging with Vitality Active Rewards alone.

Read the full results from RAND Europe here.

The study method: a quasi-experimental approach.

This allowed researchers to compare data for those who used the Apple Watch incentive with those Vitality members who did not. The study looked at potential differences between the two groups. These differences included, for example, underlying health and the tendency to engage in physical activity.

Why this study method is more robust

This study method addresses the most common shortfalls of existing studies on physical activity. These shortfalls include anti-selection, small study populations, short analysis periods and the “tracker effect” – where more accurate tracking is confused with actual behaviour change.

This study, conducted by RAND Europe, addresses all these common pitfalls by assessing the impact of a loss-framed monthly incentive – Vitality Active Rewards with Apple Watch.

Measuring the effect of Apple Watch

The Vitality Active Rewards with Apple Watch benefit was introduced in 2015. The eligibility criteria for Apple Watch varies between countries. About 20% of the population in the study were eligible for the Apple Watch. A total of 11% chose to use the Apple Watch incentive.

The study method allowed for the measurement of the effect of the addition of Apple Watch incentive and determined the minimum behaviour change expected from Vitality Active Rewards with Apple Watch.

The study compared the difference between two populations in each market:

  1. People who received a gain-framed incentive: Vitality Active Rewards.
  2. People who received an additional loss-framed incentive: Apple Watch.

The study applied a fixed-effects Poisson regression (a generalised linear form of regression analysis), adjusted for the diverse characteristics and context of the study population. Factors the study considered:

  1. Differences between populations: demographics, starting fitness levels and health status.
  2. Differences between the types of physical activity and the intensity.
  3. A 24-month period to measure the sustained behaviour change and behaviour change for six months after treatment.
  4. Seasonality: variations that occur commonly in physical activity.
  5. Minimising the “tracker effect” looking at individuals who had a device before introducing the Vitality Active Rewards with Apple Watch benefit.