Mitesh S Patel1,2,3,4,5, Kevin G Volpp1,2,3,4,5, Roy Rosin4, Scarlett L Bellamy6, Dylan S Small2, Jack Heuer7, Susan Sproat7, Chris Hyson7, Nancy Haff8, Samantha M Lee9, Lisa Wesby3, Karen Hoffer3, David Shuttleworth3, Devon H Taylor3, Victoria Hilbert3, Jingsan Zhu3, Lin Yang1, Xingmei Wang1, David A Asch1,2,3,5. 1. 1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 2. 2 Wharton School, University of Pennsylvania, Philadelphia, PA, USA. 3. 3 LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA. 4. 4 The Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. 5. 5 Center for Health Equity Research and Promotion, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA. 6. 6 The Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA. 7. 7 Division of Human Resources, University of Pennsylvania, Philadelphia, PA, USA. 8. 8 Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. 9. 9 Department of Medicine, Columbia University Medical Center, New York, NY, USA.
Abstract
PURPOSE: To evaluate the effect of lottery-based financial incentives in increasing physical activity. DESIGN: Randomized, controlled trial. SETTING: University of Pennsylvania Employees. PARTICIPANTS: A total of 209 adults with body mass index ≥27. INTERVENTIONS: All participants used smartphones to track activity, were given a goal of 7000 steps per day, and received daily feedback on performance for 26 weeks. Participants randomly assigned to 1 of the 3 intervention arms received a financial incentive for 13 weeks and then were followed for 13 weeks without incentives. Daily lottery incentives were designed as a "higher frequency, smaller reward" (1 in 4 chance of winning $5), "jackpot" (1 in 400 chance of winning $500), or "combined lottery" (18% chance of $5 and 1% chance of $50). MEASURES: Mean proportion of participant days step goals were achieved. ANALYSIS: Multivariate regression. RESULTS: During the intervention, the unadjusted mean proportion of participant days that goal was achieved was 0.26 in the control arm, 0.32 in the higher frequency, smaller reward lottery arm, 0.29 in the jackpot arm, and 0.38 in the combined lottery arm. In adjusted models, only the combined lottery arm was significantly greater than control ( P = .01). The jackpot arm had a significant decline of 0.13 ( P < .001) compared to control. There were no significant differences during follow-up. CONCLUSIONS: Combined lottery incentives were most effective in increasing physical activity.
RCT Entities:
PURPOSE: To evaluate the effect of lottery-based financial incentives in increasing physical activity. DESIGN: Randomized, controlled trial. SETTING: University of Pennsylvania Employees. PARTICIPANTS: A total of 209 adults with body mass index ≥27. INTERVENTIONS: All participants used smartphones to track activity, were given a goal of 7000 steps per day, and received daily feedback on performance for 26 weeks. Participants randomly assigned to 1 of the 3 intervention arms received a financial incentive for 13 weeks and then were followed for 13 weeks without incentives. Daily lottery incentives were designed as a "higher frequency, smaller reward" (1 in 4 chance of winning $5), "jackpot" (1 in 400 chance of winning $500), or "combined lottery" (18% chance of $5 and 1% chance of $50). MEASURES: Mean proportion of participant days step goals were achieved. ANALYSIS: Multivariate regression. RESULTS: During the intervention, the unadjusted mean proportion of participant days that goal was achieved was 0.26 in the control arm, 0.32 in the higher frequency, smaller reward lottery arm, 0.29 in the jackpot arm, and 0.38 in the combined lottery arm. In adjusted models, only the combined lottery arm was significantly greater than control ( P = .01). The jackpot arm had a significant decline of 0.13 ( P < .001) compared to control. There were no significant differences during follow-up. CONCLUSIONS: Combined lottery incentives were most effective in increasing physical activity.
Authors: Mitesh S Patel; Dylan S Small; Joseph D Harrison; Victoria Hilbert; Michael P Fortunato; Ai Leen Oon; Charles A L Rareshide; Kevin G Volpp Journal: JAMA Netw Open Date: 2021-05-03
Authors: Anne N Thorndike; Jessica L McCurley; Emily D Gelsomin; Emma Anderson; Yuchiao Chang; Bianca Porneala; Charles Johnson; Eric B Rimm; Douglas E Levy Journal: JAMA Netw Open Date: 2021-06-01
Authors: Justin S White; Francisco Ramos-Gomez; Jenny X Liu; Bonnie Jue; Tracy L Finlayson; Jeremiah R Garza; Alexandra H Crawford; Sarit Helman; William Santo; Jing Cheng; James G Kahn; Stuart A Gansky Journal: PLoS One Date: 2020-07-30 Impact factor: 3.752