SINGAPORE: We all know that exercising and staying fit is important, but sometimes we need a little push to get off the couch.

Since its inception in 2015, the launch of the Health Promotion Board’s (HPB) National Steps Challenge has been met with overwhelming success. Offering health points that can be exchanged for cash-like rewards such as NTUC FairPrice vouchers, the programme has garnered a whopping 1.7 million participants - more than a quarter of Singapore’s population.

Many similar reward-based physical activity programmes have since been rolled out by both the public and private sectors, including HPB’s gamified Lumihealth app and Manulife’s ManulifeMOVE reward programme.

Yet, maintaining physical activity has proven to be a challenge for many of us.

According to National Population Health Surveys, the number of people getting enough physical activity steadily declined between 2019 to 2022. Despite the slight improvement in 2023, the total proportion of people with sufficient physical activity has not yet recovered to pre-COVID levels. The increase in work-from-home arrangements may partly explain the decline and slow recovery, as it reduces the time spent travelling to work.

Such trends are not confined to Singapore. According to a recent World Health Organization report, almost one-third (31 per cent) of adults globally, or a staggering 1.8 billion people, are “physically inactive”, meaning they do not meet the global recommendation of at least 150 minutes of moderate-intensity physical activity per week. If the current trajectory continues, this number is expected to increase to 35 per cent by 2030.

FREE SPA DAY OR PURE HARD CASH?

So, how else can we motivate people to stay active?  

That’s what a group of us researchers at Duke-NUS Medical School sought to find out.

In a four-month study, we compared 310 participants in two groups: One was offered cash rewards for meeting their monthly step goals, while the other was offered hedonic (pleasurable) rewards of the same monetary value such as spa treat...