Losing money great motivator to exercise

February 16, 2016

Financial incentives aimed at increasing physical activity were most effective when the rewards were put at risk of being lost, according to new research from the Perelman School of Medicine at the University of Pennsylvania.

By providing incentives of equal amounts, the team sought to determine which program design was most effective at motivating participants to increase physical activity and achieve the goal of 7,000 steps per day – roughly 40 percent higher than the average daily step count among U.S. adults (5,000). Progress was tracked using a mobile app which ran in the background on participants’ smartphones.

Results from the first 13 weeks of the study show that offering a reward each time the goal is achieved, or when daily lotteries were offered, were no more effective than not offering a reward at all. In those groups, participants achieved the daily goal approximately 30 to 35 percent of the time. However, participants who risked losing the reward they’d already been given achieved the goal 45 percent of the time, amounting to an almost 50 percent increase over the control group. According to the authors, these findings suggest that the way in which a financial incentive is framed is important in determining its success.

Senior author Kevin G. Volpp, MD, PhD, a professor of Medicine and Health Care Management and director of the Penn Center for Health Incentives and Behavioral Economics said “Our findings demonstrate that the potential of losing a reward is a more powerful motivator and adds important knowledge to our understanding of how to use financial incentives to encourage employee participation in wellness programs.”

The authors noted that 96 percent of participants were still actively enrolled in the study even three months after stopping incentives, which may have important implications for the role that smartphones could play in deploying these programs at broader scale.

“Our findings reveal how wearable devices and apps can play a role in motivating people to increase physical activity, but what really makes the difference is how you design the incentive strategy around those apps,” said David A. Asch, MD, MBA, a professor of Medicine and Health Care Management and director of the Penn Center for Health Care Innovation.

The authors say future studies might compare the effectiveness of incentives when combined with other motivators such as team-based designs that rely on peer support and accountability, or designs aimed at determining a more effective reward amount.

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