Peer reviewed publications using the Way To Health platform



Innovative research and evidence based publications



54 publications and counting

JAMA Netw Open.

Cost-effectiveness of Financial Incentives for Patients and Physicians to Manage Low-Density Lipoprotein Cholesterol Levels

Dec 2018
Ankur Pandya, PhD; David A. Asch, MD, MBA; Kevin G. Volpp, MD, PhD; Stephen Sy, MS; Andrea B. Troxel, ScD; Jingsan Zhu, MBA; Milton C. Weinstein, PhD; Meredith B. Rosenthal, PhD; Thomas A. Gaziano, MD, MSc

This study suggests that the financial incentives shared between patients and physicians for LDL-C level control meet conventional standards of cost-effectiveness, but these results appeared to be sensitive to assumptions about the durations of LDL-C level reductions and years of intervention costs included, as well as to the choice of time horizon.

CCT

The Healthy Weigh study of lottery-based incentives and environmental strategies for weight loss: Design and baseline characteristics.

Dec 2018
Glanz K, Shaw PA, Hoffer K, Chung A, Zhu J, Wu R, Huang QE, Choi JR, Volpp KG

Identifying effective strategies for treating obesity is a clinical challenge and a public health priority. This study demonstrated that multi-site employee-based recruitment for a weight-control intervention study is feasible but may need additional time for coordination between diverse environments.

CCT

Randomized evaluation of trial acceptability by INcentive (RETAIN): Study protocol for two embedded randomized controlled trials.

Nov 2018
Krutsinger DC, McMahon J, Stephens-Shields AJ, Bayes B, Brooks S, Hitsman BL, Lubitz SF, Reyes C, Schnoll RA, Ryan Greysen S, Mercede A, Patel MS, Reale C, Barg F, Karlawish J, Polsky D, Volpp KG, Halpern SD

The most common and conceptually sound ethical concerns with financial incentives for research participation are that they may (1) represent undue inducements by blunting peoples’ perceptions of research risks, thereby preventing fully informed consent; or (2) represent unjust inducements by encouraging enrollment preferentially among the poor. Neither of these concerns has been shown to manifest in studies testing the effects of incentives on decisions to participate in hypothetical randomized clinical trials (RCTs), but neither has been assessed in real RCTs.

Ann Am Thorac Soc.

Financial Incentives Promote Smoking Cessation Directly, Not by Increasing Use of Cessation Aids.

Oct 2018
Harhay MO, Troxel AB, Brophy C, Saulsgiver K, Volpp KG, Halpern SD

Financial Incentives Promote Smoking Cessation Directly, Not by Increasing Use of Cessation Aids

J Urol

Ecological Momentary Assessment of Factors Associated with Water Intake Among Adolescents with Kidney Stone Disease.

Aug 2018
Tasian GE, Ross M, Song L, Audrain-McGovern J, Wiebe D, Warner SG, Henderson B, Patel A, Furth SL.

Unawareness of water volume consumed and low responsiveness to the perceived need to drink more were associated with low water intake. Interventions that help adolescents recognize when and identify how to increase water intake may be effective in reducing stone recurrence.

Med Care

Comparison of Pharmacy Claims and Electronic Pill Bottles for Measurement of Medication Adherence Among Myocardial Infarction Patients.

Jul 2018
Mehta SJ, Asch DA, Troxel AB, Lim R, Lewey J, Wang W, Zhu J, Norton L, Marcus N, Volpp KG.

Pharmacy claims data provide useful but not complete data for medication adherence monitoring. New wireless technologies have the potential to provide additional data about clinical outcomes.

JGIM

Social Incentives and Gamification to Promote Weight Loss: The LOSE IT Randomized, Controlled Trial

Jul 2018
Kurtzman GW, Day SC, Small DS, Lynch M, Zhu J, Wang W, Rareshide CAL, Patel MS.

Using digital health devices to track behavior with a partner led to significant weight loss through 36 weeks, but the gamification interventions were not effective at promoting weight loss when compared to control.

JAHA

Loss‐Framed Financial Incentives and Personalized Goal‐Setting to Increase Physical Activity Among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Randomized Trial

Jun 2018
Neel P. Chokshi, Srinath Adusumalli, Dylan S. Small, Alexander Morris, Jordyn Feingold, Yoonhee P. Ha, Marta D. Lynch, Charles A.L. Rareshide, Victoria Hilbert and Mitesh S. Patel

ACTIVE REWARD was a 24‐week home‐based, remotely monitored, randomized trial with a 16‐week intervention (8‐week ramp‐up incentive phase and 8‐week maintenance incentive phase) and an 8‐week follow‐up. Patients used wearable devices to track step counts and establish a baseline. Patients in control received no other interventions. Loss‐framed financial incentives with personalized goal setting significantly increased physical activity among ischemic heart disease patients using wearable devices during the 16‐week intervention, and effects were sustained during the 8‐week follow‐up.

JMIR For Res

Barriers and Opportunities for Using Wearable Devices to Increase Physical Activity Among Veterans: Pilot Study

Jun 2018
Rebecca H Kim, MD, MPH ; Mitesh S Patel, MD, MBA, MS

Veterans engaged in using wearable devices at high rates

Nutr & Diab

Article | OPEN | Published: 25 May 2018 Financial incentive strategies for maintenance of weight loss: results from an internet-based randomized controlled trial

May 2018
William S. Yancy Jr., Pamela A. Shaw, Lisa Wesby, Victoria Hilbert, Lin Yang, Jingsan Zhu, Andrea Troxel, David Huffman, Gary D. Foster, Alexis C. Wojtanowski & Kevin G. Volpp

Compared with the active control of daily texting based on daily home weighing, lottery-based and direct monetary incentives provided no additional benefit for weight loss maintenance. Or in other words, texting and reminders were equally effective as financial incentives.

NEJM

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation

May 2018
Scott D. Halpern, M.D., Ph.D., Michael O. Harhay, Ph.D., Kathryn Saulsgiver, Ph.D., Christine Brophy, Andrea B. Troxel, Sc.D., and Kevin G. Volpp, M.D., Ph.D.

The study randomly assigned 6006 smokers employed by 54 companies to one of four smoking-cessation interventions or to usual care. In this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit.

BMJ Qual Saf.

Comparing standard office-based follow-up with text-based remote monitoring in the management of postpartum hypertension: a randomised clinical trial

Apr 2018
Hirshberg A, Downes K, Srinivas S

Text-based monitoring is more effective in obtaining blood pressures and meeting current clinical guidelines in the immediate postdischarge period in women with pregnancy-related hypertension compared with traditional office-based follow-up.

J Gen Intern Med

Partners and Alerts in Medication Adherence: A Randomized Clinical Trial

Mar 2018
Kessler JB, Troxel AB, Asch DA, Mehta SJ, Marcus N, Lim R, Zhu J, Shrank W, Brennan T, Volpp KG

Automated alerts were effective at improving medication adherence. Assigning a medication adherence partner did not statistically significantly affect adherence rates.

Am J Health Promot.

A Randomized, Controlled Trial of Lottery-Based Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults

Jan 2018
Patel MS, Volpp KG, Rosin R, Bellamy SL, Small DS, Heuer J, Sproat S, Hyson C, Haff N, Lee SM, Wesby L, Hoffer K, Shuttleworth D, Taylor DH, Hilbert V, Zhu J, Yang L, Wang X, Asch DA

Combined lottery incentives were most effective in increasing physical activity

Ann Intern Med

Using Wearable Devices and Smartphones to Track Physical Activity: Initial Activation, Sustained Use, and Step Counts Across Sociodemographic Characteristics in a National Sample

Nov 2017
Mitesh S. Patel, MD, MBA, MS; Luca Foschini, PhD; Gregory W. Kurtzman, BA; Jingsan Zhu, MBA, MS; Wenli Wang, MS; Charles A.L. Rareshide, MS; Susan M. Zbikowski, PhD

Describes rates of initial use of activity trackers, sustained use after 6 months, and step counts across different sociodemographic characteristics from a wellness program offered across the United States.

JAMA Intern Med.

Effect of a Game-Based Intervention Designed to Enhance Social Incentives to Increase Physical Activity Among Families The BE FIT Randomized Clinical Trial

Nov 2017
Mitesh S. Patel, MD, MBA, MS; Emelia J. Benjamin, MD, ScM; Kevin G. Volpp, MD, PhD; Caroline S. Fox, MD, MPH; Dylan S. Small, PhD; Joseph M. Massaro, PhD; Jane J. Lee, PhD; Victoria Hilbert, MPH, RD; Maureen Valentino, BA; Devon H. Taylor, MPH; Emily S. Manders, BS; Karen Mutalik, BS; Jingsan Zhu, MBA, MS; Wenli Wang, MS; Joanne M. Murabito, MD, ScM

Gamification designed to leverage insights from behavioral economics to enhance social incentives significantly increased physical activity among families in the community.

JAMA Pediatr.

Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes

Oct 2017
Charlene A. Wong, MD, MSHP; Victoria A. Miller, PhD; Kathryn Murphy, PhD; Dylan Small, PhD; Carol A. Ford, MD; Steven M. Willi, MD; Jordyn Feingold, MAPP; Alexander Morris, BS; Yoonhee P. Ha, MSc, MPhil; Jingsan Zhu, MS, MBA2; Wenli Wang, MS2; Mitesh S. Patel, MD, MBA, MS2

In a randomized clinical trial including 90 adolescents and young adults with poorly controlled type 1 diabetes, daily financial incentives improved glucose monitoring in the intervention group (50.0%) vs the control group (18.9%) but did not affect their glycemic control. Financial incentives showed promise for improving glucose monitoring behaviors among adolescents and young adults with type 1 diabetes

Healthcare

Physician attitudes toward participating in a financial incentive program for LDL reduction are associated with patient outcomes

Sep 2017
Tianyu Liu, David A.Asch, Kevin G.Volpp, Jingsan Zhu, Wenli Wang, Andrea B. Troxel, Aderinola Adejare, Darra D. Finnerty, Karen Hoffer, Judy A. Shea

PCPs participating in a P4P program generally agree with the concept of financial incentives and are open to sharing incentives between physicians and patients. Physician beliefs about incentives may have an influence on patient outcomes, particularly in a shared incentive setting, but more research is needed to elucidate the exact nature of this interaction.

JAMA Intern Med.

Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction: The HeartStrong Randomized Clinical Trial

Jun 2017
Kevin G. Volpp, MD, PhD; Andrea B. Troxel, ScD6; Shivan J. Mehta, MD, MBA, MSHP; Laurie Norton, MA; Jingsan Zhu, MS, MBA; Raymond Lim, MA; Wenli Wang, MS; Noora Marcus, MA; Christian Terwiesch, PhD; Kristen Caldarella, MHA; Tova Levin, MBA; Mike Relish, MA; Nathan Negin, MD; Aaron Smith-McLallen, PhD; Richard Snyder, MD; Claire M. Spettell, PhD; Brian Drachman, MD; Daniel Kolansky, MD; David A. Asch, MD, MBA

In this randomized clinical trial of 1509 patients following acute myocardial infarction, there were no statistically significant differences between study arms in time to first rehospitalization for a vascular event or death, medication adherence, or cost.

J Beh Med

Time to selected quit date and subsequent rates of sustained smoking abstinence

Jun 2017
George L. Anesi, Scott D. Halpern, Michael O. Harhay, Kevin G. Volpp, Kathryn Saulsgiver

In efforts to combat tobacco dependence, most smoking cessation programs offer individuals who smoke the choice of a target quit date. However, it is uncertain whether the time to the selected quit date is associated with participants’ chances of achieving sustained abstinence. In a pre-specified secondary analysis of a randomized clinical trial of four financial-incentive programs or usual care to encourage smoking cessation (Halpern et al. in N Engl J Med 372(22):2108–2117, doi:10.1056/NEJMoa1414293, 2015), study participants were instructed to select a quit date between 0 and 90 days from enrollment. Among those who selected a quit date and provided complete baseline data (n = 1848), we used multivariable logistic regression to evaluate the association of the time to the selected quit date with 6- and 12-month biochemically-confirmed abstinence rates. In the fully adjusted model, the probability of being abstinent at 6 months if the participant selected a quit date in weeks 1, 5, 10, and 13 were 39.6, 22.6, 10.9, and 4.3%, respectively.

J Gen Intern Med

Patient and Partner Feedback Reports to Improve Statin Medication Adherence: A Randomized Control Trial

Mar 2017
Ashok Reddy, Tiffany L. Huseman, Anne Canamucio, Steven C. Marcus, David A. AschK, evin Volpp, Judith A. Long

Simple nudges such as reminders and feedback reports to either a patient or a partner may facilitate improved medication adherence.

Am. J. Kidney Dis.

Automated Reminders and Physician Notification to Promote Immunosuppression Adherence Among Kidney Transplant Recipients: A Randomized Trial

Mar 2017
Peter P. Reese, MD, MSCE, Roy D. Bloom, MD, Jennifer Trofe-Clark, PharmD, Adam Mussell, MA, Daniel Leidy, BA, Simona Levsky, BS, Jingsan Zhu, MS, MBA, Lin Yang, MS, Wenli Wang, MS, Andrea Troxel, ScD, Harold I. Feldman, MD, MSCE, Kevin Volpp, MD, PhD

Provider notification and customized reminders appear promising in helping patients achieve better medication adherence, but these strategies require evaluation in trials powered to detect differences in clinical outcomes

Am J Prev Med.

A Trial of Financial and Social Incentives to Increase Older Adults' Walking

Mar 2017
Kristin A.HarkinsBA, Jeffrey T.Kullgren MD, MS, MPH; Scarlett L.Bellamy ScD; Jason Karlawish MD; Karen Glanz PhD, MPH

Incentive schemes that use donations to a charity of choice, personal financial incentives, or a combination of the two can each increase older adults’ initial uptake of increased levels of walking.

J of Clin Out Mgmt.

Rapid-Cycle Innovation Testing of Text-Based Monitoring for Management of Postpartum Hypertension

Feb 2017
Adi Hirshberg,MD, Marianne D. Bittle,MSN,RNC–OB, Matthew VanDerTuyn,MID, Katy Mahraj,MSI, David A. Asch,MD,MBA, Roy Rosin,MBA, Ian Bennett,MD,PhD, Sindhu K. Srinivas,MD,MSCE

Our results suggest that remote blood pressure monitoring via text message communication engages patients and shows promise as a convenient and effective means of hypertension surveillance in the immediate postpartum period, in accordance to ACOG guidelines

Healthcare

Physician attitudes toward participating in a financial incentive program for LDL reduction are associated with patient outcomes

Dec 2016
Tianyu Liu, David A.Asch, Kevin G.Volpp, Jingsan Zhu, Wenli Wang, Andrea B.Troxel, Aderinola Adejare, Darra D.Finnerty, Karen Hoffer, Judy A.Shea

In primary care practices, shared financial incentives for physicians and patients, but not incentives to physicians or patients alone, resulted in a statistically significant difference in reduction of LDL-C levels at 12 months. This reduction was modest, however, and further information is needed to understand whether this approach represents good value

JAMA Cardiol.

Participation Rates With Opt-out Enrollment in a Remote Monitoring Intervention for Patients With Myocardial Infarction

Oct 2016
Shivan J. Mehta, MD, MBA, MSHP; Andrea B. Troxel, ScD; Noora Marcus, MA; Christina Jameson, BS; Devon Taylor, BS; David A. Asch, MD, MBA; Kevin G. Volpp, MD, PhD

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Ann Intern Med.

The design and conduct of Keep It Off - An online randomized trial of financial incentives for weight-loss maintenance

Sep 2016
Pamela A Shaw, William S Yancy, Jr, Lisa Wesby, Victoria Ulrich, Andrea B Troxel, David Huffman, Gary D Foster, Kevin Volpp

Obesity continues to be a serious public health challenge. Rates are increasing worldwide, with nearly 70% of the US adults overweight or obese, leading to increased clinical and economic burden. While successful approaches for achieving weight loss have been identified, techniques for long-term maintenance of initial weight loss have largely been unsuccessful. Financial incentive interventions have been shown in several settings to be successful in motivating participants to adopt healthy behaviors.

AHJ

Rationale and design of a randomized trial of automated hovering for post-myocardial infarction patients: The HeartStrong program

Sep 2016
Andrea B. Troxel, ScD; Andrea B. Troxel, ScD; Andrea B. Troxel, David A. Asch, MD, MBA, Shivan J. Mehta, MD, MBA, MSHP, Laurie Norton, MA, Devon Taylor, BS, Tirza A. Calderon, MPH, Raymond Lim, MA, Jingsan Zhu, MS, MBA, Daniel M. Kolansky, MD, Brian M. Drachman, MD, Kevin G. Volpp, MD, PhD

Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low.

JGIM

Individual Versus Team-Based Financial Incentives to Increase Physical Activity: A Randomized, Controlled Trial

Jul 2016
Mitesh S. Patel, David A. Asch, Roy Rosin, Dylan S. Small, Scarlett L. Bellamy, Kimberly Eberbach, Karen J. Walters, Nancy Haff, Samantha M. Lee, Lisa Wesby, Karen Hoffer, David Shuttleworth, Devon H. Taylor, Victoria Hilbert, Jingsan Zhu, Lin Yang, Xingmei Wang, Kevin G. Volpp

Financial incentives rewarded for a combination of individual and team performance were most effective for increasing physical activity.

Am J Health Promot.

A Randomized Trial of Social Comparison Feedback and Financial Incentives to Increase Physical Activity

Jul 2016
Mitesh S. Patel, MD, MBA, MS, Kevin G. Volpp, MD, PhD, Roy Rosin, MBA, Scarlett L. Bellamy, ScD, Dylan S. Small, PhD, Michele A. Fletcher, CPA, Rosemary Osman-Koss, BS, Jennifer L. Brady, MA, RD, LDN, Nancy Haff, MD, Samantha M. Lee, BSE, Lisa Wesby, MS, Karen Hoffer, BS, David Shuttleworth, MS, Devon H. Taylor, BS, Victoria Hilbert, MPH, RD, Jingsan Zhu, MBA, MS, Lin Yang, MS, Xingmei Wang, MS, David A. Asch, MD, MBA

Social comparison to the 50th percentile with financial incentives was most effective for increasing physical activity.

Am J Health Promot.

A Randomized Controlled Trial of Employer Matching of Employees? Monetary Contributions to Deposit Contracts to Promote Weight Loss

Jul 2016
Jeffrey T. Kullgren, MD, MS, MPH, Andrea B. Troxel, ScD, George Loewenstein, PhD, Laurie A. Norton, MA, Dana Gatto, BS, Yuanyuan Tao, MS, Jingsan Zhu, MS, MBA, Heather Schofield, MS, PhD, Judy A. Shea, PhD, David A. Asch, MD, MBA, Thomas Pellathy, PhD, Jay Driggers, MBA, Kevin G. Volpp, MD, PhD

Participation in deposit contracts to promote weight loss was low, and matching deposits did not increase participation. For deposit contracts to impact population health, ongoing participation will need to be higher.

Ann Intern Med.

Two Randomized Controlled Pilot Trials of Social Forces to Improve Statin Adherence among Patients with Diabetes

Apr 2016
Peter P. Reese, Judd B. Kessler, Jalpa A. Doshi, Joelle Friedman, Adam S. Mussell, Caroline Carney, Jingsan Zhu, Wenli Wang, Andrea Troxel, Peinie Young, Victor Lawnicki, Swapnil Rajpathak, Kevin Volpp

Medication nonadherence is an important obstacle to cardiovascular disease management.

Am J Respir Crit Care Med

Heterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation

Jan 2016
Scott D. Halpern, Benjamin French, Dylan S. Small, Kathryn Saulsgiver, Michael O. Harhay, Janet Audrain-McGovern, George Loewenstein, David A. Asch, and Kevin G. Volpp

Heterogeneity among smokers in their acceptance and response to different forms of incentives suggests potential benefits of targeting behavior-change interventions based on patient characteristics.

J Health Econ

Habit formation in children: Evidence from incentives for healthy eating.

Jan 2016
Loewenstein G, Price J, Volpp K

Over a 3- or 5-week period, students received an incentive for eating a serving of fruits or vegetables during lunch. Relative to an average baseline rate of 39%, providing small incentives doubled the fraction of children eating at least one serving of fruits or vegetables. Two months after the end of the intervention, the consumption rate at schools remained 21% above baseline for the 3-week treatment and 44% above baseline for the 5-week treatment. These findings indicate that short-run incentives can produce changes in behavior that persist after incentives are removed.

Hlth Aff

Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013–15 Study

Jan 2016
Mitesh S. Patel, David A. Asch, Andrea B. Troxel, Michele Fletcher, Rosemary Osman-Koss, Jennifer Brady, Lisa Wesby, Victoria Hilbert, Jingsan Zhu, Wenli Wang, and Kevin G. Volpp

The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both.

Health Aff

Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.

Jan 2016
Mitesh S. Patel, David A. Asch, Andrea B. Troxel, Michele Fletcher, Rosemary Osman-Koss, Jennifer Brady, Lisa Wesby, Victoria Hilbert, Jingsan Zhu, Wenli Wang, and Kevin G. Volpp

The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both.

JAMA.

Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels

Nov 2015
David A. Asch, MD; Andrea B. Troxel, ScD; Walter F. Stewart, PhD, MPH; Thomas D. Sequist, MD, MPH; James B. Jones, PhD; AnneMarie G. Hirsch, PhD, MPH; Karen Hoffer, BS; Jingsan Zhu, MBA; Wenli Wang, MS; Amanda Hodlofski, MPH; Antonette B. Frasch, MD; Mark G. Weiner, MD; Darra D. Finnerty, BS; Meredith B. Rosenthal, PhD; Kelsey Gangemi, MPH; Kevin G. Volpp, MD, PhD

In primary care practices, shared financial incentives for physicians and patients, but not incentives to physicians or patients alone, resulted in a statistically significant difference in reduction of LDL-C levels at 12 months. This reduction was modest, however, and further information is needed to understand whether this approach represents good value

Am J Health Promot.

Stages of Change and Patient Activation Measure Scores in the Context of Incentive-Based Health Interventions

Oct 2015
Becker NV, Asch DA, Kullgren JT, Bellamy SL, Sen AP, Volpp KG.

To determine if two widely used behavioral change measures-Stages of Change (SoC) and Patient Activation Measure (PAM)-correlate with each other, are affected by financial incentives, or predict positive outcomes in the context of incentive-based health interventions.

Ann Allergy Asthma Immunol

A behavioral economics intervention to encourage epinephrine- carrying among food-allergic adults: a randomized controlled trial

Sep 2015
Carolyn C. Cannuscio, ScD, Roxanne Dupuis, MSPH, Amy Graves, BA, Jane W. Seymour, MPH, Sarah Kounaves, MSc, Emily Strupp, BA, Damien Leri, MSEd, Rosemary Frasso, PhD, David Grande, MD, Zachary F. Meisel, MD

Adolescents and young adults with food allergies are at increased risk of adverse events, including death from anaphylaxis. Epinephrine is the cornerstone of emergency response, yet few individuals with serious food allergies consistently carry their emergency medication. A mixed-methods randomized controlled trial in young adults with food allergies investigated the carrying of epinephrine auto-injectors using financial incentives plus text message reminders vs text message reminders alone. Epinephrine carriage was assessed 10 times during the 49-day intervention using rapid-reply cell phone photographs plus daily code words. Although the intervention and control groups reported favorable impressions of text message-based reminder systems, the intervention group performed significantly better than the control group on a photograph-based measurement of epinephrine carriage.

Sleep

Web-Based Access to Positive Airway Pressure Usage with or without an Initial Financial Incentive Improves Treatment Use in Patients with Obstructive Sleep Apnea

Aug 2015
Samuel T. Kuna, MD; David Shuttleworth Luqi Chi, MD; Sharon Schutte-Rodin, MD; Eliot Friedman, MD; Hengyi Guo; Sandeep Dhand, MD; Lin Yang, MS; Jingsan Zhu, MS, MBA; Scarlett L. Bellamy, ScD; Kevin G. Volpp, MD, PhD; David A. Asch, MD, MBA

Positive airway pressure adherence is significantly improved by giving patients Web access to information about their use of the treatment. Inclusion of a financial incentive in the first week had no additive effect in improving adherence.

Am J Health Promot.

The role of behavioral economic incentive design and demographic characteristics in financial incentive-based approaches to changing health behaviors: a meta-analysis.

Jun 2015
Haff N, Patel MS, Lim R, Zhu J, Troxel AB, Asch DA, Volpp KG.

Financial incentives designed using concepts from behavioral economics were effective for promoting health behavior change. There were no large and consistent relationships between the effectiveness of financial incentives and observable demographic characteristics. Second-order examinations of incentive structure suggest potential relationships among the effectiveness of financial incentives, incentive structure, and the demographic characteristics of race and income.

N Engl J Med

Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation

May 2015
Scott D. Halpern, M.D., Ph.D., Benjamin French, Ph.D., Dylan S. Small, Ph.D., Kathryn Saulsgiver, Ph.D., Michael O. Harhay, M.P.H., Janet Audrain-McGovern, Ph.D., George Loewenstein, Ph.D., Troyen A. Brennan, M.D., J.D., David A. Asch, M.D., M.B.A., and Kevin G. Volpp, M.D., Ph.D.

Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented programs

Am J Health Promot

The Role of Behavioral Economic Incentive Design and Demographic Characteristics in Financial Incentive-Based Approaches to Changing Health Behaviors: A Meta-Analysis

May 2015
Haff N, Patel MS, Lim R, Zhu J, Troxel AB, Asch DA, Volpp KG.

Evaluate the use of behavioral economics to design financial incentives to promote health behavior change and to explore associations with demographic characteristics

JAMA

Accuracy of Smartphone Applications and Wearable Devices for Tracking Physical Activity Data

Feb 2015
Meredith A. Case, BA; Holland A. Burwick; Kevin G. Volpp, MD, PhD; Mitesh S. Patel, MD, MBA, MS

The objective of this study was to evaluate the accuracy of smartphone applications and wearable devices compared with direct observation of step counts, a metric successfully used in interventions to improve clinical outcomes.

JAMA

Accuracy of Smartphone Applications and Wearable Devices for Tracking Physical Activity Data

Feb 2015
Meredith A. Case, BA; Holland A. Burwick; Kevin G. Volpp, MD, PhD; Mitesh S. Patel, MD, MBA, MS

Many smartphone applications and wearable devices were accurate for tracking step counts. Data from smartphones were only slightly different than observed step counts, but could be higher or lower. Wearable devices differed more and 1 device reported step counts more than 20% lower than observed. Step counts are often used to derive other measures of physical activity, such as distance or calories burned. Underlying differences in device accuracy may be compounded in these measures.

JAMA

Wearable Devices as Facilitators, Not Drivers, of Health Behavior Change

Feb 2015
Mitesh S. Patel, MD, MBA, MS; David A. Asch, MD, MBA; Kevin G. Volpp, MD, PhD

The notion is that by recording and reporting information about behaviors such as physical activity or sleep patterns, these devices can educate and motivate individuals toward better habits and better health. The gap between recording information and changing behavior is substantial, however, and while these devices are increasing in popularity, little evidence suggests that they are bridging that gap.

Health Educ Behav.

A Mixed Methods Randomized Controlled Trial of Financial Incentives and Peer Networks to Promote Walking among Older Adults

Oct 2014
Jeffrey T. Kullgren, MD, MS, MPH, Kristin A. Harkins, BA,d Scarlett L. Bellamy, ScD, Amy Gonzales, PhD, Yuanyuan Tao, MS, Jingsan Zhu, MS, MBA, Kevin G. Volpp, MD, PhD, David A. Asch, MD, MBA, Michele Heisler, MD, MPA, and Jason Karlawish, MD

Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more.

J Gen Intern Med

Financial Incentives for Home-Based Health Monitoring: A Randomized Controlled Trial

Feb 2014
Aditi P. Sen, Taylor B. Sewell, E. Brooks Riley, Beth Stearman, Scarlett L. Bellamy, Michelle F. Hu, Yuanyuan Tao, Jingsan Zhu, James D. Park, George Loewenstein, David A. Asch, Kevin G. Volpp

Home wireless device monitoring could play an important role in improving the health of patients with poorly controlled chronic diseases, but daily engagement rates among these patients may be low.

Ann Intern Med

Individual vs. Group-Based Incentives for Weight Loss: A Randomized, Controlled Trial

Apr 2013
Jeffrey T. Kullgren, MD, MS, MPH, Andrea B. Troxel, ScD, George Loewenstein, PhD, David A. Asch, MD, MBA, Laurie A. Norton, MA, Lisa Wesby, MS, Yuanyuan Tao, MS, Jingsan Zhu, MS, MBA, and Kevin G. Volpp, MD, PhD

Test the effectiveness of two financial incentive designs for promoting weight loss among obese employees

Am J Health Promot.

Effectiveness of Financial Incentives for Longer-Term Smoking Cessation: Evidence of Absence or Absence of Evidence?

Apr 2012
Andrea B. Troxel, ScD and Kevin G. Volpp, MD, PhD

This study highlights that in the context of smoking cessation we have much to learn about the effectiveness of incentives; what is clear is that the current literature provides inadequate evidence to make a determination. More adequately powered studies that test variations in incentive design, magnitude, and payment schedule are needed to determine the effectiveness of this approach in increasing the rate of smoking cessation.

Ann Intern Med

Peer Mentoring and Financial Incentives to Improve Glucose Control in African American Veterans: A Randomized, Controlled Trial

Mar 2012
Judith A. Long, MD, Erica C. Jahnle, BA, Diane M. Richardson, PhD, George Loewenstein, PhD, and Kevin G. Volpp, MD, PhD

Compared to whites, African Americans have a greater incidence of diabetes, decreased control, and higher rates of micro-vascular complications. A peer mentorship model could be a scalable approach to improving control in this population and reducing disparities in diabetic outcomes.

Ann Intern Med.

Peer Mentoring and Financial Incentives to Improve Glucose Control in African American Veterans: A Randomized, Controlled Trial

Mar 2012
Judith A. Long, MD, Erica C. Jahnle, BA, Diane M. Richardson, PhD, George Loewenstein, PhD, and Kevin G. Volpp, MD, PhD

The objective of this study was to determine whether peer mentors or financial incentives are superior to usual care in helping African American Veterans improve their glycosylated hemoglobin (HbA1c) levels which was validated.

NEJM

A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation

Feb 2009
Kevin G. Volpp, M.D., Ph.D., Andrea B. Troxel, Sc.D., Mark V. Pauly, Ph.D., Henry A. Glick, Ph.D., Andrea Puig, B.A., David A. Asch, M.D., M.B.A., Robert Galvin, M.D., M.B.A., Jingsan Zhu, M.B.A., Fei Wan, M.S., Jill DeGuzman, B.S., Elizabeth Corbett, M.L.S., Janet Weiner, M.P.H., and Janet Audrain-McGovern, Ph.D.

In this study of employees of one large company, financial incentives for smoking cessation significantly increased the rates of smoking cessation.

BMC Hlth Srv Res

A test of financial incentives to improve warfarin adherence

Mar 2008
Kevin G Volpp, George Loewenstein, Andrea B Troxel, Jalpa Doshi, Maureen Price, Mitchell Laskin and Stephen E Kimmel

A daily lottery-based financial incentive demonstrated the potential for significant improvements in missed doses of warfarin and time out of INR range.