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

Opportunity

Physical activity is associated with many health benefits including reduced rates of cardiovascular disease, diabetes, hypertension, and obesity.  However, more than 50% of adults in the United States don't achieve enough regular physical activity to obtain such benefits. More than 85% 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.

Approach

We designed a 6-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 with the same expected value, but framed in different ways.

Impact

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 and relative to the control group, increased physical activity goal achievement by 50%. 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. 

Collaborators

Human Resources Department, University of Pennsylvania

Funding

National Institute on Aging (NIA), NIH

Related Videos

‘Should we pay to improve health behaviours?’

Professor Katy Milkman of the University of Pennsylvania, Dr. Marc Mitchell of Western University, Dr. Mitesh Patel of the Penn Medicine Nudge Unit, and Kieron Boyle of Guy’s and St. Thomas’ Charity discuss incentives at BX2019.

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