Way to Be Active - UPenn

Test the effectiveness of 3 methods to frame financial incentives to increase physical activity among overweight and obese adults.

Mitesh S. Patel, MD, MBA, MS
Principan Investigator
David A. Asch, MD, MBA
Investigator

Background and Aim:

Financial incentive designs to increase physical activity have not been well-examined. Aim was to test the effectiveness of 3 methods to frame financial incentives to increase physical activity among overweight and obese adults.

Intervention and Design:

A randomized, controlled trial conduction at the University of Pennsylvania. Enrolled 281 adult employees (body mass index ≥27 kg/m2).

Intervention: - 13-week intervention. Participants had a goal of 7000 steps per day and were randomly assigned to a control group with daily feedback or 1 of 3 financial incentive programs with daily feedback: a gain incentive ($1.40 given each day the goal was achieved), lottery incentive (daily eligibility [expected value approximately $1.40] if goal was achieved), or loss incentive ($42 allocated monthly upfront and $1.40 removed each day the goal was not achieved). Participants were followed for another 13 weeks with daily performance feedback but no incentives.

Main Outcomes and Measures: - Primary outcome was the mean proportion of participant-days that the 7000-step goal was achieved during the intervention. Secondary outcomes included the mean proportion of participant-days achieving the goal during follow-up and the mean daily steps during intervention and follow-up.

Way to Health Use

  • Study Enrollment: Enroll and randomize participants in the study

  • Device Integration: Collect step count data from participants’ devices

  • Financial Incentives: Provide participants with incentives for meeting goals

Findings and Conclusions

The mean proportion of participant-days achieving the goal was 0.30 (95% CI, 0.22 to 0.37) in the control group, 0.35 (CI, 0.28 to 0.42) in the gain-incentive group, 0.36 (CI, 0.29 to 0.43) in the lottery-incentive group, and 0.45 (CI, 0.38 to 0.52) in the loss-incentive group. In adjusted analyses, only the loss-incentive group had a significantly greater mean proportion of participant-days achieving the goal than control (adjusted difference, 0.16 [CI, 0.06 to 0.26]; P = 0.001), but the adjusted difference in mean daily steps was not significant (861 [CI, 24 to 1746]; P = 0.056). During follow-up, daily steps decreased for all incentive groups and were not different from control.

Financial incentives framed as a loss were most effective for achieving physical activity goals.

Publications


Framing Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults: A Randomized, Controlled Trial