Incentives for Preventative Health Care: Increasing Completion of Health Risk Assessments

Carnegie Mellon University

Status: Completed

Conditions: Prevention

Treatments: Behavioral: Regret Lottery; Behavioral: Direct Payment

Study type: Interventional

Funder types: Other

Identifiers

NCT00891111

CMUHS08613

Details and patient eligibility

About

The purpose of this study is to understand using incentives to encourage employees to increase participation in an aspect of a corporate wellness program - filling out health risk assessments. This study will test whether lottery-linked incentives are more effective than guaranteed incentives in encouraging people to fill out health risk assessments.

This study will be run in an employer setting in which rates of health risk assessment completion are suboptimal. This study would be conducted within a workplace setting in which the firm is divided into a number of geographically situated and functionally related subunits. The investigators will run a "complete your health risk assessment now!" program for 4 weeks. Each work unit will obtain a symbol. Every week, one symbol will be randomly drawn, publicly announced, and anyone in that work unit at the firm who has received their preventive screening would receive a $100 prize. In addition, if all of employees in that unit have completed their forms, then the prize will be increased to $125.

The investigators expect this condition to result in greater compliance compared to a control condition in which employees would receive weekly reminders and a direct payment of a $25 gift card for completing the form at anytime during the 4 weeks of the study. This is analogous to direct payments that have been used by insurers to encourage completion of such forms in other contexts.

Full description

The purpose of this study is to apply concepts from behavioral economics to increase the effectiveness of incentives for preventative health care.

Health risk assessments are an important part of preventative healthcare. Employees fill out these forms and are given feedback about their health risks and steps they can take to improve their health. This study will be run in an employer setting in which rates of health risk assessment completion are suboptimal. This study would be conducted within a workplace setting in which the firm is divided into a number of geographically situated and functionally related subunits. We will run a "complete your health risk assessment now!" program for 4 weeks. Each work unit will obtain a symbol. Every week, one symbol will be randomly drawn, publicly announced, and anyone in that work unit at the firm who has received their preventive screening would receive a $100 prize. In addition, if all of employees in that unit have completed their forms, then the prize will be increased to $125.

This program plays on a number of psychological factors: 1) avoidance of regret, which one will experience if the number/symbol of the unit one is a member of is drawn and one does not win a prize because one is not participating in the wellness program 2) amplification of such regret by social means - because other people around you who are participating will receive cash prizes 3) mild social pressure, because high enrollments will yield benefits for all participants.

Enrollment: 634 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Full time employees

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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634 participants in 2 patient groups

Direct Payment

Experimental group

Description:

Direct Payment: Employees receive a $25 gift card upon completion of a Health Risk Assessment

Treatment:

Behavioral: Direct Payment

Regret Lottery

Experimental group

Description:

Regret Lottery: Employees are divided into work units of about 5 employees. Employees in the lottery-linked incentive condition will be eligible for a weekly lottery drawing only if they have already completed their health risk assessment. The lotteries will work as follows. Participants will be assigned to work units of about 10 people. Each week, one work group is drawn at random. If a participants group was drawn and that participant already completed the health risk assessment, then that person will win a $100 cash prize. If all of the members of his or her work group also filled out the health risk assessment, then the prize will be boosted.

Treatment:

Behavioral: Regret Lottery