Mitesh S Patel1, Kevin G Volpp2, Roy Rosin3, Scarlett L Bellamy4, Dylan S Small5, Michele A Fletcher6, Rosemary Osman-Koss6, Jennifer L Brady6, Nancy Haff7, Samantha M Lee8, Lisa Wesby9, Karen Hoffer9, David Shuttleworth9, Devon H Taylor9, Victoria Hilbert9, Jingsan Zhu9, Lin Yang4, Xingmei Wang4, David A Asch2. 1. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Wharton School, University of Pennsylvania, Philadelphia, PA, USA LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA Center for Health Equity Research and Promotion, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA mpatel@upenn.edu. 2. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Wharton School, University of Pennsylvania, Philadelphia, PA, USA LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA Center for Health Equity Research and Promotion, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA. 3. Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA. 4. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 5. Wharton School, University of Pennsylvania, Philadelphia, PA, USA. 6. University of Pennsylvania Health System, University of Pennsylvania, Philadelphia, PA, USA. 7. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. 8. Department of Medicine, Columbia University Medical Center, New York, NY, USA. 9. LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
Abstract
PURPOSE: To compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity. DESIGN: Randomized trial (Clinicaltrials.gov number, NCT02030080). SETTING: Philadelphia, Pennsylvania. PARTICIPANTS: Two hundred eighty-six adults. INTERVENTIONS: Twenty-six weeks of weekly feedback on team performance compared to the 50th percentile (n = 100) or the 75th percentile (n = 64) and 13 weeks of weekly lottery-based financial incentive plus feedback on team performance compared to the 50th percentile (n = 80) or the 75th percentile (n = 44) followed by 13 weeks of only performance feedback. MEASURES: Mean proportion of participant-days achieving the 7000-step goal during the 13-week intervention. ANALYSIS: Generalized linear mixed models adjusting for repeated measures and clustering by team. RESULTS: Compared to the 75th percentile without incentives during the intervention period, the mean proportion achieving the 7000-step goal was significantly greater for the 50th percentile with incentives group (0.45 vs 0.27, difference: 0.18, 95% confidence interval [CI]: 0.04 to 0.32; P = .012) but not for the 75th percentile with incentives group (0.38 vs 0.27, difference: 0.11, 95% CI: -0.05 to 0.27; P = .19) or the 50th percentile without incentives group (0.30 vs 0.27, difference: 0.03, 95% CI: -0.10 to 0.16; P = .67). CONCLUSION: Social comparison to the 50th percentile with financial incentives was most effective for increasing physical activity.
RCT Entities:
PURPOSE: To compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity. DESIGN: Randomized trial (Clinicaltrials.gov number, NCT02030080). SETTING: Philadelphia, Pennsylvania. PARTICIPANTS: Two hundred eighty-six adults. INTERVENTIONS: Twenty-six weeks of weekly feedback on team performance compared to the 50th percentile (n = 100) or the 75th percentile (n = 64) and 13 weeks of weekly lottery-based financial incentive plus feedback on team performance compared to the 50th percentile (n = 80) or the 75th percentile (n = 44) followed by 13 weeks of only performance feedback. MEASURES: Mean proportion of participant-days achieving the 7000-step goal during the 13-week intervention. ANALYSIS: Generalized linear mixed models adjusting for repeated measures and clustering by team. RESULTS: Compared to the 75th percentile without incentives during the intervention period, the mean proportion achieving the 7000-step goal was significantly greater for the 50th percentile with incentives group (0.45 vs 0.27, difference: 0.18, 95% confidence interval [CI]: 0.04 to 0.32; P = .012) but not for the 75th percentile with incentives group (0.38 vs 0.27, difference: 0.11, 95% CI: -0.05 to 0.27; P = .19) or the 50th percentile without incentives group (0.30 vs 0.27, difference: 0.03, 95% CI: -0.10 to 0.16; P = .67). CONCLUSION: Social comparison to the 50th percentile with financial incentives was most effective for increasing physical activity.
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