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• Taking-up the Vitality Active Rewards with Apple Watch benefit, compared to the Vitality Active Rewards scheme, is associated with an average increase of tracked activity days per month of about 34 per cent, leading to an additional 4.8 days of activity per month.
• There is some variation across the three country samples, with the largest percentage increase in total activity days in South Africa (44.2 per cent), followed by the United States (30.6 per cent) and the United Kingdom (27.7 per cent).
• Looking at the different exercise intensity categories — light, standard and advanced activity — the largest relative increase for members is among the advanced activity days, suggesting that there is not only an overall increase in activity levels but also an increase in more intense exercise events.
• The Apple Watch benefit that motivates groups such as obese people to be more active. In this at-risk group the uptake of the benefit is associated with an average increase in tracked activity levels in the range of 109 per cent (SA), 160 per cent (UK) and 200 per cent (US), corresponding to an absolute increase in activity days per month of 4.5 days (SA), 5.7 days (UK) and 1.8 days (US). However, it is important to highlight that the uptake rate of the benefit is generally lower among this group.
• The positive associations between the benefit and physical activity persist over time (at least over the 24-month repayment period of the Apple Watch).

The benefits of physical activity include a lowered risk of some major non-communicable diseases and improving wellbeing and mental health. However, roughly about one third of the global adult population is not meeting the minimum weekly level of physical activity recommended by the World Health Organisation.

Discovery, a South African multi-national insurance group, offers two types of incentives to its members: Vitality Active Rewards and Vitality Active Rewards with Apple Watch. The Vitality Active Rewards scheme, a gain-framed incentive, rewards individuals for tracking and reaching different thresholds of physical activity, whereas the Vitality Active Rewards with Apple Watch benefit makes monthly repayments for an Apple Watch in amounts linked to different levels of physical activity thresholds that the individual reaches per month.

Discovery commissioned RAND Europe to conduct an independent assessment on whether the Vitality Active Rewards with Apple Watch benefit is associated with increased physical activity levels for Vitality members that take up the benefit, compared to those individuals that only participate in the Vitality Active Rewards programme. The study also examined whether these associations persist over time.

The findings of this study suggest that incentivising physical activity to tackle inactivity and a sedentary lifestyle can lead to better activity levels. When more unhealthy individuals take up an incentive of this kind, the results can lead on average to a more pronounced behaviour change than we see in already relatively more active and healthy individuals. This is important when designing health promotion programmes.

• Chapter One

  Background

• Chapter Two

  The Vitality programme and Vitality's Active Rewards incentive and Active Rewards with Apple Watch benefit

• Chapter Three

  Research approach: data and methods

• Chapter Four

  Results and discussion

• Chapter Five

  Conclusion

• Appendix A

  Summary of the literature linking financial incentives and physical activity

• Appendix B

  Associations between participating in Active Rewards and tracked physical activity levels