Not everyone can afford a personal trainer to yell in their ear and motivate them to get off the couch, but in one English city, the government wants to fill that role. The Stoke-on-Trent City Council has started texting overweight citizens to try to get them to eat healthier food and exercise to lose weight.
More than 100,000 inhabitants of Stoke-on-Trent are overweight or obese, and the council is texting a list of people who are over 18 and have a BMI of 25 or higher. Noteably, everyone on the list signed up for the program, and no one is required to receive the city's texts if they don't want to.
There are daily texts, weekly surveys, and follow-ups, plus 500 people will also have a telephone interview. The program cost a total of about $17,000, but the idea is to save on bigger medical expenses down the line by helping citizens avoid negative health effects from being overweight. The program is modeled on similar private services like "Slimming World," and the money the council spent includes a license for the U.K. National Health Service's mobile health software.
Adrian Knapper, the city council member in charge of health, well-being, and culture, told ComputerWorld U.K. that:
Our public health team are using the texting technique as just one part of a comprehensive set of public health activities. ... The costs of obesity for the local NHS in terms of increased levels of disability, disease and early death are frightening—£50 million a year. Our programme means people who already want to lose weight and have signed up with us to get support will receive a cheap and effective nudge to help them keep motivated.
The texts give advice about adding more fruits and vegetables, reducing snacking that isn't nutritious, encouraging physical activity, and gauging a person's progress. Some texts are questions that send different follow-ups based on whether a person answers "yes" or "no."
Mobile health initiatives are everywhere and are becoming increasingly popular, but it's still unclear how much they accomplish. When your city council is sending you positive reinforcement and telling you to eat more vegetables, the government is almost more nanny than state.