Evaluating the Feasibility, Acceptability, and Effects of Deposit Contracts With and Without Daily Feedback to Promote Physical Activity

in Journal of Physical Activity and Health

Click name to view affiliation

Stephanie G. Kerrigan
Search for other papers by Stephanie G. Kerrigan in
Current site
Google Scholar
PubMed
Close
,
Evan M. Forman
Search for other papers by Evan M. Forman in
Current site
Google Scholar
PubMed
Close
,
Mitesh Patel
Search for other papers by Mitesh Patel in
Current site
Google Scholar
PubMed
Close
,
Dave Williams
Search for other papers by Dave Williams in
Current site
Google Scholar
PubMed
Close
,
Fengqing Zhang
Search for other papers by Fengqing Zhang in
Current site
Google Scholar
PubMed
Close
,
Ross D. Crosby
Search for other papers by Ross D. Crosby in
Current site
Google Scholar
PubMed
Close
, and
Meghan L. Butryn
Search for other papers by Meghan L. Butryn in
Current site
Google Scholar
PubMed
Close
Restricted access

Background: Despite interest in financial incentive programs, evidence regarding the feasibility, acceptability, and effectiveness of deposit contracts (ie, use of participants’ own money as a financial reward) for increasing physical activity (PA) is limited. Furthermore, evidence regarding the use of feedback within incentive programs is limited. Purpose: To evaluate: (1) the feasibility and acceptability of deposit contracts for increasing objectively measured PA and (2) the effects of deposit contracts with or without ongoing feedback on PA. Methods: Participants (n = 24) were exposed to 3 conditions (1) self-monitoring, (2) incentive, and (3) incentive with feedback in an ABACABAC design, with the order of incentive conditions counterbalanced across participants. Results: Effect sizes suggest that individuals had a modest increase in PA during the incentive conditions compared with self-monitoring. Presentation order moderated results, such that individuals exposed to incentives with feedback first performed more poorly across both incentive conditions. In addition, individuals often cited the deposit contract as a reason for not enrolling, and those who did participate reported inadequate acceptability of the incentives and feedback. Conclusions: Results suggest that while deposit contracts may engender modest increases in PA, this type of incentive may not be feasible or acceptable for promoting PA.

Kerrigan is with the Program for Obesity, Weight, and Eating Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT. Forman, Zhang, and Butryn are with the Department of Psychology, Drexel University, Philadelphia, PA. Forman and Butryn are also with WELL Center, Drexel University, Philadelphia, PA. Patel is with the Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; the Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; the Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, PA; and Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA. Williams is with the Departments of Behavioral & Social Sciences and Psychiatry & Human Behavior, Brown School of Public Health, Providence, RI. Crosby is with the Sanford Center for Bio-Behavioral Research, Fargo, ND; and the School of Medicine and Health Sciences, University of North Dakota, Fargo, ND.

Kerrigan (stephanie.kerrigan@yale.edu) is corresponding author.
  • Collapse
  • Expand
  • 1.

    Giles EL, Robalino S, McColl E, Sniehotta FF, Adams J. The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis. PLoS One. 2014;9:e90347. PubMed ID: 24618584 doi:10.1371/journal.pone.0090347

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Patel MS, Asch DA, Roy Rosin M, et al. Framing financial incentives to increase physical activity among overweight and obese adults. Ann Intern Med. 2016;164:385394. PubMed ID: 26881417 doi:10.7326/M15-1635

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Patel MS, Asch DA, Troxel AB, et al. Premium-based financial incentives did not promote workplace weight loss in a 2013–15 study. Health Aff. 2016;35:7179. PubMed ID: 26733703 doi:10.1377/hlthaff.2015.0945

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Tversky A, Kahneman D. Loss aversion in riskless choice: a reference-dependent model. Q J Econ. 1991;106:10391061. doi:10.2307/2937956

  • 5.

    Burns RJ. Can We Pay People to Act Healthily? Testing the Relative Effectiveness of Incentive Dimensions and Underlying Psychological Mediators. Minneapolis, MN: University of Minnesota; 2014.

    • Search Google Scholar
    • Export Citation
  • 6.

    Chokshi NP, Adusumalli S, Small DS, et al. Loss-framed financial incentives and personalized goal setting increase physical activity in ischemic heart disease patients using wearable devices: the ACTIVE REWARD randomized clinical trial. J Am Heart Assoc. 2018;7(12):pii: e009173. doi:10.1161/JAHA.118.009173

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Thorgeirsson T, Kawachi I. Behavioral economics: merging psychology and economics for lifestyle interventions. Am J Prevent Med. 2013;44:185189. doi:10.1016/j.amepre.2012.10.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science. 1981;211:453458. PubMed ID: 7455683 doi:10.1126/science.7455683

  • 9.

    Fitterling JM, Martin JE, Gramling S, Cole P, Milan MA. Behavioral management of exercise training in vascular headache patients: an investigation of exercise adherence and headache activity. J Appl Behav Anal. 1988;21:919. PubMed ID: 3372405 doi:10.1901/jaba.1988.21-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Robison JI, Rogers M, Carlson J, et al. Effects of a 6-month incentive-based exercise program on adherence and work capacity. Med Sci Sports Exerc. 1992;24(1):8593. PubMed ID: 1549001 doi:10.1249/00005768-199201000-00015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Fennell C, Gerhart H, Seo Y, Hauge K, Glickman EL. Combined incentives versus no-incentive exercise programs on objectively measured physical activity and health-related variables. Physiol Behav. 2016;163:245250. PubMed ID: 27211332 doi:10.1016/j.physbeh.2016.05.030

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Giles EL, Sniehotta FF, McColl E, Adams J. Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups. BMC Public Health. 2015;15:58. PubMed ID: 25636330 doi:10.1186/s12889-015-1409-y

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Volpp KG, Galvin R. Reward-based incentives for smoking cessation: how a carrot became a stick. JAMA. 2014;311:909910. PubMed ID: 24493405 doi:10.1001/jama.2014.418

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Adams MA, Hurley JC, Todd M, et al. Adaptive goal setting and financial incentives: a 2 × 2 factorial randomized controlled trial to increase adults’ physical activity. BMC Public Health. 2017;17:286. PubMed ID: 28356097 doi:10.1186/s12889-017-4197-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Adams MA, Sallis JF, Norman GJ, Hovell MF, Hekler EB, Perata E. An adaptive physical activity intervention for overweight adults: a randomized controlled trial. PLoS One. 2013;8:e82901. PubMed ID: 24349392 doi:10.1371/journal.pone.0082901

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Kullgren JT, Harkins KA, Bellamy SL, et al. A mixed-methods randomized controlled trial of financial incentives and peer networks to promote walking among older adults. Health Educ Behav. 2014;41:43S50S. PubMed ID: 25274710 doi:10.1177/1090198114540464

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Patel MS, Asch DA, Rosin R, et al. Individual versus team-based financial incentives to increase physical activity: a randomized, controlled trial. J Gen Int Med. 2016;31:746754. doi:10.1007/s11606-016-3627-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Patel MS, Volpp KG, Rosin R, et al. A randomized, controlled trial of lottery-based financial incentives to increase physical activity among overweight and obese adults. Am J Health Promot. 2018;32(7):15681575. PubMed ID: 29534597 doi:10.1177/0890117118758932

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Losina E, Collins JE, Deshpande BR, et al. Financial incentives and health coaching to improve physical activity following total knee replacement: a randomized controlled trial. Arthritis Care Res. 2018;70(5):732740. doi:10.1002/acr.23324

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Strohacker K, Galárraga O, Emerson J, Fricchione SR, Lohse M, Williams DM. Impact of small monetary incentives on exercise in university students. Am J Health Behav. 2015;39:779786. PubMed ID: 26450545 doi:10.5993/AJHB.39.6.5

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Ashe MC, Winters M, Hoppmann CA, et al. “Not just another walking program”: everyday activity supports you (EASY) model—a randomized pilot study for a parallel randomized controlled trial. Pilot Feas Stud. 2015;1:4. doi:10.1186/2055-5784-1-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Kurti AN, Dallery J. Internet-based contingency management increases walking in sedentary adults. J Appl Behav Anal. 2013;46:568581. PubMed ID: 24114220 doi:10.1002/jaba.58

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Dontje ML, de Groot M, Lengton RR, van der Schans CP, Krijnen WP. Measuring steps with the Fitbit activity tracker: an inter-device reliability study. J Med Eng Technol. 2015:39(5):286290.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Takacs J, Pollock CL, Guenther JR, Bahar M, Napier C, Hunt MA. Validation of the Fitbit One activity monitor device during treadmill walking. J Sci Med Sport. 2014;17:496500. PubMed ID: 24268570 doi:10.1016/j.jsams.2013.10.241

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Cadmus-Bertram L, Marcus BH, Patterson RE, Parker BA, Morey BL. Use of the fitbit to measure adherence to a physical activity intervention among overweight or obese, postmenopausal women: self-monitoring trajectory during 16 weeks. JMIR Mhealth Uhealth. 2015;3:e96. PubMed ID: 26586418 doi:10.2196/mhealth.4229

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Kyllo LB, Landers DM. Goal setting in sport and exercise: a research synthesis to resolve the controversy. J Sport Exerc Psychol. 1995;17:117137. doi:10.1123/jsep.17.2.117

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Jourden FJ. The influence of feedback framing on self-regulatory mechanisms: a glass half full or half empty? BEBR faculty working paper; no 93-0117. 1993.

    • Search Google Scholar
    • Export Citation
  • 28.

    Choe EK, Lee B, Munson S, Pratt W, Kientz JA. Persuasive performance feedback: the effect of framing on self-efficacy. In: AMIA Annual Symposium ProceedingsBethesda, MD; American Medical Informatics Association: 2013:825.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Eikey E, Poole E, Reddy M. Information presentation in health apps and devices: the effect of color, distance to goal, weight perception, and interest on users’ self-efficacy for accomplishing goals. iConference 2015 Proceedings; 2015. https://www.ideals.illinois.edu/handle/2142/73650. Accessed October 4, 2018.

    • Search Google Scholar
    • Export Citation
  • 30.

    Kim Y-H, Jeon JH, Choe EK, Lee B, Kim K, Seo J. TimeAware: leveraging framing effects to enhance personal productivity. In: Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems. New York, NY: ACM; 2016:272283.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2963 545 10
Full Text Views 39 5 0
PDF Downloads 41 13 1