Structuring Financial Incentives to Increase Physical Activity

National University of Singapore

Status: Completed

Conditions: Weight Loss; Physical Activity

Treatments: Behavioral: Financial Incentive

Study type: Interventional

Funder types: Other

Identifiers

NCT03305172

SG-STEP

Details and patient eligibility

About

The purpose of this study is to evaluate the effectiveness of different structures of long term financial incentives on increasing physical activity performed by subjects, as measured by the number of steps walked per day.

Investigators are interested in studying whether physical activity increases during an intervention period (with incentives) and a post-intervention period (with no incentives).

Full description

The proposed study is a field experiment. Adults within the ages of 25 and 60 years of age, and with a body mass index of 22 or higher will be eligible to participate.

The study will consist of (1) a two-week baseline period, (2) a 36-week intervention period, and (3) a 12-week follow-up period.

At the beginning of the study, subjects will be given a wearable fitness device and their daily step count will be monitored for two weeks; this is the baseline period. After the two-week baseline period, the subjects will be randomly assigned to one of the five different conditions (Control, Gain, Loss, Gain Streak, or Loss Streak) and will be given the goal to increase their baseline step counts by 2,500 steps.

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HYPOTHESES -- Investigators expect the following:

1. Loss Aversion: Subjects in the Loss treatment will achieve the goal on a greater number of days than subjects in the Gain treatment.
2. Streak: Subjects in the Gain treatment will achieve the goal on a greater number of days than subjects in the Gain Streak treatment.
3. Loss Streak: Subjects in the Loss treatment will achieve the goal on a greater number of days than subjects in the Loss Streak treatment. Whether subjects in the Loss Streak treatment will perform better or worse than subjects in the other two treatments will be investigated.

CONTRIBUTION -- Prior research has not examined the effect of a long term financial incentive (36 weeks) on individual behavior in achieving a goal. In this study, the investigators also examine two additional financial incentive structures: Gain Streak and Loss Streak. If the hypotheses are correct, the results have important implications for designing financial incentives to encourage good behavior and to encourage good habit formation across domains.

Enrollment: 620 patients

Sex: All

Ages: 25 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Singapore citizens and permanent residents
• Adults with BMI greater than 22
• Ownership of a smartphone or tablet
• Only one member per household can participate in the study

Exclusion criteria

• Women who are pregnant or breast feeding, or who intend to become pregnant over next year

• Subjects who are already participating in another physical activity program or study

• Subjects who are unable to participate for a total of 1 year

• Subjects who are unwilling to wear the fitness device

• Subjects who already walk more than 10,000 steps a day (self-reported per-day-average over seven days)

• Subjects who have any of the following health conditions:

  • high blood pressure
  • high cholesterol
  • heart attack
  • heart failure
  • stroke
  • chronic obstructive pulmonary disease
  • kidney disease
  • diabetes (type 2)

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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620 participants in 5 patient groups

Control

No Intervention group

Description:

Subjects in the Control treatment are not given any financial incentive to achieve the goal.

Gain Treatment

Experimental group

Description:

Financial Incentive: Each subject in the Gain treatment will earn a certain amount of money for each day the goal is achieved. The money earned will be added to a virtual account that the subject has, and will be paid to the subject at the end of the intervention period.

Treatment:

Behavioral: Financial Incentive

Loss Treatment

Experimental group

Description:

Financial Incentive: Each subject in the Loss treatment will be given a certain amount of money in his/her virtual account at the beginning of every week. For each day that the subject does not achieve the goal, a small portion of that money will be deducted from the virtual account. The balance that is left in the virtual account will be paid to the subject at the end of the intervention period.

Treatment:

Behavioral: Financial Incentive

Gain Streak Treatment

Experimental group

Description:

Financial Incentive: Each subject in the Gain Streak treatment get an increasing amount of money added to his/her virtual account for every continuous day that they achieve the goal. The maximum cumulative amount per week is same as in the other treatment conditions. The payment is reset at the beginning of each week, or if the subject misses the goal on any day. The money in the virtual account will be paid to the subject at the end of the intervention period.

Treatment:

Behavioral: Financial Incentive

Loss Streak Treatment

Experimental group

Description:

Financial Incentive: Each subject in the Loss Streak treatment will be given a certain amount of money in his/her virtual account at the beginning of every week. An increasing amount of money will be deducted for each consecutive day the subject does not achieve the goal. The payment is reset at the beginning of each week, or when the subject achieves the goal (i.e., deductions are reset when the streak is broken). The balance that is left in the virtual account will be paid to the subject at the end of the intervention period.

Treatment:

Behavioral: Financial Incentive