Social comparisons and financial incentives to increase physical activity

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. Many wellness programs and mobile apps use leaderboards to compare progress across individuals and groups of people, but the best way to design these comparisons is unknown. Moreover, the impact of financial incentives with social comparisons has not been well evaluated.

Approach

We designed a 6-month randomized controlled trial to test different ways of combining social comparison feedback with financial incentives to increase physical activity. We partnered with the University of Pennsylvania Health System, enrolling 286 employees. All participants used their smartphones to track activity and formed teams of four persons.  Each team was randomly assigned to one of four arms.  Teams received social comparisons to the 50th percentile (normative feedback) or the 75th percentile (top performers or leaderboard type feedback), and did or did not receive financial incentives.

Impact

Framing social comparisons to the 50th percentile (normative feedback) with financial incentives was the most effective intervention.  Participants who received feedback compared to the 75th percentile without incentives had the lowest level of physical activity. These findings indicate the way comparison feedback is framed can significantly influence how it impacts individual and team behavior. This study was awarded “Paper of the Year” by the American Journal of Health Promotion.

Collaborators 

Human Resources Department, University of Pennsylvania Health System 

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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