Association between time preference, present-bias and physical activity: implications for designing behavior change interventions

Abstract

BackgroundThe decision to initiate or maintain a healthy habit, such as physical activity involves a trade-off between a short-term cost, such as time and effort, which are commonly identified as barriers to physical activity, and a long-term health benefit. Research suggests that individual time preference may be associated with unhealthy behaviors. However, empirical evidence of this for physical activity is scant. This study investigated the relationship between time preference and physical activity, and how this might influence behavior change.MethodsEmployees (n = 176; mean age 42.2 years) who participated in a physical activity intervention were invited to take part in a behavioral economic field experiment. Two economic experiments, using multiple price lists and monetary trade-off tables involving real money choices, were conducted face-to-face with participants to measure the two components of time preference, namely present-bias and discount rate. Together with individual risk preferences, these three variables were jointly estimated by maximum likelihood. These three parameters were expressed as a linear function of the levels of physical activity while controlling for socio-demographic variables within the same maximum likelihood framework.ResultsThose who were present-biased and who had higher discount rates did significantly less physical activity than their patient and non present-biased counterparts. A 3% lower discount rate and 1.14 unit decrement in the present-bias parameter was associated with a 30 min increase of physical activity per week. This negative association was more significant for certain sub-groups, such as younger and married adults and those with higher staff grade and those who have children. Participants who dropped out of the study earlier were more present-biased.ConclusionsResults demonstrated that discount rate and present-biasedness have a significant impact on physical activity levels. Such concepts have been largely overlooked and underutilized in physical activity interventions. Promising implications include 1) utilizing individuals’ time preferences to better target interventions; 2) taking account of time preferences in the intervention design; 3) interventions attempting to correct for present-biasedness.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6305-9) contains supplementary material, which is available to authorized users.

Time preferences, diabetes self‐management behaviours and outcomes: a systematic review

“…According to theory, a higher discount rate, all else being equal, should result in less health promotion, as costs incurred now are weighted higher than the expected longterm health benefits; thus, it is likely that differences in HbA 1c predicted by time preferences are mediated by selfcare activities, with two studies finding some evidence of this [35,39] and one study suggesting that present bias is an independent driver of self-care [40]. Associations between time preferences, health behaviours and outcomes have also been found in relation to unhealthy food intake [11][12][13], obesity [22][23][24], physical inactivity [14,15] and smoking [16][17][18][19][20][21], further strengthening the findings identified in this review. In general, the literature on causal inference between time preferences and health behaviour is sparse [9,10], and only one of the included papers was able to claim causality [40].…”

“…Several models that capture time-inconsistent, presentbiased preferences have been proposed, including hyperbolic and quasi-hyperbolic models (mathematical descriptions of discounting models are provided in Appendix S1) [29]. These models have been used to explain why some individuals may, against their own current self-interest, experience barriers in changing their lifestyle and be less likely to engage in healthrelated activities with immediate costs, such as exercising [14,15], eating healthily [12,13] or abstaining from smoking [16][17][18][19][20][21].…”

“…Previous literature has found associations between higher discount rates and worse health-related behaviours and outcomes in the context of food intake [11][12][13], exercise [14,15], smoking [16][17][18][19][20][21] and obesity [22][23][24]. Although unhealthy behaviour, from the individual perspective, might be a rational choice, it is likely to impose additional costs to the healthcare sector, providing a rationale for targeted health interventions.…”

The effect of regulatory focus and time preference on the dual process of physical activity: A cross‐sectional study among nurses

“…Time preference has been examined as a factor influencing individual decision‐making in various areas of life, including health (Kang & Ikeda, 2016; Story, Vlaev, Seymour, Darzi, & Dolan, 2014). Recent studies have examined the relationship between this orientation and the adoption of physical activity (Acland & Levy, 2015; Conell‐Price & Jamison, 2015; Hsu & Vlaev, 2014; Humphreys, Ruseski, & Zhou, 2015; Hunter et al, 2018; Kosteas, 2015; Mørkbak, Gyrd‐Hansen, & Kjær, 2017; Shuval et al, 2017; Shuval, Si, Nguyen, & Leonard, 2015; Van Der Pol, Hennessy, & Manns, 2017), however, the findings of its effect on health promotion behaviours are inconclusive (Story et al, 2014). In addition, the role of this personal orientation in the dual process has not yet been explored.…”

Leveraging Family Dynamics to Increase the Effectiveness of Incentives for Physical Activity: The FIT-FAM Randomized Controlled Trial

“…Incentives, by increasing the bene ts, are expected to induce greater levels of physical activity. Moreover, this nding holds even in the presence of several common biases, such as present-bias where individuals place too much weight on the immediate costs of exercise and too little weight (from their future selves' perspective) on the potential health bene ts that may not materialize until well into the future [6][7][8].…”