10K Steps + Fitbit

Ceci ConnollyNearly every morning lately, as I make my daily dart to the metro station two blocks away, I pass a familiar face. She is one of about a dozen women who toil in the local nail salon. She does not live in my neighborhood, yet I see her early most mornings hiking up our hill, long before the salon opens.

Most days I wave and smile. But one recent morning I stopped and asked what she was doing. Her English is so-so and my Vietnamese is non-existent. But she managed to proudly convey, “Ten thousand steps!”

She’s not the only one. I myself have caught the walking bug, egged on by my better half and a Fitbit. For me, the rubber wristband has been revelatory. Given how active I am, I just assumed I was getting 10,000 steps every day. Far from it. Knowing your count – and how far you are from the daily goal – is an effective nudge to get off the metro one stop early or choose a lunch spot that’s a few blocks further away.

Some of the biggest brains in our country today are struggling with how to reduce our nation’s medical tab – and make us healthier. One giant clue: in 2010, 86 percent of all health care spending was on patients with one or more chronic medical conditions such as heart disease, stroke, type 2 diabetes and obesity, which are largely preventable. In other words, if we could all commit to shedding a few pounds, move around a bit more and drink a little less, we’d slash costs and feel better in the process. It sounds so simple, but behavior change has turned out to be incredibly difficult.

My encounter on the street was a stark reminder of the value of little things, especially when it comes to improving health. It’s what Stanford behavioral economist BJ Fogg, PhD, calls Tiny Habits. Begun by Fogg in late 2011, Tiny Habits helps individuals implement practical and lasting change by working with their environment to instigate small, mindful changes. Through miniscule, health-conscious adjustments – like opting to take the stairs instead of the elevator each day – the Tiny Habits method reinforces that a little goes a long way.

And because everyone could use a good partner, community-based health plans are joining the movement.

Capital District Physicians’ Health Plan (CDPHP) in Albany, offers InMotion, a mobile app that allows users to track physical activity and nutritional intake, map training routes and share information with friends. Free for both CDPHP members and non-members and available on nearly every mobile phone, InMotion lets users sync the app with several different wearable devices, including FitBit, Connect, MyFitnessPal, Nike+ and Jawbone.

The Take a Healthy Step program created by UPMC Health Plan of Pittsburgh, lets employers reward employees for healthful practices, such as receiving a flu shot, working with a health coach or undergoing a vision or dental visit. With each healthy step, employees earn points that can be credited toward insurance deductibles or for prize drawings. Employers tweak the incentives as needed.

Based in Buffalo, Independent Health’s Max plan provides an allowance of up to $50 toward a wireless activity tracker for members and their partners. The Max plan has low out-of-pocket costs for primary care visits, urgent care services, some medications and telehealth consultations, all of which are exempt from members’ deductibles. In addition, Max consumers can earn money back by participating in Independent Health’s nutrition and fitness benefits options.

Kaiser Permanente’s Everybody Walk initiative encourages individuals to walk 30 minutes a day five days a week. In addition to an interactive website, Everybody Walk offers a mobile app that lists the health benefits of walking, provides information on walking trails and allows users to track their activity and connect with friends.

The irony of course is that there is no magic, let alone science, behind the 10,000 steps a day mantra. In fact, the 10,000 steps campaign began in the 1960s, when pedometers were marketed as “manpo-kei,” meaning “10,000 steps meter.” The idea took off, and since then studies touting the health benefits of 10,000 steps have proliferated.

But that’s not the point. This is about behavior change and how simple, catchy, achievable tiny habits can become ingrained.

Walking meetings are the tiny habit of choice for Ted Eytan, M.D., M.S., MPH, Medical Director at the Kaiser Permanente Center for Total Health. “Walking meetings are easy and can be incorporated into daily life – they’re infectious. They’re a very catchy and simple behavioral change, rather than a far-off health care goal.”

Even in our own office, one woman lost 27 pounds over 6 months armed only with a good pair of sneakers and a Fitbit. She’s organized an online community for our ACHP walkers and like Eytan is a major proponent of walking meetings.

Let me be clear, this isn’t a product endorsement. You don’t need a fancy gizmo on your wrist to walk more, although those Tory Burch bands sure are stylish. But if a device or coupon or buddy helps get us moving, maybe our health care challenges aren’t so insurmountable.

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5 replies »

  1. Biowearables vendors are mining and selling imprecise and inaccurate data about us

  2. For the last year or so, I’ve been tracking my step count using the Health app on my iPhone 6. It gives me my step count for the day as well as my average daily step count for the trailing week, trailing month and trailing year. It also tracks flights of stairs climbed. I often find that another short walk of a half mile or so will get me to my goal for the day which I wouldn’t have otherwise done if I didn’t know how many steps I’ve walked. For someone who likes data, and likes to set goals, it’s a good motivator and it’s free.

    Since I’m not athletic, exercise was never fun. While I enjoy walking, everything else is a chore – bike riding, running, aerobics, or I’m just not any good at it – golf, tennis, etc. so I have no interest in doing activities like those even though they may be fun for other people who are more athletic. The good news is that I’ve always maintained a normal weight and never smoked. The bad news is that heart disease runs in my family and I needed quintuple bypass surgery at age 53 and I had a couple of other heart procedures since then.

    At this point in life, I’m interested in longevity and maintaining the ability to perform all of the normal activities of daily living for as long as possible. I don’t need to win any athletic competitions, run any marathons, etc. and I have no interest in doing so. I can still walk at a pretty good pace for someone my age (70) and I think that’s probably good enough. That said, virtually all of my medical claims, including the drugs I take, relate to the management of heart disease and blood pressure and, from time to time, I need an expensive high tech intervention. That makes me part of the 86% of healthcare costs that Ceci referred to despite my best efforts to stay as healthy as I can.

  3. One of the panelists at this year’s Health 2.0 WinterTech brought that up.

    Tangentially, I guess we shouldn’t be concerned that biowearables vendors are mining and selling imprecise and inaccurate data about us.

  4. I’ve been thinking about this one lately.

    Not sure yet, but seems to me that the outrage over the reliability of data from Fitbit and devices of its ilk, may be missing the point. I am not yet convinced that the point of measurement should be administering one person clinical trials.

    If we get someone – as in Ceci’s example above – recording and thinking about their health and their numbers in a vaguely scientific way – that’s a good thing, no?

    In my experience, the problem is that most of us just aren’t paying attention.

    There are other devices on the market where accuracy and reliability are hugely important (see the dreaded personal drowning detection app, cancer detection apps, personal heart attack monitor kit. ) where the potential grievous harm outweighs the oversold benefits

    I’d love to hear from a lawyer on the “for entertainment purposes only” thing