Jeffrey T Kullgren1, Andrea B Troxel2, George Loewenstein3, Laurie A Norton4, Dana Gatto4, Yuanyuan Tao4, Jingsan Zhu4, Heather Schofield5, Judy A Shea4, David A Asch6, Thomas Pellathy7, Jay Driggers8, Kevin G Volpp6. 1. VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA jkullgre@med.umich.edu. 2. Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Penn CMU Roybal P30 Center on Behavioral Economics and Health, Philadelphia, PA, USA Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 3. Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Penn CMU Roybal P30 Center on Behavioral Economics and Health, Philadelphia, PA, USA Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA, USA. 4. Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Penn CMU Roybal P30 Center on Behavioral Economics and Health, Philadelphia, PA, USA Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 5. The Center for Global Development, University of Pennsylvania, Philadelphia, PA, USA. 6. Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Penn CMU Roybal P30 Center on Behavioral Economics and Health, Philadelphia, PA, USA Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Center for Health Equity Research & Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA Department of Health Care Management, the Wharton School, University of Pennsylvania, Philadelphia, PA, USA. 7. McKinsey & Company, Pittsburgh, PA, USA. 8. Horizon Healthcare Innovations, Newark, NJ, USA.
Abstract
PURPOSE: To test whether employer matching of employees' monetary contributions increases employees' (1) participation in deposit contracts to promote weight loss and (2) weight loss. DESIGN: A 36-week randomized trial. SETTING: Large employer in the northeast United States. PARTICIPANTS: One hundred thirty-two obese employees. INTERVENTIONS: Over 24 weeks, participants were asked to lose 24 pounds and randomized to monthly weigh-ins or daily weigh-ins with monthly opportunities to deposit $1 to $3 per day that was not matched, matched 1:1, or matched 2:1. Deposits and matched funds were returned to participants for each day they were below their goal weight. MEASURES: Rates of making ≥1 deposit, weight loss at 24 weeks (primary outcome), and 36 weeks. ANALYSIS: Deposit rates were compared using χ(2) tests. Weight loss was compared using t tests. RESULTS: Among participants eligible to make deposits, 29% made ≥1 deposit and matching did not increase participation. At 24 weeks, control participants gained an average of 1.0 pound, whereas 1:1 match participants lost an average of 5.3 pounds (P = .005). After 36 weeks, control participants gained an average of 2.1 pounds, whereas no match participants lost an average of 5.1 pounds (P = .008). CONCLUSION: 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.
RCT Entities:
PURPOSE: To test whether employer matching of employees' monetary contributions increases employees' (1) participation in deposit contracts to promote weight loss and (2) weight loss. DESIGN: A 36-week randomized trial. SETTING: Large employer in the northeast United States. PARTICIPANTS: One hundred thirty-two obese employees. INTERVENTIONS: Over 24 weeks, participants were asked to lose 24 pounds and randomized to monthly weigh-ins or daily weigh-ins with monthly opportunities to deposit $1 to $3 per day that was not matched, matched 1:1, or matched 2:1. Deposits and matched funds were returned to participants for each day they were below their goal weight. MEASURES: Rates of making ≥1 deposit, weight loss at 24 weeks (primary outcome), and 36 weeks. ANALYSIS: Deposit rates were compared using χ(2) tests. Weight loss was compared using t tests. RESULTS: Among participants eligible to make deposits, 29% made ≥1 deposit and matching did not increase participation. At 24 weeks, control participants gained an average of 1.0 pound, whereas 1:1 match participants lost an average of 5.3 pounds (P = .005). After 36 weeks, control participants gained an average of 2.1 pounds, whereas no match participants lost an average of 5.1 pounds (P = .008). CONCLUSION: 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.
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