Opportunity

Physical activity is associated with many health benefits, including reduced rates of cardiovascular disease, diabetes, hypertension, and obesity. However, more than 50 percent of adults in the United States do not get enough regular physical activity to obtain such benefits.   

Intervention 

We designed a six-month randomized controlled trial to test the efficacy of multiple financial incentives to increase physical activity and partnered with the Human Resources Department at the University of Pennsylvania to enroll 281 overweight and obese employees.   

Participants used their smartphones to track steps and were randomly assigned to a control group or one of three financial incentives. Each incentive arm was offered the same daily monetary value.  

In the gain-framed arm, participants were rewarded after goals were achieved; in the loss-framed arm, money was placed in a virtual account and taken away if goals were not achieved; and in the lottery arm, participants were entered into a lottery to win money if their goals were achieved.   

Impact 

The loss-framed incentive was the most effective at increasing physical activity, with physical activity goal achievement increasing by 50 percent relative to the control group. The gain-framed incentive showed no difference from the control arm, and the lottery incentive did slightly better than the gain-framed incentive but was not as effective as the loss-framed incentive.    

More than 85 percent of large employers use financial incentives for health promotion. The findings from this study can be leveraged to optimize the design of such incentives.