Risk of Losing Money Has Greater Impact as an Exercise Incentive

Wellness programs that base financial incentives on loss aversion could result in better outcomes, according to a trial of how certain financial incentives impact physician activity among overweight and obese adults.

Researchers from the Perelman School of Medicine at the University of Pennsylvania ran a trial to determine how certain financial incentives may increase physical activity among overweight and obese adults.

The objective of this study was to determine the effectiveness of different methods of framing financial incentives on physical activity, as there has been little research done on financial incentive designs with this purpose in mind.

For a 26-week period, 281 adult employees with a body mass index (BMI) greater than 27, were given a daily 7000-step goal and monitored on their success rate. The participants were randomly assigned 4 different rewards for the first 13-week period: the control group received feedback only, the first group earned $1.40 every day their goal was achieved, the second group was entered into a daily lottery with the potential to win $1.40 every day their goal was achieved, and the third group lost $1.40 from a monthly $42 allowance for every day their goal was not achieved. For the second 13-week period all groups received feedback with no monetary consequences. Steps were tracked using a mobile app on the participants’ smartphones.

The results showed that the first 2 groups—those that earned a financial award and those that were entered in a lottery—were no more successful in achieving their daily goal than those in the control group. The loss aversion group, however, was the most successful of all the groups. The first 2 groups achieved their goal 30% to 35% of the time while the third group achieved its goal 45% of the time. Steps decreased for all groups during the second 13-week period when no incentives were offered. Yet, the researchers noticed that 96% of participants remained actively enrolled in the study even after 3 months with no incentives.

“Workplace wellness programs aimed at increasing physical activity and other healthy behaviors have also become increasingly popular, but there's a lack of understanding about how to design incentives within these programs,” lead author Mitesh S. Patel, MD, MBA, MS, said in a statement. “Our findings suggest that these programs could result in better outcomes if they designed financial incentives based on principles from behavioral economics such as loss aversion.”

For the future, the researchers are interested in seeing how phone applications may continue influencing physical activity. Other studies may include incentives combined with other motivating factors such as peer support or accountability, or discovering a more effective reward amount.