Health Wearables, Gamification, and Healthful Activity

Abstract

Health wearables in combination with gamification enable interventions that have the potential to increase physical activity --- a key determinant of health. However, the extant literature does not provide conclusive evidence on the benefits of such gamification and how these benefits will vary across individuals and gamification features. In this paper, we investigate the effect of Fitbit leaderboards on the number of steps taken by the user. Using a unique dataset of Fitbit wearable users, some of whom participate in a leaderboard, we find that leaderboards lead to a ≈370 (3.5 percent) step increase in the users' daily physical activity. However, we find that the benefits of leaderboard are highly heterogeneous. Surprisingly, we find that those who were highly active prior to adoption are hurt by leaderboards and walk ≈630 fewer steps daily post adoption (a 5 percent relative decrease). In contrast, those who were sedentary prior to adoption benefited substantially from leaderboards and walked an additional ≈1,300 steps daily after adoption (a 15 percent relative increase). We also find that the number of other active users on the leaderboard increased benefit but that this benefit decreased with additional users. Finally, we observe that strong prior performance on the leaderboard positively impacted subsequent physical activity. Overall, our results point to generally positive, but nuanced, benefits of gamification enabled by health wearables. In a non-trivial proportion of cases, individuals opt into variants of these interventions with negative effects on their physical activity.