Exercise Incentives for Sedentary Lifestyle

Overseen By Viveka Ayala-Heredia

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Brown University

Disqualifiers: Not YMCA member, Under 18, others

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

Compensation: Varies

Number of Visits: 3

Duration: 6 months

330 Participants Needed

Trial Summary

What is the purpose of this trial?

The investigators will conduct a randomized controlled trial to test financial incentive programs (versus control) to promote physical activity among 330 adults who have a YMCA membership. Participants will have the opportunity to earn up to $100 or $200 (depending on the condition they are assigned to) for attending at least 50 sessions at the YMCA over 6 months. Participants will have two 6-month windows during which they will have the opportunity to earn the incentive. In addition to the incentives, participants will complete research assessments every 3 months.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on exercise and financial incentives, so it's unlikely that your medications would be affected.

What data supports the effectiveness of the treatment Monetary Incentives, Financial Incentives, Monetary Rewards for sedentary lifestyle?

Research suggests that financial incentives can motivate people to improve their physical activity, healthy diet, and weight control, which are important for reducing obesity. These incentives may help people stick to exercise routines by making it more rewarding to meet their goals. ^{1 2 3 4 5}

Is it safe to use financial incentives to encourage exercise in humans?

The research on financial incentives for exercise, such as using apps or insurance-based programs, does not report any safety concerns for humans. These programs are generally considered safe as they aim to motivate increased physical activity. ^{3 6 7 8 9}

How does the treatment 'Exercise Incentives for Sedentary Lifestyle' differ from other treatments for sedentary lifestyle?

This treatment is unique because it uses financial incentives to encourage physical activity, which is different from traditional methods that might focus on exercise programs or lifestyle counseling. The financial rewards are designed to motivate individuals by providing immediate benefits for engaging in physical activity, making it a novel approach compared to other treatments. ^{5 7 10 11 12}

Research Team

David M Williams, Ph.D.

Principal Investigator

Brown University School of Public Health

Omar Galarraga, Ph.D.

Principal Investigator

Brown University School of Public Health

Eligibility Criteria

This trial is for adults over 18 who are members or willing to join one of the specified YMCA branches and can physically exercise. It's not for those under 18, non-members unwilling to join, people unable to exercise, or individuals advised against exercising due to health conditions.

Inclusion Criteria

I am 18 years old or older.

Physically capable of engaging in exercise

A current member, or willing to become a current member of one of the following branches of the YMCA: Bayside Family YMCA (Barrington, RI), Cranston YMCA (Cranston, RI), East Side/Mt. Hope YMCA (Providence, RI), Kent County YMCA (Warwick, RI), Newman YMCA (Seekonk, MA), South County YMCA (South Kingston, RI)

Exclusion Criteria

I am not a member and do not wish to join any YMCA branches listed.

I am under 18 years old.

I am unable to perform any physical exercise.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in exercise sessions at the YMCA with financial incentives for completing 50 sessions over 6 months

6 months

Regular YMCA visits

Follow-up

Participants are monitored for changes in physical activity and other health-related measures

6 months

Research assessments every 3 months

Extension

Participants have an additional 6-month window to earn incentives for exercise sessions

6 months

Treatment Details

Interventions

• Monetary Incentives

Trial Overview The study tests if financial rewards encourage YMCA members with inactive lifestyles to work out more. Participants could earn $100-$200 by attending at least 50 sessions within two separate six-month periods and will be assessed every three months.

Participant Groups

Group I: Message 2 - $200 Experimental Treatment 1 Intervention

Participants are offered an incentive of $200 to complete 50 exercise sessions at the YMCA within 6 months (Description of incentive 2).

Group II: Message 2 - $100 Experimental Treatment 1 Intervention

Participants are offered an incentive of $100 to complete 50 exercise sessions at the YMCA within 6 months (Description of incentive 2).

Group III: Message 1 - $200 Experimental Treatment 1 Intervention

Participants are offered an incentive of $200 to complete 50 exercise sessions at the YMCA within 6 months (Description of incentive 1).

Group IV: Message 1 - $100 Experimental Treatment 1 Intervention

Participants are offered an incentive of $100 to complete 50 exercise sessions at the YMCA within 6 months (Description of incentive 1)

Group V: Control Active Control 1 Intervention

Participants complete all assessments, and are eligible to receive compensation for participating in the research components of the study.

Who Is Running the Clinical Trial?

Brown University

Lead Sponsor

Trials

480

Recruited

724,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Findings from Research

In a study of 35 randomized controlled trials, financial incentives (FIs) based on behavioral-economic principles, particularly deposit contracts, were found to be the most effective in promoting healthy diet, weight control, and physical activity, significantly increasing goal achievement compared to no incentives.

While both deposit and lottery-based incentives improved physical activity levels during the intervention, only the deposit incentive maintained its effectiveness in the follow-up period, suggesting that behavioral insights can enhance the long-term impact of financial incentives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of the Effectiveness of Behavioral Economic Incentive Programs for Goal Achievement on Healthy Diet, Weight Control and Physical Activity: A Systematic Review and Network Meta-analysis. Boonmanunt, S., Pattanaprateep, O., Ongphiphadhanakul, B., et al.[2023]

A systematic review of 10 studies on material incentives for exercise found that while incentives can boost exercise behavior during the intervention, their effectiveness in maintaining that behavior after the incentives are removed is inconsistent.

The research highlighted significant variability in how different studies implemented incentives and measured outcomes, indicating a need for more standardized approaches to determine the best strategies for promoting long-term exercise habits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of incentives on exercise behavior: a systematic review of randomized controlled trials. Strohacker, K., Galarraga, O., Williams, DM.[2022]

Daily feedback significantly increased the number of steps taken by participants compared to weekly feedback, highlighting the importance of timely information in promoting physical activity.

Contingent incentives did not lead to a significant increase in steps compared to noncontingent incentives, suggesting that the type of reward may not be as effective as the feedback mechanism itself.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Project Step: A Randomized Controlled Trial Investigating the Effects of Frequent Feedback and Contingent Incentives on Physical Activity. Kerrigan, SG., Forman, EM., Williams, D., et al.[2022]

A study involving 24 participants found that deposit contracts, which use participants' own money as a financial incentive, led to a modest increase in physical activity compared to self-monitoring.

However, many participants found the deposit contract approach to be unacceptable, and those who did participate reported that the incentives and feedback were inadequate, suggesting that this method may not be a feasible way to promote physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Feasibility, Acceptability, and Effects of Deposit Contracts With and Without Daily Feedback to Promote Physical Activity. Kerrigan, SG., Forman, EM., Patel, M., et al.[2020]

This systematic review aims to evaluate the effectiveness of financial incentives in increasing physical activity among adults, focusing on randomized controlled trials and utilizing a comprehensive search strategy across multiple databases.

The review will compare the impact of positive financial rewards versus negative financial penalties on physical activity, providing insights that could inform future public health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of financial incentives on physical activity in adults: a systematic review protocol. Luong, MN., Bennell, KL., Hall, M., et al.[2018]

A trial involving 800 desk-bound office workers is testing the effectiveness of a wireless pedometer combined with financial incentives (cash or charity donations) to encourage increased physical activity.

The study aims to determine if these wearable technologies, along with incentives, can lead to sustained behavior change in physical activity, potentially offering a scalable solution for public health initiatives against non-communicable diseases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Design and baseline characteristics of participants in the TRial of Economic Incentives to Promote Physical Activity (TRIPPA): a randomized controlled trial of a six month pedometer program with financial incentives. Finkelstein, EA., Sahasranaman, A., John, G., et al.[2022]

A systematic review of 23 randomized controlled trials involving 6074 participants found that financial incentives significantly increased physical activity (PA), with most studies reporting positive effects during the intervention period.

Even after the removal of incentives, participants maintained higher daily step counts, suggesting that short-term financial incentives can lead to sustained increases in physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial incentives for physical activity in adults: systematic review and meta-analysis. Mitchell, MS., Orstad, SL., Biswas, A., et al.[2022]

Using the Sweatcoin app, which converts physical activity into virtual currency, led to an average increase of 19% in daily step count among 5892 users over a 6-month period, indicating significant behavior change in physical activity.

The app was particularly effective for individuals who are overweight or less active, suggesting that incentives can motivate those who typically struggle to maintain regular exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Activity Behavior Change Driven by Engagement With an Incentive-Based App: Evaluating the Impact of Sweatcoin. Elliott, M., Eck, F., Khmelev, E., et al.[2020]

This study involves 330 participants in a randomized controlled trial (RCT) to evaluate the effectiveness of an exercise incentive program that rewards attendance at a YMCA fitness facility, aiming to increase physical activity levels among adults who currently do not meet activity guidelines.

The trial will assess the impact of different incentive amounts and framing (gain vs. loss) on fitness facility visits and overall physical activity, using objective data to measure outcomes over a total of 12 months, which will help determine the most effective strategies for promoting regular exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Testing an insurance-based monetary incentive program for exercise: RCT design and rationale. Williams, DM., Bohlen, LC., Dunsiger, S., et al.[2023]

In a study involving 3515 adults, financial incentives for physical activity were most effective when disbursed at a constant rate, leading to an increase of 306.7 more steps per day compared to a control group.

The positive effects of constant incentives persisted for one week after the intervention, but the benefits diminished after that, indicating that while financial incentives can boost activity, their impact may not be long-lasting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial. Bachireddy, C., Joung, A., John, LK., et al.[2020]

This review aims to evaluate the effectiveness of financial incentives provided by employers to encourage physical activity among employees in high-income countries, focusing on adherence to programs and related health outcomes like sick leave.

The study will include randomized controlled trials and assess various factors such as age, gender, and implementation quality, with plans for meta-analysis if sufficient data is available, ensuring a comprehensive understanding of the impact of financial incentives on physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using financial incentives to increase physical activity among employees as a strategy of workplace health promotion: protocol for a systematic review. Heise, TL., Frense, J., Christianson, L., et al.[2021]

In a study involving 281 overweight and obese adults, financial incentives framed as a loss (where participants lost money for not meeting their step goals) were the most effective in increasing physical activity, with a significant increase in the proportion of days participants achieved their 7000-step goal compared to a control group.

While the loss incentive led to better goal achievement during the intervention, the increase in daily steps did not remain significant during the follow-up period, indicating that the effectiveness of financial incentives may diminish once the incentives are removed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Framing Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults: A Randomized, Controlled Trial. Patel, MS., Asch, DA., Rosin, R., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Evaluation of the Effectiveness of Behavioral Economic Incentive Programs for Goal Achievement on Healthy Diet, Weight Control and Physical Activity: A Systematic Review and Network Meta-analysis. [2023]

2. England pubmed.ncbi.nlm.nih.gov

The impact of incentives on exercise behavior: a systematic review of randomized controlled trials. [2022]

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

Project Step: A Randomized Controlled Trial Investigating the Effects of Frequent Feedback and Contingent Incentives on Physical Activity. [2022]

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

Evaluating the Feasibility, Acceptability, and Effects of Deposit Contracts With and Without Daily Feedback to Promote Physical Activity. [2020]

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

The impact of financial incentives on physical activity in adults: a systematic review protocol. [2018]

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

Design and baseline characteristics of participants in the TRial of Economic Incentives to Promote Physical Activity (TRIPPA): a randomized controlled trial of a six month pedometer program with financial incentives. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Financial incentives for physical activity in adults: systematic review and meta-analysis. [2022]

8. Canada pubmed.ncbi.nlm.nih.gov

Physical Activity Behavior Change Driven by Engagement With an Incentive-Based App: Evaluating the Impact of Sweatcoin. [2020]

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

Testing an insurance-based monetary incentive program for exercise: RCT design and rationale. [2023]

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

Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial. [2020]

11. England pubmed.ncbi.nlm.nih.gov

Using financial incentives to increase physical activity among employees as a strategy of workplace health promotion: protocol for a systematic review. [2021]

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

Framing Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults: A Randomized, Controlled Trial. [2022]