NYUAD programme 'nudges' Abu Dhabi seniors to triple their exercise

A programme designed to “nudge” elderly people in Abu Dhabi to exercise more has led some residents to more than triple the time they spend being active each day.

The Forever Fit programme, developed by NYU Abu Dhabi’s Centre for Behavioural Institutional Design (C-BID), has succeeded in encouraging the least active seniors to exercise for an average of 15 minutes a day — three times as much as before.

Developed as part of a collaboration with the Department of Community Development (DCD) in Abu Dhabi, the programme involved the production of an original booklet containing ideas for simple exercises.

We found here an effect which is between 200 per cent and 400 per cent. It’s a really strong effect

Prof Nikos Nikiforakis, C-BID

The physical booklet was favoured over electronic content as research found a relatively low level of digital literacy among elderly people in Abu Dhabi.

The effectiveness of the programme was measured using randomised controlled trials and, when differences in individual characteristics were accounted for during analysis of the results, the increase in daily exercise among the least active people was even greater — more than four times as much as before the intervention.

ABU DHABI, UNITED ARAB EMIRATES, 27 SEPTEMBER 2018-Dr. Ernesto Reuben for a story about research at NYU Abu Dhabi on gender stereotypes. Leslie Pableo for The National for Daniel Bardsley’s story — Dr Ernesto Reuben helped to design the Forever Fit nudge. Leslie Pableo / The National

“These were people who were previously inactive. People who were not exercising. Before our intervention they were doing less than five minutes per day,” said Prof Nikos Nikiforakis, C-BID’s co-director and principal investigator of the Forever Fit programme.

“I was really very positively surprised. The [academic] literature suggests most nudges have a single-digit impact — between no impact and 9 per cent. We found here an effect which is between 200 per cent and 400 per cent. It’s a really strong effect.”

Nudges, the uses of which were popularised in a 2008 book, Nudge: Improving Decisions About Health, Wealth and Happiness, are less coercive ways to change behaviour than, for example, changes in taxes or subsidies.

Based on data from other countries on how exercise improves health, the additional minutes of activity among the least active group could increase life expectancy by two years and reduce mortality by 18 per cent.

“Why do I think it’s been successful? I think the reason is because we did a very careful diagnosis of the population we were interested to help,” said Prof Nikiforakis.

Prof Ernesto Reuben, co-principal investigator of C-BID, who helped to design the Forever Fit nudge, suggested the effort that went into this nudge design helped to improve the outcome.

“A lot of nudges which are out there, they’re basically designed with some kind of intuition without doing a careful pre-diagnosis of the problem,” he said.

During a diagnosis stage of the Forever Fit programme, senior adults were asked about their daily lives and habits, which allowed researchers to identify obstacles that reduced their physical activity.

“That allowed us to design a programme, tailor-made to that group, that specifically addresses the causes of physical activity,” Prof Reuben said.

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Prof Nikiforakis cautioned that the increase in exercise levels may not be sustained in the long run, but there was no sign during the four-week period when measurements were taken of activity declining.

Among elderly people who exercised more to begin with, increases in physical activity were seen, although these were smaller than among the previously inactive.

Following its success, the Forever Fit Programme is scheduled to be rolled out more widely by DCD, while C-BID is planning to carry out further projects for other public and private-sector organisations.

Also, in November, C-BID will host a conference, Behavioural Policy Design in the Mena Region, that will feature speakers including Cass Sunstein, a professor at Harvard University and co-author of Nudge.