Why can’t health be a sufficient incentive?

There have been a slew of consumer healthcare devices that have come to market ranging from fancy pedometers and activity meters to apps that track your every move to a toothbrush. Yes, an intelligent, app-connected, electronic toothbrush.

I am all for tracking behaviors. Quantifying behaviors can be used to detect depression or Alzheimer’s  or even manage migraines. Of course, tracking activity can also be used to lose weight or train for a race.

Gamification?
One challenge with all of these monitoring devices is keeping people engaged for longer than the excitement of a new whiz-bang electronic device can last. Also, the challenge is that these devices become less useful as the behavior they seek to modify takes hold. To keep relevant and engaging, device makers have created fancy data interfaces, social connections, and, even gamification.

Gamification is the idea that adding game elements, such as badges, achievement awards, cheering, or leaderboards, makes an activity more engaging. And there might be cases where gamification might make something more engaging, though I can’t see how managing migraines can be turned into a game.

Back to our toothbrush.

Justifying ends and means
The toothbrush system awards folks on how much and how long they brush their teeth.

This brings me to my first concern: be careful what you measure. Is there a correlation between good oral health and frequency and length of brushing? Sure, there is some correlation, but when do diminishing returns kick in? Sure, brushing after meals is good. But if you reward someone for frequency and duration of brushing, how long until someone is brushing all the time just to get achievement awards? Yes, kids can be obsessive like that. [And that music the kid listens to for as long as they brush? Watch them try to play the same tune for a very long time, constantly brushing without stop.]

This brings me to my second concern: why can’t good health be the reward? I understand that we want to reward good behavior, but how can we do that without gimmiky gaming badges and awards, especially when it has something to do with our health? To me, any health program that tries to modify behavior should do it through promoting good behavior rather than conditioning the behavior through non-related rewards. This goes for a diet (learning how to eat right, not just lose weight) or a toothbrush (learning proper oral hygiene, not gaming a system).

This brings me to my third concern: coupons. Really? What I didn’t say is that the toothbrush users will also be rewarded with coupons. And coupons just rub me the wrong way. For one, the connection between coupons and tooth brushing doesn’t seem clear to me. Also, and back to the previous two concerns, are we trying to devise a nifty coupon-generating device or are we trying to instill good brushing habit and proper oral hygiene?

How devices help
I totally think the use of an electronic toothbrush can be quite beneficial to promoting proper oral health. As part of a system of periodic check-ups, proper eating, and flossing, brushing is important. And tracking brushing might be good for educating children, tracking and correlating usage patterns with dental or oral outcomes, or even for seniors to keep track of the last time they brushed.

To be fair, the toothbrush makers do a good job of pointing all this out. But none of these really should require coupons or achievement badges to get folks to do it. Heck, so many of us already brush our teeth daily without coupons or awards. Simply wanting to avoid bad dentist visits and halitosis are good motivators, too. So, perhaps a bit of measurement can help folks who are a bit on the slack side. But in the end, it’s good health we want, not a clockwork orange coupon-clipper with shiny teeth.

What do you think? Am I being a frump?

[Thank you @changeist for unknowingly providing the spark to write this.]