Effects of Charitable Versus Monetary Incentives on the Acceptance of and Adherence to a Pedometer-Based Health Intervention: Study Protocol and Baseline Characteristics of a Cluster-Randomized Controlled Trial.

Elgar Fleisch,Flavius Kehr,Jan-Niklas Kramer,Fabian Wahle,Niklas Elser,Tobias Kowatsch

doi:10.2196/resprot.6089

Abstract

BackgroundResearch has so far benefited from the use of pedometers in physical activity interventions. However, when public health institutions (eg, insurance companies) implement pedometer-based interventions in practice, people may refrain from participating due to privacy concerns. This might greatly limit the applicability of such interventions. Financial incentives have been successfully used to influence both health behavior and privacy concerns, and may thus have a beneficial effect on the acceptance of pedometer-based interventions.ObjectiveThis paper presents the design and baseline characteristics of a cluster-randomized controlled trial that seeks to examine the effect of financial incentives on the acceptance of and adherence to a pedometer-based physical activity intervention offered by a health insurance company.MethodsMore than 18,000 customers of a large Swiss health insurance company were allocated to a financial incentive, a charitable incentive, or a control group and invited to participate in a health prevention program. Participants used a pedometer to track their daily physical activity over the course of 6 months. A Web-based questionnaire was administered at the beginning and at the end of the intervention and additional data was provided by the insurance company. The primary outcome of the study will be the participation rate, secondary outcomes will be adherence to the prevention program, physical activity, and health status of the participants among others.ResultsBaseline characteristics indicate that residence of participants, baseline physical activity, and subjective health should be used as covariates in the statistical analysis of the secondary outcomes of the study.ConclusionsThis is the first study in western cultures testing the effectiveness of financial incentives with regard to a pedometer-based health intervention offered by a large health insurer to their customers. Given that the incentives prove to be effective, this study provides the basis for powerful health prevention programs of public health institutions that are easy to implement and can reach large numbers of people in need.

Highlights

In 2012, noncommunicable diseases (NCD) such as cardiovascular diseases, cancers, respiratory diseases, and diabetes were responsible for 68% of deaths worldwide [1]
Baseline characteristics indicate that residence of participants, baseline physical activity, and subjective health should be used as covariates in the statistical analysis of the secondary outcomes of the study
This is the first study in western cultures testing the effectiveness of financial incentives with regard to a pedometer-based health intervention offered by a large health insurer to their customers

Summary

Introduction

In 2012, noncommunicable diseases (NCD) such as cardiovascular diseases, cancers, respiratory diseases, and diabetes were responsible for 68% of deaths worldwide [1]. The pedometer enables its user to monitor and evaluate his or her daily activity, and directly supports the user’s self-regulating subfunctions [12]. According to the latter, self-regulation mediates external influences and provides the basis for purposeful action and self-directed change [12]. When public health institutions (eg, insurance companies) implement pedometer-based interventions in practice, people may refrain from participating due to privacy concerns. This might greatly limit the applicability of such interventions. Financial incentives have been successfully used to influence both health behavior and privacy concerns, and may have a beneficial effect on the acceptance of pedometer-based interventions

Methods

Results

Discussion

Conclusion