​With diabetes on the rise, the HPB got innovative to encourage people to cast off their sedentry lifestyle - and exercise. 


Just what drives Singaporeans to exercise – competition? Charity?

Nope, it’s personal reward. Even token amounts will do.

“Singaporeans generally like to have a little bit of flutter. They get this indiscernible joy from receiving $1 or $2 back from the government, perhaps as a compensation for the taxes they pay!” said Mr Zee Yoong Kang, CEO, Health Promotion Board (HPB).

In trying to put the finger on what motivates people to exercise, the HPB had surveyed some polytechnic students. The exercise involved getting them to walk a certain distance for various incentives such as $10 for themselves, $10 for charity (their school), or $10 if they beat a rival school.

“I was surprised that competing against the hated school down the road didn’t come up much better than charity. I wasn’t surprised that Singaporeans were motivated by individual rewards,” said Mr Zee.

He was speaking – albeit tongue-in-cheek – about the HPB’s experience in designing the National Steps Challenge at the recent international Ministerial Conference on Diabetes 2018. The Challenge, now in its fourth series, offers participants token rewards for reaching certain exercise milestones as a way of motivating people to be more physically active.

Rewarding people for following a healthy lifestyle through diet and exercise “gamifies” what is often a chore for most, he said. The tracker, he added, not only helps motivate wearers by telling them how well they are progressing, it also provides feedback for the HPB that allows adjustments to be made to the programme to “increase engagement”. For instance, the Corporate Challenge was introduced in season 2 to encourage people at work to motivate each other to walk more.

The tracker also allows HPB to measure the effectiveness of the programme. Corporate Challenge participants, the HPB found, walked more than the average individual participant. The tracker was also able to tell the HPB that people had started to wear the trackers even before the Challenge period started. Interestingly, as walking became a part of participants’ daily routine, people continued to wear their trackers and to walk as much or even more than they did during the Challenge period, Mr Zee said.

Singaporeans, he added, gave a variety of reasons for not exercising, including a lack of time. Yet, the HPB has found that the weekends were the periods that people moved the least. “We doubled the amount of points for the weekend to compensate for that,” Mr Zee said.

Since the Challenge was introduced in late 2015, more than a million people in Singapore have signed up on the nationwide exercise programme. Mr Zee said that even though the Challenge poses a huge logistical exercise, particularly in terms of giving out the trackers, “we have avoided the temptation to just mail out these trackers even though we know it’s a lot less work”.

Besides the concern that people wouldn’t value something received in the post and throw out the tracker, “we had to stage this exercise to mobilise the country to join in the programme”, said Mr Zee.

“If we persist in population interventions like that, we can make a significant impact in the fight against diabetes and other NCDs (non-communicable diseases),” Mr Zee said, noting that reducing inactivity is the best way for tackling NCDs, including diabetes.

The Conference brought together more than 300 international and local delegates, including health ministers, senior government officials, and academics from 18 countries around the world, the World Health Organization (WHO) and the World Bank.

Speakers at the Conference warned of an impending tsunami of people diagnosed with diabetics if nothing is made to arrest the rising trend. While such a scenario would put tremendous pressure on healthcare systems, an explosion in the number of people with diabetes would be disastrous in less developed and small countries like Tonga which had little or no resources to deal with the complications that can arise from uncontrolled diabetes.

According to the WHO, the number of people with the disease has risen to 422 million in 2014 from 108 million in 1980. In 2016 alone, 1.6 million deaths were caused directly by diabetes. Nearly two-thirds of diabetics live in Asia. About 96 million people have diabetes in Southeast Asia, of which 90 per cent have type 2 or lifestyle-related diabetes which is preventable.


Read about the conference highlights and other diabetes-related information at www.mcod2018.sg.

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