Improving health behaviors decreases the risk of chronic disease and increases longevity, but the health behavior change process is incredibly difficult. A key challenge is that health behavior change is typically hard to measure quantitatively and therefore difficult to track and easy to ignore. In addition, healthy behaviors typically take months to years to deliver a return on investment and the return is not guaranteed (eating nutritious foods and avoiding unhealthy foods may help improve your heart health longer term but it may not) while the rewards of unhealthy behaviors are often definite and immediate (the cake in front of you at the moment tastes great, and the next piece is highly likely to taste great as well). This imbalance makes it difficult for individuals to mount the energy to get started and can quickly sap motivation to continue. Also, with every failed attempt at health behavior change, confidence in success typically drops. This can lead to a state of learned helplessness where individuals give up on the belief that there is any action that they can take that will make a difference.
Fitbit devices and the Fitbit app make it easy to measure health behavior change, increase the immediate reward of progress, and enhance social support, all of which contribute to success. Fitbit data shows that Fitbit users, compared to their starting point, on average increase their steps, increase their sleep, and lose weight. Including Fitbit also increases the effectiveness of other behavior change interventions such as physical activity programs, diabetes prevention programs, and disease management programs. A recent meta-analysis looked at randomized, controlled trials of health behavior change interventions that included one arm with Fitbit device and one without, and users with a Fitbit increased steps, increased moderate to vigorous physical activity, and lost weight to a greater degree than those without.
To enhance health behavior change support, Fitbit now offers a Premium + Health Coaching service in which users can receive seamless support from a human health coach in the Fitbit app. Coaches help individuals to understand their current behaviors and their motivations for change as well as their barriers to success. They work with participants to set goals that are primed for success — small, step-wise, measurable goals with very specific time expectations. Then they support individuals in sticking with their plan through the challenges that day-to-day life presents. Coaches can see participant data from the Fitbit app and can communicate through secure text messages in the app. Finally, every few weeks, coaches help participants to reflect on their progress, both their successes and their difficulties, so that they can work together to make adjustments to their shared plan. Reaching health behavior change goals requires persistence and iteration, and coaches provide the expertise, accountability, and empathy that participants need to navigate this journey.
To measure the impact of the Premium + Health Coaching service, a randomized controlled trial was recently conducted that compared outcomes for a group of participants that had a Fitbit tracker or smartwatch and a Fitbit scale and that used the standard Fitbit app to a group of participants that had a Fitbit tracker or smartwatch and a Fitbit scale but also had access to the Premium + Health Coaching service. The two groups of participants had similar age, gender, activity, and weight at the start of the study and were randomly assigned to one of the two groups to avoid any bias. Compared to the participants that used the standard Fitbit app, those that used the Premium + Health Coaching service increased their activity more (an average of 470 more steps per day than the standard group and 1.6 more active minutes per day), decreased their resting heart rate more (an average of 0.82 more beats per minute reduction), and decreased their weight more (an average of more than twice as much weight loss as the standard group).
In addition to measuring these changes, participants were also asked their perceptions about their success, their motivations to change, and their confidence that they could succeed across a variety of health behaviors and outcomes. Participants in the Premium + Health Coaching group perceived that they improved their health behaviors of activity, nutrition, stress management as well as their health outcomes of weight, body shape and size, and overall health more than those in the standard Fitbit app. (Perceptions in improvements in sleep were similar across the two groups.) These perceptions are important because, not only because they evaluate some outcomes that are difficult to measure quantitatively, but they also help to understand participant feelings and they also impact motivation and confidence, which are important factors in behavior change success in the present and the future. Participants in the Premium + Health Coaching service reported greater motivation and confidence, compared to standard app participants, across every health behavior and outcome that was addressed, which is an exciting and powerful outcome. This included activity, nutrition, sleep, and stress management as well as weight, body shape and size, and overall health.
With these results about the impact of the Premium + Health Coaching service on health behavior change and health outcomes, Fitbit users now have multiple paths to succeed in reaching their goals. They can use the standard Fitbit app with a Fitbit device, which provides a critical foundation of components that facilitate success, all while making the process fun and engaging. Or they can add on the Premium + Health Coaching service to receive additional support and accountability, which helps to boost improvements as well as motivation and confidence. All of the while, Fitbit will continue to measure the impact of its solutions so that it can continue to enhance their effectiveness.
New Study Demonstrates that Engaging in Fitbit Premium + Health Coaching Leads to Better Health Outcomes is written by John Moore, MD, PhD for healthsolutions.fitbit.com