Commitment Lotteries Promote Physical Activity Among Overweight Adults—A Cluster Randomized Trial

Abstract

Background The World Health Organization has identified physical inactivity as the fourth leading risk factor for global mortality. People often intend to engage in physical activity on a regular basis, but have trouble doing so. To realize their health goals, people can voluntarily accept deadlines with consequences that restrict undesired future behaviors (i.e., commitment devices).Purpose We examined if lottery-based deadlines that leverage regret aversion would help overweight individuals in attaining their goal of attending their gym twice per week. At each deadline a lottery winner was drawn from all participants. The winners were only eligible for their prize if they attained their gym-attendance goals. Importantly, nonattending lottery winners were informed about their forgone prize. The promise of this counterfactual feedback was designed to evoke anticipated regret and emphasize the deadlines.Methods Six corporate gyms with a total of 163 overweight participants were randomized to one of three arms. We compared (i) weekly short-term lotteries for 13 weeks; (ii) the same short-term lotteries in combination with an additional long-term lottery after 26 weeks; and (iii) a control arm without lotteries.Results After 13 weeks, participants in the lottery arms attained their attendance goals more often than participants in the control arm. After 26 weeks, we observe a decline in goal attainment in the short-term lottery arm and the highest goal attainment in the long-term lottery arm. ConclusionsWith novel applications, the current research adds to a growing body of research that demonstrates the effectiveness of commitment devices in closing the gap between health goals and behavior. Clinical Trial informationThis trial is registered in the Dutch Trial Register. Identifier: NTR5559

Physical activity after commitment lotteries: examining long-term results in a cluster randomized trial

“…As we presented in previous work (Van der Swaluw et al, 2018 ), in the current sample, 13 weekly lotteries (short-term lottery arm) supported regular gym attendance. After the 13 weekly lotteries, participants in our trial attended their gym considerably less.…”

“…A meta-analysis by Haff et al ( 2015 ) that compared the effectiveness of several commitment lotteries between demographic groups found no gender differences, nor differences in education or broad ranges of income (except a slight reduced effect with incomes > $87.500). In previous analyses, we also observed no differences in intervention-effectiveness between income- or education categories (Van der Swaluw et al, 2018 ). This may be an indication of commitment lotteries being broadly applicable.…”

“…Figure 2 displays percentages of goal attainment per arm per week. Results on goal-attainment in the first 26 weeks of the trial have been presented before (Van der Swaluw et al, 2018 ). Between weeks 27- 52, the aggregated percentage of goal attainment was 24% in the long-term lottery arm and 16 and 15% in the short-term arm and control arm respectively.…”

Feel good now or regret it later? The respective roles of affective attitudes and anticipated affective reactions for explaining health‐promoting and health risk behavioral intentions

“…Experimental work in this area has been increasing in recent years, and evidence has been growing for the utility of targeting both affective attitudes (Carfora, Caso, & Conner, 2017; Conner et al, 2015, 2011; Walsh & Kiviniemi, 2014) and anticipated affective reactions to leverage health promoting behavior engagement (Conner et al, 2016; Dillard, Fagerlin, Dal Cin, Zikmund-Fisher, & Ubel, 2010; Ellis et al, 2018; Kwan, Stevens, & Bryan, 2017; Sandberg & Conner, 2011). For instance, a recent study conducted by van der Swaluw and colleagues (2018) used an innovative “lottery” intervention to attempt to make salient anticipated regret for overweight participants aiming to attend the gym at least twice per week. Specifically, voluntary “lottery deadlines” were imposed such that when the lottery was drawn, only participants who had met their gym attendance goal for the week were eligible to win.…”

One size fits all? Designing financial incentives tailored to individual economic preferences

“…Often, insights from behavioral economics are used to motivate or design the financial incentives used. For example, financial incentives have been used that capitalize on behavioral insights such as loss aversion (e.g., deposit/commitment contracts: Bryan et al, 2010;Giné et al, 2010;Bhattacharya et al, 2015;Volpp et al, 2008) or probability weighting (e.g., lottery incentives: Volpp et al, 2008;Haisley et al, 2012;Kimmel et al, 2012;van der Swaluw et al, 2018). The effectiveness of such financial incentives, which Galizzi (2014) refers to as behaviorally inspired incentives, is hypothesized to be amplified by deviations from traditional rationality.…”