Health Wearables, Gamification, and Healthful Activity

Management Science (

19 Pages Posted: 20 Oct 2023

See all articles by Muhammad Zia Hydari

Muhammad Zia Hydari

University of Pittsburgh, Katz Graduate School of Business

Idris Adjerid

Pamplin College of Business

Aaron Striegel

University of Notre Dame

Date Written: December 19, 2022


Health wearables in combination with gamification enable interventions that have the potential to increase physical activity—a key determinant of health. However, the extant literature does not provide conclusive evidence on the benefits of gamification, and there are persistent concerns that competition-based gamification approaches will only benefit those who are highly active at the expense of those who are sedentary. We investigate the effect of Fitbit leaderboards on the number of steps taken by the user. Using a unique data set of Fitbit wearable users, some of whom participate in a leaderboard, we find that leaderboards lead to a 370 (3.5%) step increase in the users’ daily physical activity. However, we find that the benefits of leaderboards are highly heterogeneous. Surprisingly, we find that those who were highly active prior to adoption are hurt by leaderboards and walk 630 fewer steps daily after adoption (a 5% relative decrease). In contrast, those who were sedentary prior to adoption benefited substantially from leaderboards and walked an additional 1,300 steps daily after adoption (a 15% relative increase). We find that these effects emerge because sedentary individuals benefit even when leaderboards are small and when they do not rank first on them. In contrast, highly active individuals are harmed by smaller leaderboards and only see benefit when they rank highly on large leaderboards. We posit that this unexpected divergence in effects could be due to the underappreciated potential of noncompetition dynamics (e.g., changes in expectations for exercise) to benefit sedentary users, but harm more active ones.

Note: Funding: This work was supported by the National Institutes of Health [Grant 5R01HL117757].

COI: None to declare.

Ethics/ consent: The data was collected for a multi-year longitudinal study of social networks and health funded by the National Health, Lung and Blood Institute of the National Institutes of Health (5R01HL117757-04). We complied with all NHLBI and NIH requirements, including informed consent and IRB approvals. The details are at:

Keywords: health wearables, gamification, health, fitness, physical activity, activity trackers, health technology

Suggested Citation

Hydari, Muhammad Zia and Adjerid, Idris and Striegel, Aaron, Health Wearables, Gamification, and Healthful Activity (December 19, 2022). Management Science (, Available at SSRN: or

Muhammad Zia Hydari (Contact Author)

University of Pittsburgh, Katz Graduate School of Business ( email )

Roberto Clemente Drive
Pittsburgh, PA 15260
United States

Idris Adjerid

Pamplin College of Business ( email )

2058 Pamplin College of Business
Blacksburg, VA 20461
United States

Aaron Striegel

University of Notre Dame ( email )

361 Mendoza College of Business
Notre Dame, IN 46556-5646
United States

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