The Vitality Active Rewards with Apple Watch Benefit

Research Questions

  1. Does uptake of the smartwatch benefit among the members correspond to changes in physical activity levels relative to the non-smartwatch benefit programme alone, and are these effect sizes sustained after the benefit expires?
  2. Among those who accessed the smartwatch benefit, does the renewal of the benefit correspond to changes in physical activity levels relative to the first smartwatch benefit?
  3. Among people who selected into subsequent smartwatch benefits, does renewal of the benefit correspond to changes in physical activity levels relative to before the first benefit?

Physical activity is well known to have positive effects on multiple health outcomes, including cardiovascular risk, diabetes, cancer, mental health and all-cause mortality. Despite this, recent data shows that only between 61-66% of adults in the UK meet the government recommended amount of physical activity (150min/week moderate or 75 min/week vigorous intensity activity). Smartwatches allow users to track their physical activity and can be a helpful tool to encourage people to be more physically active.

In 2018, RAND Europe conducted an analysis of the impact of an insurance provider’s smartwatch benefit on physical activity outcomes among their members in the UK; however, given that the benefit was relatively new, there was limited follow-up on members (average of approximately six months). Therefore, we conducted a longitudinal, observational study to examine longer-term physical activity impacts of this benefit.

We included data on members who were eligible for this benefit collected from January 2016 to September 2022. We used an interrupted time-series analysis approach to examine the relationships between the smartwatch benefit status over time and physical activity outcomes. Models included statistical adjustment for gender and baseline body-mass index and smoking status, as well as calendar month and year from first recorded month of physical activity to the last. Standard errors were calculated using robust variance-covariance estimation with clustering by each member. 

Key Findings

  • Higher levels of physical activity were found among adults 35 years of age or older as compared with those 18 to 34 years of age, males as compared with females, never smokers compared with ever smokers and those with BMI in the healthy range as compared with underweight, overweight or obese.
  • The first smartwatch benefit was associated with a 40% increase in physical activity days per month, as well as a higher proportion of high-level physical activity days, relative to before the start of the smartwatch benefit or compared with never accessing the benefit. These associations appear to be sustained after the first smart benefit expires.
  • For the second and third smartwatch benefits, physical activity was still increased but to a lesser extent, 13% for the second and 11% for the third. Despite waning effects over time and a decrease in the number of physical activity days, a higher proportion of high-level physical activity days appears to be sustained with subsequent smartwatch benefits, at least while these benefits are active. For high-level physical activity days, a second smartwatch benefit was associated with a 15% increase in physical activity days and a third smartwatch benefit 27% increase, compared with the first smartwatch benefit.
  • Taken together, these results suggest that, although the magnitude of increases in physical activity tend to be lower with each subsequent benefit, the overall effects on physical activity, especially the proportion of high-level physical activity, appear to be sustained over time.

Table of Contents

  • Chapter One


  • Chapter Two

    Data and Methods

  • Chapter Three


  • Chapter Four


  • Annex A

    Member flow chart

  • Annex B

    Sensitivity analyses

Research conducted by

This research was sponsored by Vitality UK and conducted by RAND Europe.

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