As societies around the world become more affluent, health problems arising from malnutrition and hunger are being joined by a new problem – rising obesity rates. In the case of South Africa, a recent World Health Organization survey found that 41% of females and 21% of males are obese. The rising rates of obesity are related to increases in obesity-related disease and health care costs. This is particularly true amongst the rising population of skilled office workers, whose sedentary jobs offer little opportunity for physical activity throughout the workweek.
In September 2013, the Western Cape Government (WCG) created the “Walk4 Health” initiative – a partnership between the WCG, ideas42, the Sports Science Institute of South Africa, the Heart and Stroke Foundation for South Africa, ICAS\HealthInSite e|Care, and the University of Cape Town (UCT). The initiative had the goal of promoting a culture of health and wellness in the Western Cape.
ideas42 and UCT applied insights from the behavioral sciences to design a friendly competition between several departments of the WCG offices, called Walk4Health. The goal was to make it both more salient and more enjoyable for people to be active while at work by promoting increased physical activity for improved health and introducing a competitive aspect to daily activities. Participants wore a pedometer device that tracked their daily steps. Recognizing the power of social norms on small lifestyle choices in a group setting, we incorporated incentives for participation, timely feedback via personal pedometers, and gamification to generate sustained attention within the teams into the challenge pilot. A public leaderboard was announced and tracked weekly, enabling participants to compare their progress to that of others and motivate them to stay on track and climb higher in the rankings. Each team also had Wellness Ambassadors to their respective government departments that would serve as a model for other employees to take up healthy habits and more active daily routines.
The intervention was tested through a six-week pilot, and we gauged the effectiveness of our challenge in aiding in weight loss and physical fitness by taking opt-in participants’ pre and post biometric assessments. We found that the pilot did appear to effectively help participants lose weight, as well as lead to other improvements in standard makers of health such as BMI, cholesterol level, and blood pressure, as measured through comparison of pre- and post-challenge biometric assessments of participants. While the sample for this pilot was small, and contained no true control group, the results are suggestive of positive effects. The success of the six-week pilot program led the Department of the Premier (DOTP) within the WCG to instigate a second Walk4Health program that would run over the entire course of the year.
The South Africa Walk4Health pilot offered preliminary evidence that the application of behavioral science can be a powerful remedy to everyday social problems. In a busy modern workplace where employees have little time or cognitive bandwidth to think about their health, the impact of small tweaks that nudge them to engage in healthy behaviors without requiring a lot of attention is real and measurable. The potential for targeting the obesity epidemic and resulting diseases through workplace-based wellness is significant and should be explored further.