Financial Incentives for Exercise Adherence in Adults

Mitchell, Marc; Goodman, Jack M.; Alter, David A.; John, Leslie K.; Oh, Paul; Pakosh, Maureen; Faulkner, Guy

doi:10.1016/j.amepre.2013.06.017

Cited by 239 publications

(235 citation statements)

References 33 publications

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“…First, a key element of our study design was the use of loss aversion, a principle from behavioral economics 13, 17, 18, 19, 28, 29, 30, 31, 32, 33, 34. Most previous financial incentive‐based physical activity interventions have used gain‐framed incentives16, 39, 40, 41—individuals earn a reward after the behavior is achieved. However, our previous work among overweight and obese individuals found that loss‐framed incentives were more effective than gain‐framed incentives 18.…”

Section: Discussionmentioning

confidence: 99%

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

Chokshi

Adusumalli

Small

et al. 2018

JAHA

124

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BackgroundRegular physical activity reduces the risk of cardiovascular events, but most ischemic heart disease (IHD) patients do not obtain enough.Methods and ResultsACTIVE REWARD (A Clinical Trial Investigating Effects of a Randomized Evaluation of Wearable Activity Trackers with Financial Rewards) 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. Patients in the incentive arm received personalized step goals and daily feedback for all 24 weeks. In the ramp‐up incentive phase, daily step goals increased weekly by 15% from baseline with a maximum of 10 000 steps and then remained fixed. Each week, $14 was allocated to a virtual account; $2 could be lost per day for not achieving step goals. The primary outcome was change in mean daily steps from baseline to the maintenance incentive phase. Ischemic heart disease patients had a mean (SD) age of 60 (11) years and 70% were male. Compared with control, patients in the incentive arm had a significantly greater increase in mean daily steps from baseline during ramp‐up (1388 versus 385; adjusted difference, 1061 [95% confidence interval, 386–1736]; P<0.01), maintenance (1501 versus 264; adjusted difference, 1368 [95% confidence interval, 571–2164]; P<0.001), and follow‐up (1066 versus 92; adjusted difference, 1154 [95% confidence interval, 282–2027]; P<0.01).ConclusionsLoss‐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.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02531022.

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Section: Discussionmentioning

confidence: 99%

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

Chokshi

Adusumalli

Small

et al. 2018

JAHA

124

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“…[16][17][18] The evaluation of financial incentives for promoting physical activity has been limited, and many of the prior studies utilize designs that are based on standard economic theory, which generally assumes individuals act rationally. 19,20 Insights from behavioral economics reveal that the design and the delivery of incentives have an important influence on their effectiveness. 21,22 Evidence also suggests that behavioral change programs may be more effective when individuals participate together, 23,24 and when they are more socially connected.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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BACKGROUND: More than half of adults in the United States do not attain the minimum recommended level of physical activity to achieve health benefits. The optimal design of financial incentives to promote physical activity is unknown. OBJECTIVE: To compare the effectiveness of individual versus team-based financial incentives to increase physical activity. DESIGN: Randomized, controlled trial comparing three interventions to control. PARTICIPANTS: Three hundred and four adult employees from an organization in Philadelphia formed 76 four-member teams. INTERVENTIONS: All participants received daily feedback on performance towards achieving a daily 7000 step goal during the intervention (weeks 1-13) and follow-up (weeks 14-26) periods. The control arm received no other intervention. In the three financial incentive arms, drawings were held in which one team was selected as the winner every other day during the 13-week intervention. A participant on a winning team was eligible as follows: $50 if he or she met the goal (individual incentive), $50 only if all four team members met the goal (team incentive), or $20 if he or she met the goal individually and $10 more for each of three teammates that also met the goal (combined incentive). MAIN MEASURES: Mean proportion of participantdays achieving the 7000 step goal during the intervention. KEY RESULTS: Compared to the control group during the intervention period, the mean proportion achieving the 7000 step goal was significantly greater for the com- There were no significant differences between arms during the follow-up period (weeks 14-26). CONCLUSIONS: Financial incentives rewarded for a combination of individual and team performance were most effective for increasing physical activity. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT02001194.

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“…Increasingly, private insurance companies, recognizing the cost savings to be accrued from increased engagement in regular exercise [28][29][30], offer their members a variety of incentives to engage in exercise, such as reimbursement for gym memberships, cash rebates for selecting healthy food at the grocery store, and reduced premiums for people who engage in regular exercise [31,32]. The top 10 health insurance companies as ranked by US News and World Report all offer their members incentives for engagement in exercise [33].…”

Section: Exercise Can Reduce the Public Health Burden Of Serious Mentmentioning

confidence: 99%

Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine

Pratt

Jerome

Schneider

et al. 2016

Behav. Med. Pract. Policy Res.

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Financial Incentives for Exercise Adherence in Adults

Cited by 239 publications

References 33 publications

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

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

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

Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine

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