Beyond fitness trackers: Motivating the unmotivated to exercise more

(light piano music) – [Mark] This session will
be given by Scott Delp, and Scott’s been leading a program about motivating mobility, and what he means by
this, he’ll explain more, but we all know exercise is good for us, but we all don’t do it
as much as we should, and so his project is trying
to deal with that conundrum. Scott. (audience applauding) – [Scott] So our goal is to
motivate physical activity on a global scale, and the team is producing
tools and knowledge that can be deployed at a
low cost on a planetary scale to improve both mental
health and physical health of millions of individuals. Like Mark said, we know that
exercise is good for us, but in the U.S. alone
approximately 260,000,000 people do not get sufficient physical activity to maintain their bodies and their minds. That’s 78% of the population according to the Center for Disease Control. Now the cost of this
inactivity is staggering. In a recent article, Min
Lee and her colleagues, reported that 5.3 million deaths per year can be attributed to physical inactivity. 5.3 million deaths per year. So you can make a calculation like that because 18 major diseases and disorders are linked to physical activity. There’s strong correlation
between physical activity and things we might consider, cardiovascular disease,
diabetes, yes that’s true, but also six types of cancer are related to physical activity as is anxiety, depression, and cognitive decline. So that’s the bad news. The good news is that physical
activity is potent medicine. One of our team members, Abby King, chaired the national
committee on physical activity that just produced this fantastic report that summarizes all of the evidence that’s been gathered
over the last 40 years, and it makes very clear the potent effect of physical activity, and what I wanted to do is just read you a single quote from this report. So here’s the quote, “A
single bout of moderate “to vigorous, physical activity
will reduce blood pressure, “improve sleep, reduce anxiety,
and improve cognition.” So you can reduce your anxiety and improve your thought clarity with a single bout of physical activity. Going for a bike ride,
playing a game of tennis, that’s awesome! That’s incredibly motivating. The other thing to know is that small doses have a big impact. This doesn’t mean that you need to be running six miles
a day, six days a week. If you get up from your
desk and you move about, there’s very clear evidence that you begin to accrue benefit. So, how are we doing? We recently conducted the
largest worldwide assessment of physical activity
that has been performed. We worked with a local mobile app company, and what we gathered was
minute-by-minute step counts for two million people
in a hundred countries. So this was the biggest
survey of physical activity by a factor of a thousand. We were able to characterize
planetary scale trends in physical activity. One of the things that we found was that there’s inequality in
activity across a population. So, just like there’s income inequality, there’s rich people and poor people, there’s physical inactivity inequality, and when their inactivity
inequality is high, women are differentially disadvantaged. So there’s more activity poor women, and if you relate that to lifespan when there are activity poor women, it costs women in terms of life years. So, again, it’s a big problem. The other thing we discovered is that if you want to intervene, the place to have the biggest impact, is where there’s activity
poor individuals. Now there’s no shortage of devices to measure your physical activity, but unfortunately, most if not all, activity interventions are
failing and they fail in part because they provide lots of information, but simply providing the information doesn’t help you move more. If you survey people about, “Well, why can’t you get more activity?” and people, no one ever responds, “Well, it’s because I don’t
know exactly precisely “how many steps I take each day.” And in fact, informing people
of these quantitative metrics, for some people, can produce
a mindset of inadequacy. There’ll frequently be nudges that might come during a meeting
or an inopportune time, and so soon you begin to ignore them. In most cases, people use
physical activity monitors over the short term and then
throw ’em in the drawer, and that’s in part because
it’s a one size fits all. We’re motivated by different things. We respond to different things, and there hasn’t been
good personalization. So, our team is developing
scientific evidence and is based on evidence to
replace information overloads with an understanding of mindsets that is how you think about the world influencing your behavior
and your physiology. To replace constant nudging with well-validated
behavior change theory. So, we know about behavior change. There’s decades of research
and almost none of that has been incorporated into
current activity monitoring. To achieve sustained
engagement by storytelling. People love stories, and engaging in a story
as you move through the story by being active is one of the approaches we’re taking, and also data-driven personalization. So, we’re bringing these
approaches together in our catalyst project, and what I wanted to do is
just give you a little bit of insight into the evidence
that we’ve developed so far in the first year of the project. So, first about mindsets. So, what are mindsets? They’re lenses through
which we see the world, and they influence your
attention, your motivation, and amazingly, your physiology. So, the placebo is a great example. You can take a sugar pill and if you think it’s
gonna get you better, in many instances, there’s
profound healing effect from taking essentially
nothing other than a placebo. This is shown across almost
all fields of medicine, the profound placebo effect. So no particular medicine has a strong physiological response. So we wanted to investigate
how getting genetic information influences your cardiovascular fitness. So, Brad Turnwald, who
was a student in Ali’s lab worked with folks in my lab
where we brought them in, we did a VO2 max test. So, we have them run on a
treadmill to exhaustion, and while they do that we measure their ventilatory gases. How much oxygen they take,
how much CO2 they put out. They came back a week later, and we done a blood draw, and we randomized them into telling them whether they had excellent
genes for exercise or not. We then ran the same test, and if we told them they were excellent, they didn’t change. If we told them they had the
gene that was not excellent, their capacity was
statistically significant and significantly reduced. So, they were working just as hard, but things changed that
you cannot control it. Your changed voluntary oxygen to CO2 and things that you have
no voluntary control over. What this demonstrates is that the way you deliver information can have a powerful effect
not just on people’s behavior, but on how their body’s respond to particular physical activity, and we’re wanna use the
information to design messaging that’s personalized that affects
mindset in a positive way. We also need to get
lasting behavior change. Getting behavior change
for a week or a month, or even three months doesn’t work, and Abby King has had good success with long-term behavior change
with implementing theory. This is not a fancy app. This is kind of an old
school, sit at a computer and have Carmen talk to you and she did an intervention, Abby did an intervention
in a community center that served low-income,
Latino, older adults, and the average session
lasted six minutes. They came back for four months, and this was the result they got. This is the change in minutes
of physical activity per week. So, there was a control group
that didn’t change from zero, and Carmen, this virtual advisor, was able to get 250 minutes of additional activity. Four hours of additional
activity per week. That is a ton of additional, this is the biggest change I’ve ever seen! If you can get four more hours of physical activity per week, you know, half an hour a day, eight days a week, that’s doing really well. So, we really think that implementing this behavior change theory
can have a big impact. James Landay is on the team and he’s working with Paula Moya from the English department on developing narratives to
promote long-term engagement. What James has been able to show is that simply state-of-the-art detection and feedback is not enough, that simple stories are compelling, and that the multi-chapter narratives where you engage people over the long-term and the story advances by you engaging in physical activity can potentially change long-term behavior. Jure Leskovec is an expert in artificial intelligence
and personalization. He developed the Friend
Finder algorithm on Facebook. This is Jure now. He must’ve developed that
algorithm when he was about 12. (audience laughing) He also does personalization for Pinterest to get you to figure out
how to click on various ads and engage over the long-term there. Here he’s applying his expertise to examine how to personalize feedback to users of health applications to engage them over long-term dynamics, and one of the things
that we care about is whether you have a social network and you know your friends
can help you exercise, but can virtual friends help you exercise. The answer is yes. What’s plotted here is
the average daily steps and you see when the experiment
starts that they go up, and they go up in both
the blue and the red. The blue is a group of
individuals who were motivated, asked a friend to join them, the friend didn’t join them, but they still improved. The red is the additional
boost that you get from a friend joining you. This is a single friend and you see that you get a boost in activity for a period of three to four months. That’s pretty good. When you add a second friend, they don’t do quite as much and
it dies off a little earlier and of course it varies
from person to person. Interestingly, if you do competitions and you add friend groups, the groups that do best are mixed gender, 50/50 men and women, and also if the groups are matched. If you get people who are all
performing at a high level, they compete with each other, or groups that are really trying
to build up, they compete, but if you have a mismatched group, it doesn’t work very well. So, these are powerful approaches that we’re applying to a range of populations, older adults, people with pre-diabetes, individuals with arthritis, and also with cardiovascular disease. So, because we can bring in people from English, Computer Science, Psychology, Bioengineering, like myself, together with people
in the medical school, we can intervene on these populations. So, our impact is to
provide fundamental insights that we can disseminate and also the app developers
out there in the world would make our information
freely available and can be incorporated into
commercial applications. Methods that are validated scientifically and really provide a new
paradigm for low-cost medicine that can be disseminated worldwide to improve physical and mental health. Thank you very much. (audience applauding)

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