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

Abstract

To overcome self-control difficulties, people can commit to their health goals by voluntarily accepting deadlines with consequences. In a commitment lottery, the winners are drawn from all participants, but can only claim their prize if they also attained their gym-attendance goals. In a 52-week, three-arm trial across six company gyms, we tested if commitment lotteries with behavioral economic underpinnings would promote physical activity among overweight adults. In previous work, we presented an effective 26-week intervention. In the present paper we analyzed maintenance of goal attainment at 52-week follow-up and the development of weight over time. We compared weight and goal attainment (gym attendance ≥ 2 per week) between three arms that—in the intervention period- consisted of (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 lottery-deadlines. After a successful 26-week intervention, goal attainment declined between weeks 27 and 52 in the long-term lottery arm, but remained higher than in the control group. Goal attainment did not differ between the short-term lottery arm and control arm. Weight declined slightly in all arms in the first 13 weeks of the trial and remained stable from there on. Commitment lotteries can support regular gym attendance up to 52 weeks, but more research is needed to achieve higher levels of maintenance and weight loss.

Health Promotion through Monetary Incentives: Evaluating the Impact of Different Reinforcement Schedules on Engagement Levels with a mHealth App

“…From this study, it is found that (variable) monetary incentives can foster health behavior, which is in line with findings from earlier studies [7,8,10,11,13]. However, as opposed to findings from Berardi and colleagues [13], no single reinforcement schedule was found to have a more profound impact on app engagement or the adoption of health behaviors in our study: In our study, every reinforcement schedule we evaluated had a similar impact on user engagement levels.…”

“…For example, a study (N = 1299) even found that, to promote the completion of a health risk assessment, it is more effective to distribute financial incentives through a lottery (i.e., prize value of USD 100, with an expected value of USD 25), than to pay end users a fixed fee of USD 25 for completing the assessment [10]. Furthermore, it was found that financial rewards (i.e., EUR 100, or a voucher for a luxury family-vacation) distributed through lotteries are especially promising to increase physical activity levels and gym attendance in overweight adults (N = 163) [11]. Nevertheless, the relationship between different reinforcement schedules and their implications for the overall mHealth campaign costs remain unclear.…”

Goalkeeper: A Zero-Sum Exergame for Motivating Physical Activity

“…A special category of financial exergames are those that employ deposit contracts. To boost one's self-discipline, one may commit to goals by voluntarily accepting deadlines with consequences [57]. Deposit contracts are pre-commitment strategies that force one's future self to certain behaviors [60].…”

Lottery incentives for smoking cessation at the workplace: design and protocol of the smoke-free lottery - a cluster randomized trial

“…A promising design used by behavioral economists and medical professionals is the use of regret lotteries , which have been demonstrated to support weight loss [ 27 ], medication adherence [ 28 ] and physical activity [ 29 , 30 ] at relatively low costs [ 31 ] across differing populations [ 32 ]. By their design, the lotteries aim to tap into multiple psychological insights on decision-making, with the goal to gain as much health out of every euro spent.…”