In February, JAMA published a viewpoint article arguing that wearable devices “facilitate,” rather than “drive,” behavior change. The authors state that while measuring behaviors can help to change them, there is a gap between pure measurement and intervention. I agree with their assertions; without good feedback loops and goal-setting, measurement alone can only influence behavior so much.
Just a few weeks ago, JAMA published a response from other practitioners pushing back that active monitoring on its own might have some beneficial effects. This too is true. It’s partly because of the Hawthorne Effect.
The Hawthorne Effect was discovered in a series of early productivity studies in the 1920s at an electric factory called Hawthorne Works (hence, the name). Researchers made changes to the lighting, layout, task order, and other aspects of factory workers’ routine to determine ways to improve their productivity. They found that any change to the status quo temporarily improved productivity. Psychologists later figured out the reason why: People behave differently when they know they’re being watched.
Wearable devices, in some ways, are a modern example of the Hawthorne Effect. At least at first, until we forget we’re wearing them, they give us the impression of being watched. As a consequence, we behave “better.”
That’s why both the authors of the original JAMA piece and the commentary are right. Simply using a wearable can change behavior, but probably not for the long term. Effective sustainable behavior change takes a more thoughtful application of behavior science. Still, there is value for stakeholders such as employers, health plans, and loving spouses to know that the gift of a Fitbit might be the first step to a more active lifestyle.