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Penn Medicine researchers found that adding fun and competitive elements to workplace wellness programs help drive positive results. Credit: Kylie Cooper

Researchers at Penn Medicine found that individuals' progress in workplace wellness programs designed to nudge them toward physical activity is influenced by personal and psychological characteristics.

In the study — which was published on Oct. 14 in PLOS One — around 600 obese or overweight employees from the consulting firm Deloitte took part in a physical activity program over a six month period, tracking their step counts with wearable devices. The study found that adding fun activities and competitive elements to the program helped drive positive results.

The research expanded on a similar study in 2019, which analyzed the best ways to motivate people through a physical activity program called STEP UP. 

“A one-size-fits-all approach to nudging new behaviors within wellness programs can have limited success,” director of the Penn Medicine Nudge Unit and senior author of the study Mitesh Patel told Penn Medicine News. “We’ve shown that different forms of nudging can be effective, and in this latest study on this program, we’ve now demonstrated that matching nudges to the right behavior profiles can unlock their full potential.”

In the STEP UP program, participants were randomized into four different groups: one in which the participants only had their goals and the device and three others that had games tied to their goals. Participants in the three latter grounds were instructed to do their best to meet daily goals and achieved points if they obtained their goals or lost points if goals were not met. The gamification groups showed success in this study. 

For the new study, researchers divided individuals into different “phenotypes,” which are psychological and behavioral characteristics.

“Participants in the study had completed surveys to help us hone in on their personality type, social support, risk preferences, and other factors,” assistant professor of Medicine and medical director of Provider Engagement, Population Health, at Mount Sinai Health System in New York City Shirley Chen told Penn Medicine News. "We used a statistical method called latent class analysis that takes this information and identifies a hidden pattern that links groups of people together based on their behavioral phenotype.”

The study categorized 54% of the study population as “more extroverted and more motivated," 20% of the study population as “less active and less social,” and 25% of the study population as “less motivated and at-risk."

The differences in phenotype were related to how individuals responded to the study’s different gamification methods. Individuals in the “extroverted and motivated” group improved their daily step counts by an average of 945 steps, but reverted progress after the intervention ended. 

The study also found that individuals in the “less active and less social” group responded significantly to all forms of gamification, compared to individuals in the control group.

“They had the most to gain,” Patel told Penn Medicine News. “So it was rewarding to see that this group benefited the most and their behavior was sustained even after the interventions stopped.”

The last phenotype of “less motivated and at-risk” revealed no differences when they took part in the study. This helped reveal who the nudges work for and who they don’t work for. 

“Broadly, our findings demonstrate that behavioral interventions have different effects on different people and one size does not fit all,” Chen said. “The concept of constructing behavioral phenotypes is a promising approach to designing and targeting behavioral interventions based on meaningful individual differences.”

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