Ep. 042 - Incentivizing Healthier Behaviours with Dr. Marc Mitchell
Nov 13, 2023SHOW NOTES
I have 'THE' Dr. Marc Mitchell on the podcast this week and he offers up some absolute gems. He's not just a kinesiology professor at Western University and a former professional athlete, he's also a wizard in the field of health behaviour change.
In this episode, Dr. Mitchell brings us face-to-face with the potency of financial incentives in shaping health behaviours and helps me understand the present self bias.
Through his research on cardiac rehab patients, Marc unearthed the impact of instantaneous rewards in overcoming our 'present bias' and how thinking long term, though important, doesn't serve us in making healthier decisions.
I'm so grateful to Dr. Mitchell in graciously offering his time and expertise.
TRANSCRIPT
Craig Spear:
Hello and welcome to man in the Arena. I'm so excited to be joined by a special guest and good friend of mine, dr Mark Mitchell, who is a kinesiology professor at Western University, where he studies and teaches all things related to health, incentives, public health and behavioral economics. On top of that, mark is also a former professional athlete who played for the Calgary Stan Peters and the Canadian Football League. Mark offers up so many keen insights and takeaways in today's episode and I'm so grateful to him for generously giving his time, not only once, but twice due to a technical difficulty also known as me, so I'm so excited to introduce you to Dr Mark Mitchell. Welcome to man in the Arena, your go-to podcast for all things related to health and weight loss for men over 40. Here we discuss strategies that will get you off the sidelines and into the game so you can achieve your optimal health. It's time to lead a legacy of longevity. Mark, I'm just so excited to have you again. I want the listeners to know the audience members to know that we actually recorded this two weeks ago and I completely botched it and hit the close button on Zoom too fast, so none of this recorded. But anyways, it's a good lesson that, yeah, we can do things the second time, do it better, and I just am grateful for you coming back so welcome, thank you.
Dr. Marc Mitchell:
I'm so excited to hear it.
Craig Spear:
So tell the listeners a little bit about how you got involved in behavioral studies, incentives, behavioral economics. Last time we spoke you mentioned your experience at U of T, but maybe you could dive into that again.
Dr. Marc Mitchell:
Yeah. So I started my PhD at the University of Toronto trying to figure out what the heck am I going to study? And then one thing led to another and stumbled across this interesting behavior change technique we referred to as financial health incentives. So can we pay people to do healthy things? And develop that idea a little bit? And then ended up testing the idea in a cardiac rehab context. So we paid people about a dollar a day to exercise after they completed the six-month cardiac rehab program, because we found adherence dropped off after those cardiac patients graduated from cardiac rehab. So that's kind of how it got started about 10, 12 years ago.
Craig Spear:
Right. So you started researching the impact of financial incentives, and so you found that that actually increased adherence from an exercise perspective.
Dr. Marc Mitchell:
Yeah. So we did some preliminary work with the cardiac rehab folks and then we ended up going really big because the idea got popular after this book called Nudge was published about behavioral economics and that was sort of like the theoretical foundation for the idea. We ended up partnering with the Public Health Agency of Canada on a project to deliver financial health incentives to Canadians across the country. We started in British Columbia and then we got going in Newfoundland and then we started in Ontario about a year after that. So we ended up paying Canadians in-scene points and other kinds of loyalty points to engage in healthy behaviors, primarily walking, but also other educational sort of things as well. We did some sun safety stuff, we did vaccination stuff, we did what else Heart and stroke risk stuff so that's where we ended up.
Craig Spear:
When I remember you saying the last time we spoke here, you are working with cardiac patients who have had like near-death experiences, some of them even kind of flatlined, and they see the inherent benefit and value of participating in an exercise program, and yet some of them just don't do it. And this is something that I've always been curious about is we know the value of exercise and eating healthy and sleeping well. The research is out there, the studies are out there, and yet we struggle to do it. We need a financial incentive to do it, and so I'm just curious, like what is your perspective on that help the listeners kind of identify, like you know, cause a lot of my guys. They'll beat themselves up, they know better but they don't do better. So what were you kind of found?
Dr. Marc Mitchell:
Yeah, well, I mean, it just speaks to how hard behavior changes, you know, and health behavior changes, especially in this day and age when we've engineered, for example, physical activity out of our lives. So, in a nutshell, you know, like the whole rewards piece, it doesn't work for everybody. It's not like the cure, all for sure. For some people it appears to work and it appears to work for those who tend to be the most at risk, so those who have the most trouble engaging in an act of lifestyle or eating fruits and veggies or quitting smoking. And one of the reasons is cause of this present bias thing that behavioral economics that I mentioned talks about. It's like we prefer to favor our present selves at the expense of our future selves. So today I would rather not take the time out of a busy schedule and not go through the uncomfortable feelings of a workout, because that benefits my present self at the expense of my future self. You know, weight loss, better health, better relationships, more productivity, all the things that we'd get with health through life. So that's one of the reasons. So the incentive provided immediately, even if really, really small, we gave people five scene points, so like five movie points, which is worth about a nickel like five cents. That seemed to stimulate physical activity, at least for some people, because it helped to tip that decisional balance to the present. So more benefit today.
Craig Spear:
No, and that's really well explained, like our present self bias makes sense, and even if you look at kind of like our neural anatomy and how we kind of have this conflict between our, you know, neocortex and our more primitive sort of limbic system, right, Now you're using fancy words that I don't understand. Yeah, I think so, but I think it's fascinating just the relationship between that as human beings and as our human experience that we have, so that this like old computer, we're fighting the new computer, so to speak, and so I can't remember exactly what you said last time, but I really it stuck with me in that like I wanted to talk about it again. How, in your opinion, can you help people move from this present self bias more to sort of a future self bias so they engage in healthier activities now and delay maybe that gratification?
Dr. Marc Mitchell:
Yeah, well, I mean, as you know better than almost anybody, it's really good to set Realistic medium-long-term goals, right, like you have to have a vision of what is wrong, wrong. But to make that happen, you have to Really zero in on those short term today type goals and benefits you know so. Like, though, in the public health space it's always been like Exercise five times a day cut your risk of cancer by 30% in 25 years, right, but the message that I teach my kinesiology students at Western is like there are, there are so many Present. You know benefits, especially in this day and age of increasing mood and anxiety disorders. Like, yeah, if you go from a sitting position to a standing position, the research suggests that you're Mood will improve. That's not Exercise, that's just going from sitting to standing right and so. So there's a lot of mood benefits. And then you'll sleep better, like tonight, if you exercise today. You'll be nicer and kinder to your, to your spouse or partner, kids and co-workers. You'll be more productive today if you exercise in the morning. So there's so many short-term benefits that we don't necessarily Appreciate. And then, when we start talking about chronic conditions like, I can't remember what the recent depression statistics are, but exercises medicine for mild and moderate depression, and that's like a now thing and it's so common, you know so. And all that being said, lots of, lots of shorter term benefits that we tend to under Emphasize, not to mention pain Right like if you've got a little pioser arthritis or if you've got lower back pain. Motion is lotion for those joints and that's. That's not 25 years down the road, that's today that you're gonna reap those benefits. So that's kind of my answer there.
Craig Spear:
No, I love that. Just focusing on on, not so like I get, maybe that's. Is this a reflection of the messaging behind advocacy for healthy living that we tend to focus too much on promoting, like the long term benefits?
Dr. Marc Mitchell:
I think so.
Craig Spear:
Yeah.
Dr. Marc Mitchell:
I think we focus too much on like doing, like the guideline, right. So it's like I don't know how much you've talked about guidelines on the podcast, but it's like the activity guideline is 150 minutes and it's like if you don't do that, then you know you've failed. But that's not the case at all. If you do like, if you're doing zero minutes a week right now and you start doing five minutes a week right now, the health and wellness benefits are huge and the curve is the steepest. Let me go from here to 60, right, as opposed to like those far off, like really hard to achieve the guideline levels you know. So that that would be the other part of it. It's like don't be discouraged. Don't be discouraged because you're not training for a triathlon, like the person next door, or you're not meeting the guidelines that that the government told you, that you saw on instagram or whatever. Right, a little bit more than what you're doing now Will reap tons of benefits, whether it's activity or from veggie and take water. Stress reduction.
Craig Spear:
No, I like that I've never speaking to. One of my clients is a cardiologist and he said that, like the, the curve is steepest in the initially right. Like the benefit of what you do on a small Scale is so much more powerful than the end of the curve where you're meeting the guidelines, the benefit. You know what I mean. So, yeah, I can't discount the importance of sort of these small, daily, incremental changes in our behavior and I think that's a message I want the people listening to this Podcast to hear is like, don't discount that in five minutes, ten minutes, whatever it is, it does add up. Like James clear tommy cabinets, right, compound effects of our behavior over time is what we want to measure, not these big swings in.
Dr. Marc Mitchell:
Yeah, yeah, because those, those aren't, those aren't sustainable and the research, right where I live, right, right.
Craig Spear:
Well, those you know. I'm glad we came back and we're able to do this, because those were the main points that I really wanted to cover. But is there any bit of advice or wisdom that you want to share with the audience?
Dr. Marc Mitchell:
outside of that, I'll say this, I'll say the same thing I ended, the last one with which is walking is the superhero of exercises, in my opinion, as a kinesiology professor. Not to discount the importance of all these other health behaviors, like smoking cessation and Mediterranean diet and stuff like that, but if you do anything to improve your health and I'm talking to all of your listeners Um, just walk a little bit more. It doesn't have to be a huge huff and puff, but try to take as many steps as you can and start with 500 steps a day that's roughly equal to about five minutes and just try to build from there. You know like you are gonna roll an ankle, you are gonna have relationship issues and get fired and houses and that'll interrupt your, your plans. But that's just part of the journey, right? So you just you do the best you can during those tough times and then you come back and hopefully try to Um, you know, get back to where you started and then and beyond.
Craig Spear:
So that's awesome. No, I really great advice and thanks for sharing that work. That's it man, that's that, you covered it, and I know it's short and sweet, but, um, yeah, it's great to have you on and thank you. If you're ready to step inside the arena and change the trajectory of your health, head on over to the spear method calm and download my free guide to learn simple and effective strategies on how to optimize your health today.
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