Small Incentives Research Articles

Impact of mobile phone delivered reminders and unconditional incentives on measles-containing vaccine timeliness and coverage: a randomised controlled trial in western Kenya

IntroductionShort message service (SMS) reminders coupled with a small monetary incentive conditioned on prompt vaccination have been shown to improve first-dose measles-containing vaccine (MCV1) uptake. We assessed whether SMS reminders...

ПОДАТКОВЕ АДМІНІСТРУВАННЯ ДІЯЛЬНОСТІ МАЛОГО ТА СЕРЕДНЬОГО БІЗНЕСУ В УКРАЇНІ

The article examines the effectiveness of tax administration of small and medium-sized businesses in Ukraine. Small and medium-sized businesses in Ukraine, as well as around the world, play an important role in the country's economy. State support for existing small businesses and incentives to create new businesses makes it possible to increase revenues from taxes and fees to the budgets of various levels, create new jobs without spending public funds, promote new products and services, help citizens express themselves. etc. In Ukraine, in such entities, more than 80% of all employees work and they produce about 65% of the total cost of manufactured products in the country. These shares have tended to grow steadily in recent years. To support such businesses, the government has created a simplified taxation system and simplified financial reporting. Based on the study, it was found that the main constraints in the development of small and medium enterprises in the country are cumbersome regulatory support for taxation of small and medium businesses, complex reporting forms and imperfect system of tax administration. Ukraine is one of the last places in Europe in terms of the time a taxpayer has to spend calculating tax liabilities, paying taxes and fees, and filling out reporting forms. It was established that the main task of the state tax service, instead of advising taxpayers and controlling their payment of tax liabilities, was to fill the budgets of various levels and cover the existing deficit. This led to opposition among businesses and the transfer of part of their activities "in the shadows". To solve this problem, it is proposed to simplify reporting forms for small and medium-sized businesses, improve and strengthen the advisory and explanatory activities of the tax service and eliminate the obligation to impose penalties on inspections of regulatory authorities, regardless of the actual results of the inspection. Improving the tax administration of such businesses will make it easier for the national economy to end the global economic crisis caused by the pandemic and to speed up the recovery and growth of domestic production and consumption.

Fair go: pay research participants properly or not at all

We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has...

Can Small Incentives Have Large Payoffs? Health Impacts of a Cash Transfer Program in Bolivia

AbstractWe study the effects of a conditional cash transfer for health care utilization, equivalent to 1% of monthly household consumption, on child survival in Bolivia. Using census data and an in...

Financial incentives versus standard of care to improve patient compliance with live kidney donor follow-up: protocol for a multi-center, parallel-group randomized controlled trial

BackgroundLive kidney donors (LKDs) account for nearly a third of kidney transplants in the United States. While donor nephrectomy poses minimal post-surgical risk, LKDs face an elevated adjusted risk of developing chronic diseases such as hypertension, diabetes, and end-stage renal disease. Routine screening presents an opportunity for the early detection and management of chronic conditions. Transplant hospital reporting requirements mandate the submission of laboratory and clinical data at 6-months, 1-year, and 2-years after kidney donation, but less than 50% of hospitals are able to comply. Strategies to increase patient engagement in follow-up efforts while minimizing administrative burden are needed. We seek to evaluate the effectiveness of using small financial incentives to promote patient compliance with LKD follow-up.Methods/designWe are conducting a two-arm randomized controlled trial (RCT) of patients who undergo live donor nephrectomy at The Johns Hopkins Hospital Comprehensive Transplant Center (MDJH) and the University of Maryland Medical Center Transplant Center (MDUM). Eligible donors will be recruited in-person at their first post-surgical clinic visit or over the phone. We will use block randomization to assign LKDs to the intervention ($25 gift card at each follow-up visit) or control arm (current standard of care). Follow-up compliance will be tracked over time. The primary outcome will be complete (all components addressed) and timely (60 days before or after expected visit date), submission of LKD follow-up data at required 6-month, 1-year, and 2-year time points. The secondary outcome will be transplant hospital-level compliance with federal reporting requirements at each visit. Rates will be compared between the two arms following the intention-to-treat principle.DiscussionSmall financial incentivization might increase patient compliance in the context of LKD follow-up, without placing undue administrative burden on transplant providers. The findings of this RCT will inform potential center- and national-level initiatives to provide all LKDs with small financial incentives to promote engagement with post-donation monitoring efforts.Trial registrationClinicalTrials.gov number: NCT03090646Date of registration: March 2, 2017Sponsors: Johns Hopkins University, University of Maryland Medical CenterFunding: The Living Legacy Foundation of Maryland

Implementation of a medication adherence program in senior public housing facilities utilizing pharmacists and health educators.

Background:Hypertension and diabetes disproportionately impact people of color when compared to majority populations. Medication adherence among seniors with chronic diseases has been suboptimal with the estimation that only half of those taking antihypertensives are adherent. Therefore, the purpose of The Managing Your Medications (MY Rx) program was to evaluate the effectiveness of evidence-based practices used to improve rates of medication adherence through information dissemination among diabetic and hypertensive African American, Asian American, and Hispanic residents housed in senior public housing facilities in the Greater Houston Area. The program comprised an 8-week intervention with individual and group components with small incentives provided throughout the program. Individual components included one home visit and telephone consultations conducted by pharmacists. Health educators provided two group education sessions on lifestyle modifications.Result:Qualitative analysis of focus group discussions revealed participant satisfaction with the MY Rx program and willingness to change after participation in the program.Conclusion:The Rx program showed the potential effectiveness of an innovative strategy in medication counseling using interdisciplinary pharmacists and health educators to promote health. It demonstrated the importance of using the patient-centered care framework in designing a community intervention program.

Effects of active referral combined with a small financial incentive on smoking cessation: study protocol for a cluster randomised controlled trial

IntroductionEvidence-based smoking cessation treatments are effective but underutilised, accentuating the need for novel approaches to increase use. This trial investigates the effects of active referral combined with a financial incentive...

Brief Report: Using Behavioral Economics to Increase HIV Knowledge and Testing Among Latinx Sexual Minority Men and Transgender Women: A Quasi-Experimental Pilot Study.

To determine how weekly text messages and small incentives impact HIV knowledge and frequency of HIV testing among Latinx sexual minority men (LSMM) and transgender women (LTGW). Prospectively randomized participants into 2 intervention arms compared with a nonrandomized comparison group. Bienestar, a primarily Latinx focused HIV service provider located across Los Angeles County. Two hundred eighteen participants self-identifying as LSMM or LTGW, HIV negative, having regular mobile phone access, ≥18 years, and fluent in English or Spanish. The "information only" (IO) group received text messages with HIV prevention information. The "information plus" (IP) group additionally could win incentives by answering weekly quiz questions correctly and testing for HIV once every 3 months. We followed participants for 12 months. HIV knowledge and frequency of HIV testing. We found no effect on HIV knowledge in the IO group but a statistically significant improvement in the IP group (79.2%-88.1%; P = 0.007). The frequency of HIV testing was higher in both intervention groups relative to the comparison group: On average, 22.0% of IO participants and 24.9% of IP participants tested at a Bienestar site within a given 3-month period, compared with 13.0% in the comparison group. This represents unadjusted relative risk ratios of 1.69 for the IO group (95% CI: 1.25 to 2.1; P < 0.01) and 1.91 for the IP group (95% CI: 1.51 to 2.31; P < 0.01), respectively. This study demonstrates that a simple, low-cost intervention may help increase HIV testing frequency among LSMM and LTGW, 2 groups at high HIV risk.

Financial incentives to promote retention in care and viral suppression in adults with HIV initiating antiretroviral therapy in Tanzania: a three-arm randomised controlled trial

Financial incentives promote use of HIV services and might support adherence to the sustained antiretroviral therapy (ART) necessary for viral suppression, but few studies have assessed a biomarker of adherence or evaluated optimal implementation. We sought to determine whether varying sized financial incentives for clinic attendance effected viral suppression in patients starting ART in Tanzania. In a three-arm, parallel-group, randomised controlled trial at four health facilities in Shinyanga region, Tanzania, adults aged 18 years or older with HIV who had started ART within the past 30 days were randomly assigned (1:1:1) using a tablet-based application (stratified by site) to receive usual care (control group) or to receive a cash incentive for monthly clinic attendance in one of two amounts: 10 000 Tanzanian Shillings (TZS; about US$4·50) or 22 500 TZS (about $10·00). There were no formal exclusion criteria. Participants were masked to the existence of two incentive sizes. Incentives were provided for up to 6 months via mobile health technology (mHealth) that linked biometric attendance monitoring to automated mobile payments. We evaluated the primary outcome of retention in care with viral suppression (<1000 copies per mL) at 6 months using logistic regression. This trial is registered with ClinicalTrials.gov, NCT03351556. Between April 24 and Dec 14, 2018, 530 participants were randomly assigned to an incentive strategy (184 in the control group, 172 in the smaller incentive group, and 174 in the larger incentive group). All participants were included in the primary intention-to-treat analysis. At 6 months, approximately 134 (73%) participants in the control group remained in care and had viral suppression, compared with 143 (83%) in the smaller incentive group (risk difference [RD] 9·8, 95% CI 1·2 to 18·5) and 150 (86%) in the larger incentive group (RD 13·0, 4·5 to 21·5); we identified a positive trend between incentive size and viral suppression (p trend=0·0032), although the incentive groups did not significantly differ (RD 3·2, -4·6 to 11·0). Adverse events included seven (4%) deaths in the control group and 11 (3%) deaths in the intervention groups, none related to study participation. Small financial incentives delivered using mHealth can improve retention in care and viral suppression in adults starting HIV treatment. Although further research should investigate the durability of effects from short-term incentives, these findings strengthen the evidence for implementing financial incentives within standard HIV care. National Institute of Mental Health at the US National Institutes of Health.

Evaluating small conditional cash transfers to improve vaccine coverage and timeliness in Pakistan

Abstract Background Low immunization coverage rates have prompted the need to design effective demand-side interventions to improve uptake. Simple SMS reminders and large (≥USD 100) incentives have been demonstrated to effectively increase immunization coverage. However, research on small incentives (≤USD 15) for immunization is sparse and there is uncertainty regarding the optimal structure of incentives in terms of size, schedule, and design. Methods A 12-arm randomized controlled trial is being conducted in Karachi, Pakistan with 10 incentive arms of varying size (amount), schedules (progressivity) and design (certainty of payment), an exclusive SMS arm and control arm. The incentives are provided through two mechanisms: mobile air time and mobile-money through a mobile-money provider. Children were enrolled when they presented to the study sites for either BCG, Penta-1, or Penta-2 vaccine. Results A total of 11,197 children were enrolled between Nov 2017 and Oct 2018 with approximately 800 children in each incentive arm and 1600 and 1599 in SMS and Control arm, respectively. As of Jan 09, 2020, Penta-3 and Measles-1 coverage are lowest in the control arm (71% and 60% respectively) and highest in the high-flat-lottery arm (78% and 69% respectively) with uniformly progressing incentive amounts along the immunization schedule. Discussion Interim results suggest that small mobile-based incentives coupled with SMS reminders can significantly improve immunization coverage in children. The final analysis will provide robust evidence of this impact and provide policy implications for the most optimal incentive structure that can build caregiver demand for effectively increasing child immunization in an LMIC setting. Key messages Small incentives (USD&amp;lt;15) coupled with simple SMS reminders can improve immunization coverage and timeliness in low resource settings in an inexpensive, logistically simple way. The study will provide experimental evidence on optimal incentive design, structure, and size of small incentives for a cost-effective approach to increase immunization coverage and timeliness.

Evaluating mobile conditional cash transfers for improving immunization coverage in Pakistan

Abstract Background Despite progress in increasing immunization coverage, poor uptake of vaccines remains a challenge, particularly in LMICs. In part, this is due to the poor socio-economic status of caregivers, lack of motivation, and parental procrastination. While there is evidence that large (≥100 USD) incentives can overcome these problems, research on small incentives that are more appropriate for an LMIC setting is sparse. Our study addresses this gap by evaluating the impact of small (≤12 USD) CCTs in increasing immunization coverage for children under the age of two. Methods A 2-year program utilizing two small incentive schemes of different amounts (high: USD9; low: USD5) was implemented in Shikarpur District, Pakistan. Caregivers (with children 0-24 months) visiting any of the 33 study immunization centers were given the opportunity to enroll. All consenting parent-child pairs were randomized in one of the two incentive schemes and incentives were disbursed following each immunization visit, using mobile money. A baseline and end-line survey was conducted to evaluate changes in pre-post coverage. Results A total of 63,336 participants were enrolled between March 2016 - April 2018, of which 41,483 were randomized in the high or low incentive schemes (remaining caregivers were enrolled in the no-incentive group). Results show a 13% and 28% increase in age-appropriate coverage for Measles-1 (M1) and fully immunized children (FIC) compared to the baseline (FIC:16%, M1: 38%). There was no difference in M1 coverage between the high and low incentive schemes. Discussion Small CCTs have induced positive behavioral change and are a powerful tool for improving immunization coverage and compliance within LMICs. Key messages Small mobile conditional cash transfers (USD&amp;lt;12) can serve as nudges to parents and lead to behavioral shifts resulting in improved immunization outcomes for children. There was no significant difference in outcomes between high and low incentives, indicating that small mobile conditional cash transfers were equally effective in improving immunization coverage.

Understanding the acceptability, barriers and facilitators for chlamydia and gonorrhoea screening in technical colleges: qualitative process evaluation of the \u201cTest n Treat\u201d trial

BackgroundLow uptake of sexually transmitted infection testing by sexually active young people is a worldwide public health problem. Screening in non-medical settings has been suggested as a method to improve uptake. The “Test n Treat” feasibility trial offered free, on-site rapid chlamydia/gonorrhoea tests with same day treatment for chlamydia (and gonorrhoea treatment at a local clinic,) to sexually active students (median age 17 years) at six technical colleges in London. Despite high rates of chlamydia (6% prevalence), uptake of testing was low (< 15%). In a qualitative study we explored the acceptability, including barriers and facilitators to uptake, of on-site chlamydia screening.MethodsIn 2016–17 we conducted a qualitative study in the interpretative tradition using face to face or telephone semi-structured interviews with students (n = 26), teaching staff (n = 3) and field researchers (n = 4). Interviews were digitally recorded, transcribed and thematically analysed.ResultsFrom the student perspective, feelings of embarrassment and the potential for stigma were deterrents to sexually transmitted infection testing. While the non-medical setting was viewed as mitigating against stigma, for some students volunteering to be screened exposed them to detrimental judgements by their peers. A small financial incentive to be screened was regarded as legitimising volunteering in a non-discrediting way. Staff and researchers confirmed these views. The very low level of knowledge about sexually transmitted infections influenced students to not view themselves as candidates for testing. There were also suggestions that some teenagers considered themselves invulnerable to sexually transmitted infections despite engaging in risky sexual behaviours. Students and researchers reported the strong influence peers had on uptake, or not, of sexually transmitted infection testing.ConclusionsThis study offers new insights into the acceptability of college-based sexually transmitted infection screening to young, multi-ethnic students. Future studies in similar high risk, hard to reach groups should consider linking testing with education about sexually transmitted infections, offering non stigmatising incentives and engaging peer influencers.

Effects of Incentives on Adherence to a Web-Based Intervention Promoting Physical Activity: Naturalistic Study.

BackgroundDespite many advantages of web-based health behavior interventions such as wide accessibility or low costs, these interventions are often accompanied by high attrition rates, particularly in usage under real-life conditions. It would therefore be helpful to implement strategies such as the use of financial incentives to motivate program participation and increase adherence.ObjectiveThis naturalistic study examined real-life usage data of a 12-week web-based physical activity (PA) intervention (Fitness Coach) among insurants who participated in an additional incentive program (incentive group) and those who did not (nonincentive group). Users in the incentive group had the perspective of receiving €30 (about US $33) cash back at the end of the intervention.MethodsRegistration and real-life usage data as part of routine data management and evaluation of the Fitness Coach were analyzed between September 2016 and June 2018. Depending on the duration of use and the weekly recording of tasks, 4 adherence groups (low, occasional, strong, and complete adherence) were defined. Demographic characteristics were collected by a self-reported questionnaire at registration. We analyzed baseline predictors and moderators of complete adherence such as participation in the program, age, gender, and BMI using binary logistic regressions.ResultsA total of 18,613 eligible persons registered for the intervention. Of these, 15,482 users chose to participate in the incentive program (incentive group): mean age 42.4 (SD 14.4) years, mean BMI 24.5 (SD 4.0) kg/m2, median (IQR) BMI 23.8 (21.7-26.4) kg/m2; 65.12% (10,082/15,482) female; and 3131 users decided not to use the incentive program (nonincentive group): mean age 40.7 (SD 13.4) years, mean BMI 26.2 (SD 5.0) kg/m2, median BMI 25.3 (IQR 22.6-28.7) kg/m2; 72.18% (2260/3131) female. At the end of the intervention, participants in the incentive program group showed 4.8 times higher complete adherence rates than those in the nonincentive program group (39.2% vs 8.1%), also yielding significantly higher odds to complete the intervention (odds ratio [OR] 12.638) for the incentive program group. Gender significantly moderated the effect with men in the incentive group showing higher odds to be completely adherent than women overall and men in the nonincentive group (OR 1.761). Furthermore, older age and male gender were significant predictors of complete adherence for all participants, whereas BMI did not predict intervention completion.ConclusionsThis is the first naturalistic study in the field of web-based PA interventions that shows the potential of even small financial incentives to increase program adherence. Male users, in particular, seem to be strongly motivated by incentives to complete the intervention. Based on these findings, health care providers can use differentiated incentive systems to increase regular participation in web-based PA interventions.

Commercial App Use Linked With Sustained Physical Activity In Two Canadian Provinces: A 12-month Quasi-experimental Study

BACKGROUND: Top tier commercial physical activity apps rarely undergo peer-reviewed evaluation. Even fewer are assessed beyond six months, the theoretical threshold for behaviour maintenance. PURPOSE: The purpose of this study was to examine whether a commercial app rewarding users with digital incentives for walking was associated with an increase in physical activity over one year. METHODS: This 12-month quasi-experimental study was conducted in two Canadian provinces (n=39113 participants). Following a two-week baseline period, participants earned digital incentives ($0.04 CAD/day) every day they reached a personalized daily step goal. Mixed-effects models estimated changes in weekly mean daily step count between the baseline period and the last two recorded weeks. Models were fit for several engagement groups and separately by baseline physical activity status within engagement groups. RESULTS: Nearly half of participants (43%) were categorized as physically inactive at baseline (fewer than 5000 daily steps), and 60% engaged with the app for at least six months [‘Regular’ (24-51 weeks of step data) or ‘Committed’ sub-groups (52 weeks)]. Weekly mean daily step count increased for physically inactive users regardless of engagement status (P<.0001). The increase was largest for ‘Regular’ and ‘Committed’ participants—1215 and 1821 steps/day, respectively. For physically active participants, step count increases were only observed in the ‘Committed’ sub-group (P<.0001). Effect sizes were modest-to-medium depending on the sub-group analyzed. CONCLUSIONS: A commercial app providing small but immediate digital incentives for individualized goals was associated with an increased weekly mean daily step count on a population-scale over one year. This effect was more evident for physically inactive and more engaged participants.

Microfinance in Russia: The Realities of Small Business Incentives

Microfinance in Russia: The Realities of Small Business Incentives

Facilitating efficient coordination in large groups: small incentive payments in nested groups

Most large real-world organizations contain multiple smaller groups, such as working groups within firms. However, can this sort of nested groups be used to alleviate coordination failures in the larger group? We report on a multi-player Stag Hunt experiment wherein we hierarchically structure a large group into mutually exclusive small groups. We offer varying incentive payments if efficient coordination is achieved at a large or small group level. The novelty of our design is that we hold the total payment size constant between treatments. In our nested incentive treatment, we reduce the reward for achieving large-group coordination by a small amount and reallocate the same amount to successful small-group coordination. The results reveal that incentive reallocations privileging small groups facilitate efficient large-group coordination in the nested group structure.

Can Reminders and Incentives Improve Implementation Within Government? Evidence from a Field Experiment

Abstract Existing research demonstrates how governments can use insights from behavioral science to design policy and alter residents’ behavior. This article proposes that the effect of behavioral interventions may be different in hierarchical organizations where the decision to change behavior and the execution of that decision are split between different individuals. We examine the effect of two small-scale interventions—personal reminders and financial incentives—in a large-scale field experiment with public schools in Denmark. The Ministry of Education invited a representative sample of public schools to adopt a program that provides information on students’ socio-emotional competencies. Results show that small financial incentives increased managers’ adoption of the program by 7 percentage points. Frontline workers’ subsequent data generation and performance information acquisition were also increased in the incentive treatment groups, even though the latter was not incentivized. Reminders paired with incentives had an impact on the managers’ adoption, but the reminder effect disappeared during the implementation phase. These findings demonstrate both the potentials and limitations of applying behavioral research on individual residents to hierarchical organizations.

Cost effectiveness of pre- and post-paid incentives for mail survey response

While incentives improve survey response rates, they entail significant costs for the researcher. A mail survey study randomized across three incentive conditions ($2 pre-paid, $10 post-paid, and $20 post-paid), found that households in the $2 pre-paid condition were more likely to respond than the $10 post-paid condition (48.5% vs. 33.5%, β = -0.536, SE = 0.154, p < .001) and the $20 post-paid condition (48.5% vs. 42.4%, β = -0.305, SE = 0.10, p = 0.11). The $2 pre-paid condition was also more cost-effective than the $10 and $20 post-paid conditions (cost-per-complete of $15.35 vs. $26.67 and $34.40, respectively). The results of this study show that a small pre-paid incentive is generally most effective for maximizing both response rates and costs. The data from the study is also used to construct a model to forecast cost-efficiency for variable eligibility conditions, through a factor-adjusted response rate.

Lessons learned from using respondent-driven sampling (RDS) to assess sexual risk behaviors among Kenyan young adults living in urban slum settlements: A process evaluation.

BackgroundRespondent-driven sampling (RDS) is a peer-referral sampling methodology used to estimate characteristics of underserved groups that cannot be randomly sampled. RDS has been implemented in several settings to identify hidden populations at risk for HIV, but few studies have reported the methodological lessons learned on RDS design and implementation for assessing sexual risk behaviors in marginalized youth.MethodsWe used RDS to recruit N = 350 young adults, aged 18 to 22, who were living in urban slum settlements in Nairobi, Kenya. A structured survey was used to assess sexual risk behaviors. Twenty seeds were selected and asked to recruit up to three eligible peers. We used small monetary incentives and a three-day recruitment coupon with sequential numbers linking recruiters to their recruits.ResultsData collection was completed in 8 days with a maximum chain length of 6 waves. Each seed yielded 16 to 21 eligible recruits. Three (15%) seeds were unproductive and were replaced. RDS benefits were high identification rates (90% coupons returned per coupons given), high eligibility rates (100% eligible recruits per coupons returned), and high efficiency (~39 eligible recruits per day). 44% of the sample was female. Most recruits (74%) reported being “friends” for 7+ years with their recruiter. RDS overcame feasibility concerns of household-, clinic-, and school-based sampling methodologies in that underserved youth who were unemployed (68%), out of school (48%), ethnic minorities (26%), and having prior residential instability (≥2 moves in the past year) (20%) were successfully recruited, based on weighted analyses. Youth reporting HIV risk behaviors, including unprotected sex (38%), sex while high/drunk (35%), and sex exchange for pay (14%), were also enrolled. However, 28% were not sexually active within the last 6 months. Challenges included managing wait times during peaks and participant referral expectations. Community engagement, use of study-stamped coupons, broad inclusion criteria, incentives, and study sites within walking distances all contributed to the successful implementation of the sampling methodology.ConclusionRDS is an important tool in reaching a diverse sample of underserved and at-risk young adults for study participation. Implications for optimizing RDS for behavioral studies in this population are discussed.

Small sustainable monetary donation-based incentives to promote physical activity: A randomized controlled trial.

To pilot test two low-cost and thus financially sustainable incentive programs to promote physical activity (PA) among low-active adults in a community setting. In a three-arm randomized controlled trial the effects of small monetary incentives (cash incentives $1/day; n = 25) were compared to charitable donations (donation $1/day; n = 25) and a control group (n = 25) on PA behavior over the course of 12 months in insufficiently active, otherwise healthy adults. Incentives were based on attendance at a local YMCA. Electronic swipe card data from the YMCA was the primary outcome, with self-reported minutes of PA as a secondary outcome. Quantile regression models showed promising effects of treatment allocation on the primary outcome (attendance) adjusted for age and employment. There was a difference between cash incentives and control conditions such that median attendance in the cash incentives condition was 19.24 visits more over 12 months (b = 19.24; SE = 8.26, 95% CI [2.75, 35.72]). There was a similar though only marginally significant trend for the donation condition showing that participants in the donation condition made 11.88 additional visits to the YMCA over 12 months relative to the control condition (b = 11.88, SE = 8.41,95% CI [-0.91, 28.67]). There was a significant correlation between objectively verified YMCA attendance and self-reported moderate-to-vigorous PA at the YMCA (ρ = 0.587) over 12 months. These promising findings provide early support for small monetary incentives and charitable donations for promoting PA in community settings. Further research on the efficacy of using financially sustainable incentive programs, including charitable donations, for PA through community organizations (e.g., YMCAs) seems warranted. (PsycINFO Database Record (c) 2020 APA, all rights reserved).