The CVD Prevention Decathlon - Impact

27% achieved clinically significant weight loss⁷

96% reduced their CVD risk²

90% increased their physical activity⁴

There was a 42% increase in physical activity over 3 months⁵

Equity of outcome across age, ethnicity, socioeconomic deprivation population characteristics⁹

95% reported increased understanding of CVD prevention³

95% reported having made improvements to their diet⁶

72% felt supported and connected between sessions⁸

Statistically significant reductions in cholesterol and BP for those with elevated levels at baseline¹⁰

75% of participants completed the programme (>6 sessions)¹

1 “Amongst programme participants 2 Participant statements via Participant Survey. 3 Participant statements via Participant Survey. 4 Participant statements via Participant Survey. 5 Participants that completed the programme and had step count data that was collected at 4 time points; step count between week 1 and 3 months post programme. 7 Overweight or obese participants that reduced their weight, defined as a reduction in weight of at least 5%. 8 Survey Respondents that had received personalised videos. 9 Participant demographics closely mirrored referral patterns across age, ethnicity, and socioeconomic deprivation. 10 Participants with elevated levels at baseline: that completed the programme (attending 6+ sessions) that had their measurements taken both within 12 months prior to starting the programme and within 6 months of finishing.

The CVD Prevention Decathlon

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The CVD Prevention Decathlon objective is to encourage adoption of positive health behaviours to improve wellbeing and reduce the risk of developing CVD.

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• It is a ten-week programme (plus 12 weeks digital only support) offering educational and physical activity sessions delivered in-person by trained educators.

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• It encourages and facilitates peer engagement and support, also utilises digital elements that provide personalisation and incentivisation. The programme is delivered in localised groups that remain consistent throughout the ten-week duration.

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• Sweatcoin provide rewards and gamification through its digital Sweatcoin app and Prevention Decathlon Health club. Participants earn Sweatcoins and tangible health related rewards, for meeting step challenges, answering health related quizzes and through virtual step races etc.

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• Citizen provide a series of personalised video messages deployed at strategic stages throughout the programme. Participants receive a series of five personalised videos aimed at addressing challenges at key points in a participant’s programme journey, such as recruitment, onboarding, attrition, and maintaining healthy behaviours after programme completion

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

The CVD Prevention Decathlon: The Situation

Programme development was funded by The South West London (SWL) Integrated Care Board (ICB) with Small Business Research Initiative (SBRI) Healthcare funding.

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• Almost a third (29%) of people in SWL live with a long-term condition
• many of whose underlying conditions put them at high risk of CVD.
• Ethnicity-based inequalities exist
• i.e., black people over-represent on SWL hypertension registers.
• Large numbers of patients are not meeting treatment targets or receive monitoring in primary care as a result of the COVID-19 pandemic.

National programmes are underway to improve medical models but prevention and self-management resource for people with CVD risk is relatively limited (compared with diabetes, for example).

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SWL ICB recognise the importance of new models of care to manage the scale of this challenge and deliver improved and equitable health outcomes for the local population.

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

CVD Prevention Decathlon: Programme efficacy in reducing risk

factors associated with CVD (outcomes)

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• 79% of programme participants had high cholesterol1;
• 33%2 had high blood pressure and 44% were on hypertension register;
• 93% had a QRISK score between 10%-20%; 76% were overweight or obese.

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The programme demonstrated encouraging improvements in CVD health, and reductions in weight loss.

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• Statistically significant reductions were observed in cholesterol and blood pressure for those with elevated levels at baseline.
• A considerable portion of participants experienced weight loss, especially those classified as overweight or obese.
• Average weight loss 1.18kg, 1.5%, across all participants was
• Average weight loss statistically significant 1.22kg (SD – 2.3), for participants whose BMI was overweight or obese
• Of the participants that achieved a reduction, (27%) achieved a clinically significant weight loss defined as a reduction in weight of at least 5%.

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024.

1 Of the people who attended with a cholesterol reading recorded from January 2023; 2 Of the people that attended 1 or more sessions. 3 Of the participants with a recorded BMI.

CVD Prevention Decathlon: Programme efficacy

(participant learning and behavioural outcomes)

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Overall, participants stated that they had achieved their goals by the end of the programme:

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• 100% respondents (85/85) fully or partially achieved the goal of increasing knowledge of CVD

• 89% fully/partially achieved goal to "Meet other people locally who are trying to improve their health".

• 68% fully/partially achieved their weight loss goals. A further 29% (n=24) stated weight loss was "Not applicable - I did not set out to achieve this” (29%) – source stat for only those people for whom weight loss was a goal

• 96% fully/partially achieved goal of reducing their risk of cardiovascular disease.

• 98% fully/partially achieved goal to "Get ideas for healthy eating".

• 90% fully/partially achieved goal of increasing physical activity.

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024.

1 Of the people who attended with a cholesterol reading recorded from January 2023; 2 Of the people that attended 1 or more sessions. 3 Of the participants with a recorded BMI.

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• 42% increase in daily steps from weeks 1 to 22

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• 4% increase from week 1 - 5 (4,877 to 5,065),
• 21% increase from week 5 to 10 (5,065 to 6,148),
• 13% increase from weeks 10 (last session) and week 22 (3 months after programme ended).

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• This shows that for these participants increases in physical activity were not only sustained but continued to increase after week 10.

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024.

1 Of the people who attended with a cholesterol reading recorded from January 2023; 2 Of the people that attended 1 or more sessions. 3 Of the participants with a recorded BMI.

CVD Prevention Decathlon: Programme efficacy (behavioural outcomes)

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There was a 42% increase in step count between week 1 and 3 months post decathlon

programme

CVD Prevention Decathlon: Programme efficacy

(participant learning and behavioural outcomes)

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Other goals participants stated that they had achieved by the end of the programme include:

• Feeling more motivated to make changes required to improve health and reduce risk (fully or partially)
• Gained awareness and understanding test results (fully achieved).
• Greater appreciation of the reasons for, and importance of taking, prescriptions (fully achieved).
• Increased motivation to make changes.
• Awareness of test results.
• Improved sleep
• Increased understanding of medication to reduce CVD risk
• Make new friends
• Practical advice on how to make positive lifestyle changes
• Understand risk factors for heart attack.

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024.

1 Of the people who attended with a cholesterol reading recorded from January 2023; 2 Of the people that attended 1 or more sessions. 3 Of the participants with a recorded BMI

CVD Prevention Decathlon: Programme participation

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The programme engaged individuals with a complex interplay of cardiovascular risk factors, with most referrals presenting high blood pressure, high cholesterol, and elevated QRISK scores.

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• Of all referrals to the new programme, 15% signed up to attend.
• Of those who signed up, 83% attended one or more session.

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The majority of participants were successfully retained and completed the programme

• A very high 75% of programme participants were retained across the duration and completed the course (i.e., attended at least six of the ten sessions).

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The programme achieved equity of access

• Participant demographics closely mirrored referral patterns across age, ethnicity, and socioeconomic deprivation, indicating equitable access for diverse populations.

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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CVD Prevention Decathlon: Programme participation

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The programme engaged individuals with a complex interplay of cardiovascular risk factors, with most referrals presenting high blood pressure, high cholesterol, and elevated QRISK scores.

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• The programme had broad appeal across ages, attracting participants from 30 – 89 years old.
• Two thirds of participants (65%) were aged 50 – 69
• The programme had broad appeal across ethnicities, attracting participants with Asian, Black, White and Mixed ethnicities
• 75% of participants were White, 15% were Asian and 7% were Black
• The programme had appeal across genders, attracting both female and male participants.
• 60% of participants were female and 40% were male.
• The programme had appeal across deprivation profiles, attracting participants from every deprivation
• Profile from 3 to 10, in line with referrals.

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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CVD Prevention Decathlon: Impact - patient health goals & knowledge

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Participant data from surveys, focus groups and individual case studies emphasise the programme’s positive impact on participants' health goals and knowledge.

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• A large majority of survey respondents reported achieving goals related to weight loss, CVD risk reduction, healthy eating, physical activity, and increased knowledge of CVD.
• Participants reported significant lifestyle changes, including improved diets and increased exercise.
• The programme's success in increasing participants knowledge is evident in the high proportion of participants reporting increased understanding of CVD risk factors, prevention strategies, and healthy lifestyle choices.
• This, combined with reported behaviour change, suggests the programme effectively supported participants to make informed decisions to reduce CVD risk

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

CVD Prevention Decathlon: Patient experience

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Participants indicated positive programme experiences and high levels of satisfaction.

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• Structured educational learning was well-received, with content seen as valuable, interesting, and accessible
• The interactive and engaging session delivery, with group discussions and games, was appreciated
• Most participants found the physical exercise to be accessible, enjoyable and beneficial; many felt that the combination of information and physical activity was crucial for making significant and lasting changes
• Participants felt being part of a group fostered a sense of community, shared learning, and mutual support
• Participants noted course educator levels of knowledge, facilitation skills and approachability

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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CVD Prevention Decathlon: Patient motivations

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Participants reported the following motivations for taking part in the programme

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• To improve overall health and prevent CVD
• To address known health concerns related to increased CVD risk.
• To access a dedicated support structure to help make positive lifestyle changes: “important knowledge and social support structure”
• To explore alternatives to medication.
• To gain relevant knowledge and skills to make self-empowered changes.
• To satisfy clinical requirements and recommendations (i.e., perceptions from being on a waiting list and/or receiving a strong recommendation from their GP)

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

They reported increased understanding of

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• 93% the risk of CVD.
• 95% how to prevent CVD
• 91% of healthy eating and dieting
• 71% of the role of physical exercise

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

CVD Prevention Decathlon: Patient knowledge improvements

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The vast majority of respondents reported improvements to their knowledge on different aspects of their health due to participating

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• 88% vast majority had tried something new
• a new physical activity
• or new recipe

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• 95% made improvements to their diet

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• 86% increased their physical activity.

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

CVD Prevention Decathlon: Patient knowledge improvements

Survey respondents also reported positive lifestyle changes that they had made as a result of participating in the programme.

CVD Prevention Decathlon: Sweatcoin Health club app

Efficacy esp. against key areas of need in the patient journey

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55% agreed the Sweatcoin app led to an increase in physical activity.

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Survey respondents described their reasons for using the Sweatcoin app

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• 87% Checking step count (41/47)
• 40% “Checking my position on the leaderboard" (19)
• 32% Answering quizzes (15)
• 28% Exploring marketplace offers (13)
• 28% Watching session recap videos (13)

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

64% agreed personalised videos were a ”helpful part of the programme”

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The majority of participants agreed that the personalised videos helped them to:

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• 65% were aware of their personal progress
• 72% felt supported and connected between sessions
• 52% got the most from their decathlon

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CVD Prevention Decathlon: Citizen Personalised Video

Efficacy esp. against key areas of need in the patient journey

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Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

CVD Prevention Decathlon: Other participant survey results

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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Testimonials

“ The programme was really good for me, I've changed my food habit a lot, and now I walk almost everywhere. I'm trying to walk more especially now its summer, it's motivating. My daughter will sometimes ask me how much we have walked together when we are out ”

“ It's motivated me to walk more. It's a good thing for me, one of the best thing that has happened. I can walk more, and now I'm not afraid even if I need to go somewhere and it is 2km, because I can just walk! “

“ Every night I look and see if I've done enough (steps)...

My goal is about 9-10k per day. But during the weekend, I'm not walking to school so it's less. and if it's not enough then I go to my garden and do some steps there. I'm really enjoying my weight loss and fitting into my clothes! ”

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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“ When your doctor’s put you on the course, that can be quite an intimidating thing. But to deliver it with a friendly, upbeat and positive way of getting in the mind frame that, ‘OK, this is gonna be interesting, but it’s gonna be fun”

“The course gave me practical tips on how to make small changes to my lifestyle that could have a big impact on my health. I've started walking more and eating more fruits and vegetables.”

"I wouldn't understand if you just told me, ‘This is good for you. That's good for you’. All the background, the science behind it, it was just awesome. You need that to educate people, to help them go forward.”

"I found the interaction with the games made the fun of it as well... also it sinks in better when there's a bit more fun like that."

“I really enjoyed the group sessions. It was great to hear from others who were going through similar things. We were able to share tips and support each other.”

“What added to it was the opportunity to ask questions which gave insight from other people's perspective. It wasn't just the lecturer and what he knew. If people didn't understand, it was an opportunity to explain it in a different way.”

"You don't feel isolated, like you're alone in this. People share and you realise, oh, ‘I’m not on my own’."

"It was nice to hear other people’s experiences so that even if you weren't gonna mention something, you probably heard it from somebody else asking that question."

"I thought it would be more clinical, and classroom based, but it was a lot more interesting and a lot friendlier. We were all motivating each other just by being there. That's what kept me going."

"I think we've been very lucky in the group that we had. Quite honestly, it was an interesting group of people, all from different backgrounds, but we all just gelled, and we had some huge laughs.”

“[Facilitator] was excellent, really brilliant. They knew what they were talking about, didn't read anything, they just spoke and were very engaging."

“Ten weeks does seem a long time to commit, but it certainly went quickly. And it suited me fine. The session I had was at 1:45 and I was working from home so I could cycle there, and it was just easy.”

“The venue was just down the road from me. I was very lucky in that respect. It encouraged me to walk a little bit more and I felt good that I already had that walk when I arrived.”

“I found out about the rewards, so after [participant] told me about her £35 voucher, I got jealous and I finally thought I'd give it a go."

"The programme was very supportive and the tutor that we had made it really fun… we all bonded as a group. So, it was really nice."

“When your doctor’s put you on the course, that can be quite an intimidating thing. But to deliver it with a friendly, upbeat and positive way of getting in the mind frame that, ‘OK, this is gonna be interesting, but it’s gonna be fun”

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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Testimonials

CVD Prevention Decathlon – Impact Sources

Source: Health Innovation Network – South West London evaluation report

1 “Amongst programme participants, 75% completed the course (i.e., attended at least six of the ten sessions). Programme completion rates were high (75%) amongst those that enrolled. Overall, the programme successfully retained the majority of participants throughout the ten sessions, but there was a small gradual decline in attendance over time.” 2 The participant survey explored participant learning and behavioural outcomes. Overall, participants stated that they had achieved their goals by the end of the programme: 96% (70/73) had either fully (27, 37%) or partially (43, 59%) achieved their goal of reducing their risk of cardiovascular disease. 3 The participant survey explored participant learning and behavioural outcomes. 95% (79/83) had increased understanding of how to prevent cardiovascular disease. The vast majority of respondents reported improvements to their knowledge on different aspects of their health due to participating in the programme. 4 The participant survey explored participant learning and behavioural outcomes. 90% (76/84) had either fully (43, 51%) or partially (33, 39%) achieved their goal of increasing physical activity. OR Survey respondents: increased their physical activity (86%, 74/86). 5 There were 140 participants that completed the programme and had step count data that was collected at 4 time points (week 1, 5, 10 and 22). These participants represent 34% of all completers and 65% of completers that had downloaded the app. There was a 42% increase in step count between week 1 of the decathlon and 3 months post programme. 6 Survey respondents: The vast majority reported that they had… made improvements to their diet (95%,82/86). 7 27% of overweight or obese participants that reduced their weight achieved a clinically significant weight loss; Of the participants that achieved a reduction, 11 (27%) achieved a clinically significant weight loss defined as a reduction in weight of at least 5%. 8 Those respondents that had received personalised videos: Most respondents (36 of 50, 72%) agreed that "Personalised videos helped me to feel supported and connected between sessions”. 9 Participant demographics closely mirrored referral patterns across age, ethnicity, and socioeconomic deprivation, indicating equitable access for diverse populations. However, there was disparity in gender representation, with females overrepresented among participants compared to referrals. 10 Statistically significant

reductions were observed in cholesterol and blood pressure for those with elevated levels at baseline: There were 64 participants that completed the programme (attending 6 or more sessions) that had their blood lipids (cholesterol) taken both within 12 months prior to starting the programme and within 6 months of finishing - Of these participants with complete cholesterol data. There were 58 participants that completed the decathlon and had blood pressure readings taken up to 12 months prior to starting on the programme and up to 6 months after finishing. All 12 participants that had high blood pressure on referral to the programme reduced their blood pressure down to a healthy range by the time they had their blood pressure monitored post the programme. 

Source: CVD Prevention Decathlon: Programme Pilot Evaluation via the Health Innovation Network South London, December 2024

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Demonstrably improving health through incentives & gamification

Sweatcoin Health

Sweatcoin ‘freemium’ features

A UK Tech success story

A free app that rewards and gamifies steps

Users walk an average of 20% more

Most downloaded Health and fitness app globally 22/23’

• #1 app in 70 countries
• 180m+ registered users
• 75k sign ups per day
• 10m monthly active users

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“It Pays to Walk”

• Makes walking fun & aspirational through gamification and rewards
• Free download, verifies and converts steps to Sweatcoins which can be spent in the in-app marketplace

“Sweatcoin... beats Whatsapp as the most popular in app store.”

“Sweatcoin... beats Whatsapp as the most popular in app store.”

Unlocking the value of physical activity and making it transferable has created a powerful new ‘movement economy’

Sweatcoin Health Mission

Reduce the health burden of chronic lifestyle conditions by incentivising movement to achieve behavioural change

We spend more each year on the treatment of obesity and diabetes than we do on the police, fire service and judicial system combined

(Public Health England)

10% of the NHS’s entire budget spent on treating complications from diabetes

(NHS England)

Physical activity is valuable �…to you, your family, your healthcare provider, your insurer, your employer & society at large

Our Health Solution Decathlon Programme

Patient/ Participant Recruitment

Refer for SWC download with custom club link

Rewards for users

Provide custom incentives for users to earn with their steps

Gamification

Leaderboards,

Virtual races, Boost button and ‘Streaks’

Educational Content

Quizzes, video content and motivational messages

User Comms

Ai virtual coaching and push notifications, emails, milestone celebrations; online and offline support

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Kick off

10 week

in-app DECATHLON program

Capture baseline patient data

Onboarding

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Tracking data and reporting

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Dashboards & post programme analysis

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12 week

in-app continued support

Preventative health value with improved outcomes and reversal of disease

Post programme support with further engagement and incentives

At 22 weeks final patient check in for health data

Face to face in person or webinar education

Prevention Decathon is an attractive proposition: Why?

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• It looks like fun – it’s not all classroom lectures there’s the opportunity to try new things as well and it's only ten weeks long.

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• It's very motivating - via the manner in which at key points of communication it's made personal to me.

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• Ongoing encouragement - It's not just weekly sessions. I'm encouraged and rewarded for taking action every day by the Sweatcoin 'club' app and personalised communications.

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• Part of a community - Meet like minded people during the programme. Most continue to be part of their community outside and after the programme.

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• Continued support, motivation and rewards - on the app for a further 12 weeks following the 10 week hybrid programme.

User testimonials

“Through informative sessions on diabetes prevention, a variety of exercise classes, and daily walking challenges with Sweatcoin, the Decathlon programme has helped me significantly improve my physical and mental health. I was shown how small changes to daily habits make a huge difference to my long-term wellbeing. This programme has shaped my health habits for life. I now have the knowledge and tools I need to make lasting, positive changes.” Geetha (53)

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"I'm a male teacher in my mid-30s, and since I started using Sweatcoin, I’ve noticed a significant improvement in my mental and physical wellbeing. When I downloaded the app, it was a wake-up call to see how few steps I was actually taking. Now, Sweatcoin motivates me to stay active and reach my daily target of 10,000 steps.” Kadi (35)

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""What I appreciate most about Sweatcoin is that it has helped me to improve my overall health and wellbeing. I feel better both physically and mentally, and I have more energy to tackle the challenges of daily life. I would definitely recommend Sweatcoin to anyone who wants to lead a more active and healthy lifestyle.” Deividas (33)

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“The programme was really good for me, I've changed my food habit a lot, and now I walk almost everywhere. I'm trying to walk more especially now its summer, it's motivating. My daughter will sometimes ask me how much we have walked together when we are out ”

“It's motivated me to walk more. It's a good thing for me, one of the best thing that has happened. I can walk more, and now I'm not afraid even if I need to go somewhere and it is 2km, because I can just walk!

“ Every night I look and see if I've done enough (steps). My goal is about 9-10k per day. But during the weekend, I'm not walking to school so it's less. and if it's not enough then I go to my garden and do some steps there. I'm really enjoying my weight loss and fitting into my clothes! ”

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Press coverage:

NHS’s gift of healthy living

NHS patients are being offered Kindles and AirPods to motivate them to change their ways and embrace healthy living.

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It is hoped that the programme will be rolled out across the UK following a successful pilot in London. The aim is to prevent long-term illnesses such as diabetes and heart disease, which are forecast to affect. 9.1 million people in England by 2040.

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Under the pilot scheme in Richmond and Wandsworth, 70 NHS patients of all ages with early signs of Type 2 diabetes were put on a 10-week health and fitness regime involving the app Sweatcoin. The app, which measures step count, works like a supermarket loyalty card, rewarding patients with prizes for achieving agreed health targets monitored on their phones. The gifts, from Sweatcoin's "business partners", include AirPods, Kindles, weighing scales and recipe books. By the end of the trial, 85 percent of patients lost an average of 3kg…

Other Press

clippings

Contact:

Simon Pickup

Head of Healthcare

s.pickup@sweatco.in

07787 115580