Incentives for Motivation

(LEMURSSI Trial)

Age: 18 - 65

Sex: Any

Trial Phase: Phase 1

Sponsor: University of Vermont

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

200 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this substudy is to determine if a brief single-session-intervention (SSI) coupled with different incentive strategies to support engaging in wellness-related activities.

Do I need to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Charity Incentives, Charity Restorative Incentives, Personal Incentives, Personal Restorative Incentives?

Research shows that financial incentives can motivate people to improve their health behaviors and manage chronic diseases better, although the results can vary. Incentive programs have been used in healthcare to encourage better performance and outcomes, but their effectiveness can depend on how they are implemented. ^{1 2 3 4 5}

How does the treatment 'Incentives for Motivation' differ from other treatments for motivation-related conditions?

The 'Incentives for Motivation' treatment is unique because it uses financial incentives to encourage behavior change, which is different from traditional treatments that may not involve monetary rewards. This approach leverages both personal and charity-based incentives to motivate individuals, potentially offering a novel way to sustain changes in health-related behaviors. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for first-year undergraduate students who own a mobile device. It aims to explore if certain incentives can boost participation in wellness activities.

Inclusion Criteria

Current undergraduate student in their first year of school who owns a mobile device

Exclusion Criteria

Not applicable.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Single Session Intervention

Participants receive a brief single-session-intervention (SSI) to provide education and strategies to improve a wellness-related goal

1 session

1 visit (in-person or virtual)

Incentive-based Activity Engagement

Participants engage in wellness-related activities with different incentive strategies over time

up to 6 months

Follow-up

Participants are monitored for completion of wellness activities and well-being measures

4 weeks

Treatment Details

Interventions

• Charity Incentives
• Charity Restorative Incentives
• Personal Incentives
• Personal Restorative Incentives

Trial Overview The study tests four types of incentives: Personal Restorative Incentives, Charity Incentives, Personal Incentives, and Charity Restorative Incentives, to see which encourages wellness activity engagement the most.

Participant Groups

Group I: Individual Receives Incentive -Restorative Incentive Experimental Treatment 1 Intervention

The participant receives incentives directly. There is a restorative incentive if they miss an activity.

Group II: Individual Receives Incentive - No Restorative Incentive Experimental Treatment 1 Intervention

Participant receives incentives directly

Group III: Charity Receives Incentive -Restorative Incentive Experimental Treatment 1 Intervention

Participant earns money for charity. There is a restorative incentive if they miss an activity.

Group IV: Charity Receives Incentive - No Restorative Incentive Experimental Treatment 1 Intervention

Participant earns money for charity

Who Is Running the Clinical Trial?

University of Vermont

Lead Sponsor

Trials

283

Recruited

3,747,000+

Findings from Research

The Pay-for-Performance system in healthcare aims to motivate providers and institutions by financially rewarding those who achieve high performance based on specific indicators.

Early results from various countries indicate that while the system is designed to improve healthcare outcomes, its actual impact on performance has been mixed, suggesting that further evaluation is needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Incentives for better performance in health care. Abduljawad, A., Al-Assaf, AF.[2021]

In South Africa, a voluntary patient incentive program led to significantly higher odds of receiving preventive care services among 2.7 million enrollees, with notable increases in services like cholesterol testing (odds ratio 2.70) and HIV testing (odds ratio 3.47).

Despite the positive impact of the incentive program on preventive care uptake, the overall rates of receiving these services remained low, indicating that while financial incentives can encourage participation, they may not be sufficient to achieve optimal preventive care levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a patient incentive program on receipt of preventive care. Mehrotra, A., An, R., Patel, DN., et al.[2021]

Ten European countries have established primary care quality indicators linked to financial incentives, with the number of indicators ranging from 1 to 134, potentially affecting physicians' income by up to 25%.

The study emphasizes the need for critical evaluation and continuous monitoring of these pay-for-performance schemes to assess their effectiveness in improving health outcomes and resource utilization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do family physicians need more payment for working better? Financial incentives in primary care. Kolozsvári, LR., Orozco-Beltran, D., Rurik, I.[2021]

In a study of 144 orthodontic patients, a reward system showed limited effectiveness in improving overall compliance, with only the oral hygiene scores of below-average compliers benefiting from the rewards compared to a control group.

The research indicated that while above-average compliers maintained their high compliance levels, the reward system may be particularly useful for motivating below-average compliers to follow treatment instructions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of behavior modification on patient compliance in orthodontics. Richter, DD., Nanda, RS., Sinha, PK., et al.[2014]

The implementation of 'pay for performance' programs in dentistry faces challenges due to structural factors such as the current state of the dental insurance market and the need for better evidence-based clinical guidelines.

For these programs to be successful, there is a need for improved knowledge, the development of evidence-based performance measures, and better integration of clinical practice guidelines into the dental profession.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pay for performance: will dentistry follow? Voinea-Griffin, A., Fellows, JL., Rindal, DB., et al.[2023]

A systematic analysis of 394 online comments from New York Times readers revealed that most people have negative perceptions of financial incentives for health improvement, viewing them as absurd or a reward for irresponsibility.

While some individuals supported financial incentives as a cost-effective way to prevent chronic diseases, the overall sentiment emphasized a desire for greater personal responsibility in health management, which may hinder the acceptance of such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The New York Times readers' opinions about paying people to take their medicine. Park, JD., Metlay, J., Asch, JM., et al.[2015]

The paper distinguishes between two meanings of personal responsibility in health and discusses various policy options to promote it through health information and incentives.

It concludes that current data on the effectiveness of incentive programs is inadequate, suggesting that evaluation criteria should include not just cost but also changes in health and socioeconomic status of participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Incentivising personal responsibility: conceptual clarification and evidence]. Schmidt, H.[2012]

Financial incentives can lead to sustained changes in health-related behaviors, such as smoking cessation and increased physical activity, with effects lasting up to 18 months after the initial incentive, and even three months after the incentives are removed.

Individuals with higher levels of deprivation showed greater responsiveness to financial incentives, particularly after 6 to 12 months, suggesting that these incentives may help reduce health inequalities, although their long-term effectiveness in reducing disease burden may be limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Personal financial incentives for changing habitual health-related behaviors: A systematic review and meta-analysis. Mantzari, E., Vogt, F., Shemilt, I., et al.[2023]

A study involving 1,217 participants found that personalized feedback significantly improved smoking cessation rates, with continuous abstinence at 3 and 12 months being twice as high in the feedback group compared to others.

In contrast, while a financial incentive increased the use of self-help materials, it did not improve cessation rates and was linked to higher relapse rates among those who quit.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program. Curry, SJ., Wagner, EH., Grothaus, LC.[2019]

Incentives and competitions did not lead to significantly higher long-term smoking cessation rates, as evidenced by 17 studies, with no lasting effects observed beyond six months after the intervention.

While the use of incentives did not improve quit rates, they were found to enhance recruitment rates for smoking cessation programs, suggesting that rewarding participation could lead to a higher number of individuals successfully quitting smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Competitions and incentives for smoking cessation. Cahill, K., Perera, R.[2022]

References

1. Oman pubmed.ncbi.nlm.nih.gov

Incentives for better performance in health care. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Impact of a patient incentive program on receipt of preventive care. [2021]

3. Spain pubmed.ncbi.nlm.nih.gov

Do family physicians need more payment for working better? Financial incentives in primary care. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Effect of behavior modification on patient compliance in orthodontics. [2014]

5. England pubmed.ncbi.nlm.nih.gov

Pay for performance: will dentistry follow? [2023]

6. United States pubmed.ncbi.nlm.nih.gov

The New York Times readers' opinions about paying people to take their medicine. [2015]

7. Netherlands pubmed.ncbi.nlm.nih.gov

[Incentivising personal responsibility: conceptual clarification and evidence]. [2012]

8. United States pubmed.ncbi.nlm.nih.gov

Personal financial incentives for changing habitual health-related behaviors: A systematic review and meta-analysis. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program. [2019]

10. England pubmed.ncbi.nlm.nih.gov

Competitions and incentives for smoking cessation. [2022]