Motivation is a major obstacle and, to some extent, a mystery for prevention. It is natural to lament low engagement rates in prevention programs. In large part, motivation and engagement remain the missing links between knowing what prevents type 2 diabetes and how to employ this knowledge. While environmental change is certainly a major part of influencing how people make decisions, we also need to learn how individual motivations work. We heard, several times, that money can be an ideal incentive—we ought to be paying people who work to stay healthy. Others question this practice and argue that we need to be far more nuanced in how we look at incentives. We spoke to Dr. Martha Nelson, of the National Institutes of Health, about the importance of behavioral economics in prevention efforts. Said Dr. Nelson, “Certainly it’s not sustainable to constantly pay someone to engage in a certain behavior,” but such an incentive can be useful in overcoming an “initial resistance.” In many cases, she noted, “You’re trying to melt away perceived barriers that aren’t really there.” Lifestyle change can only be sustained, let alone implemented, if these barriers are surmounted. Other experts spoke about motivation entirely outside of incentives and rewards. Dr. Robert Vigersky, Medical Director for Medtronic Diabetes and Past-President of the Endocrine Society, talked about how rapidly patients begin to implement lifestyle changes after seeing their own data from continuous glucose monitoring (CGM). Simply being able to visualize what’s happening in your body can increase your understanding of how your decisions affect your health.
