There are lots of ideas on how healthy habits transform into long-term lifestyle changes.

PhD candidate Marc Mitchell,writing in the American Journal of Preventive Medicine, suggests that receiving coupons and vouchers for as little as five dollars can help people stick to new fitness regimes. Under the guidance of Professors Jack Goodman and Guy Faulkner, Mitchell has completed a systematic review of research into the efficacy of financial incentives in inspiring lifestyle and health behavior change, specifically in people who've experienced cardiac problems. His analysis suggests that these small rewards increase the odds that patients will maintain an active lifestyle in the longer term.

Mitchell's project looked specifically at 1500 patients as they transitioned out of Toronto's Rehab's cardiac program, designed to help people with heart disease improve their strength and fitness to reduce their chances of future heart problems.

"Patients do great during the six-month program," observes Mitchell. "But a lot of them stop exercising after they leave. The idea is to offer a modest incentive to facilitate that transition to independent exercise." In the model that Mitchell is working on, patients will receive these incentives after submitting their daily exercise logs, through an online portal called "BestLifeRewarded."

During the second phase of his project, Mitchell led patient focus groups to determine which types of incentives resonate most with the cardiac rehab patients. Many liked the idea of receiving parking vouchers to supplement their costly trips to the hospital, while others preferred grocery store vouchers or a chance to donate their incentive to a charity of their choice.

Mitchell predicts that the act of submitting the entries will serve as a stepping stone to developing increased awareness and continued patient engagement.

"If they submit an empty entry, they'll still get the incentive," he explains. "Just doing that will continue to encourage them to self-monitor. We think of it as a gentle nudge; it's not supposed to be a carrot that we're dangling."

The final stage of the project – the launch of the pilot program – is set to begin later this fall.