Abstract
Across the globe, sedentary lifestyles and convenience foods are creating an increasing epidemic of obesity. For example, the US National Health and Examination Survey (NHANES) documented significant increases in the prevalence of obesity from 1999–2000 to 2015–2016 in both adults and youth. Obesity increases risk not only for cardiovascular disease, but also for many types of cancer. A promising approach to address this challenge is using digital financial incentives to promote healthier lifestyles. For example, researchers found that clients given money for losing weight were significantly more successful than counterparts in traditional programs. Similarly, using a mobile app, the Fitness Bank encourages regular exercise by rewarding savers with higher interest rate based on their average daily number of steps. Here we propose a design concept aligned with a digital architecture framework for the Americas, where smartphone penetration is increasing. Tech organizations will develop apps that link patients’ digital health indicators (e.g., steps, weight, and adherence) with their electronic health records, doctors and health and life insurers. The apps and doctors can offer advice and encouragement. Artificial intelligence can identify and engage future participants. Under this model, insurers will share some savings with the doctors, their staff, and clients in a virtuous circle, using an adaptive digital architecture. The evaluation will assess impact and cost, refine the model, and build on best practices.