Framing financial incentives to increase physical activity among overweight and obese adults


Physical activity is associated with many health benefits, including reduced rates of cardiovascular disease, diabetes, hypertension, and obesity. However, more than 50 percent of adults in the United States don't achieve enough regular physical activity to obtain such benefits. More than 85 percent of large employers use financial incentives for health promotion, including programs to increase physical activity. However, the best way to design incentives to increase physical activity has not been well examined.


We designed a six-month randomized controlled trial to test different ways of framing financial incentives to increase physical activity. We partnered with the Human Resources Department at the University of Pennsylvania to enroll 281 overweight and obese employees. All participants used their smartphones to track activity and were randomly assigned to a control group or one of three financial incentives. Each had the same expected value but was framed differently.


The loss-framed incentive in which money was placed in a virtual account and taken away if goals were not achieved was the most effective. Relative to the control group, physical activity goal achievement increased by 50 percent. The gain-framed incentive, which rewarded participants after goals were achieved was no different than the control arm. The lottery incentive did slightly better than the gain-framed incentive but was not as effective as the loss-framed incentive. 


Human Resources Department, University of Pennsylvania


National Institute on Aging, National Institutes of Health

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