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. Many of these programs use team-based approaches, but 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 leveraging individual vs. team-based financial incentives to increase physical activity. We partnered with Independence Blue Cross, enrolling 304 employees. All participants used their smartphones to track activity and formed teams of four. Each team was randomly assigned to a control group or one of three financial incentives with rewards contingent on the performance of the individual, team, or both.
The combined incentive, in which rewards were based partially on individual performance and partially on team performance, was the most effective. Compared to the control group, it nearly doubled physical activity goal achievement. Incentive rewards based on the performance of the individual alone or the entire team did not produce results different from the control.
Independence Blue Cross