Jeffrey T. Kullgren, MD, MS, MPH; Andrea B. Troxel, ScD; George Loewenstein, PhD; David A. Asch, MD, MBA; Laurie A. Norton, MA; Lisa Wesby, MS; Yuanyuan Tao, MS; Jingsan Zhu, MS, MBA; Kevin G. Volpp, MD, PhD
Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Veterans Affairs or the U.S. government.
Acknowledgment: The authors thank Dana Gatto, BS, and Lin Yang, MS, of the Leonard Davis Institute of Health Economics Center for Health Incentives and Behavioral Economics, Penn-CMU Roybal Center on Behavioral Economics and Health, and the Perelman School of Medicine at the University of Pennsylvania; and Robert Croner, MS, and Daniel Buckalew, MS, of the Children's Hospital of Philadelphia, for their assistance.
Grant Support: By grant RC2103282621 (National Institute on Aging). Support was also provided by the Department of Veterans Affairs and the Robert Wood Johnson Foundation.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1785.
Reproducible Research Statement: Study protocol and statistical code: Available from Dr. Kullgren (e-mail, jkullgre@med.umich.edu). Data set: Not available.
Requests for Single Reprints: Jeffrey T. Kullgren, MD, MS, MPH, Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, PO Box 130170, Ann Arbor, MI 48113-0170; e-mail, jkullgre@med.umich.edu.
Current Author Addresses: Dr. Kullgren: Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, PO Box 130170, Ann Arbor, MI 48113-0170.
Dr. Troxel: Perelman School of Medicine at the University of Pennsylvania, Department of Biostatistics and Epidemiology, 632 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Dr. Loewenstein: Carnegie Mellon University, College of Humanities and Social Sciences, 208 Porter Hall, 5000 Forbes Avenue, Pittsburgh, PA 15213.
Dr. Asch: The Wharton School, University of Pennsylvania, Health Care Management Department, 3641 Locust Walk, 210 Colonial Penn Center, Philadelphia, PA 19104.
Ms. Norton: Perelman School of Medicine at the University of Pennsylvania, Division of General Internal Medicine, 1126 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Ms. Wesby: Perelman School of Medicine at the University of Pennsylvania, Division of General Internal Medicine, 1121 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Ms. Tao: Perelman School of Medicine at the University of Pennsylvania, Division of General Internal Medicine, 1132 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Mr. Zhu: Perelman School of Medicine at the University of Pennsylvania, Division of General Internal Medicine, 1133 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Dr. Volpp: Perelman School of Medicine at the University of Pennsylvania, Division of General Internal Medicine, 1120 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021.
Author Contributions: Conception and design: J.T. Kullgren, G. Loewenstein, D.A. Asch, K.G. Volpp.
Analysis and interpretation of data: J.T. Kullgren, A.B. Troxel, D.A. Asch, Y. Tao, J. Zhu, K.G. Volpp.
Drafting of the article: J.T. Kullgren, A.B. Troxel, G. Loewenstein, K.G. Volpp.
Critical revision of the article for important intellectual content: J.T. Kullgren, A.B. Troxel, G. Loewenstein, D.A. Asch, L.A. Norton, L. Wesby, Y. Tao, J. Zhu, K.G. Volpp.
Final approval of the article: J.T. Kullgren, A.B. Troxel, G. Loewenstein, D.A. Asch, L. Wesby, J. Zhu, K.G. Volpp.
Statistical expertise: A.B. Troxel, Y. Tao, J. Zhu.
Obtaining of funding: D.A. Asch, K.G. Volpp.
Administrative, technical, or logistic support: J.T. Kullgren, L.A. Norton, L. Wesby, K.G. Volpp.
Collection and assembly of data: L.A. Norton, L. Wesby, J. Zhu.
Chinese translation
Data on the effectiveness of employer-sponsored financial incentives for employee weight loss are limited.
To test the effectiveness of 2 financial incentive designs for promoting weight loss among obese employees.
Randomized, controlled trial. (ClinicalTrials.gov: NCT01208350)
Children's Hospital of Philadelphia.
105 employees with a body mass index between 30 and 40 kg/m2.
24 weeks of monthly weigh-ins (control group; n = 35); individual incentive, designed as $100 per person per month for meeting or exceeding weight-loss goals (n = 35); and group incentive, designed as $500 per month split among participants within groups of 5 who met or exceeded weight-loss goals (n = 35).
Weight loss after 24 weeks (primary outcome) and 36 weeks and changes in behavioral mediators of weight loss (secondary outcomes).
Group-incentive participants lost more weight than control participants (mean between-group difference, 4.4 kg [95% CI, 2.0 to 6.7 kg]; P < 0.001) and individual-incentive participants (mean between-group difference, 3.2 kg [CI, 0.9 to 5.5 kg]; P = 0.008). Twelve weeks after incentives ended and after adjustment for 3-group comparisons, group-incentive participants maintained greater weight loss than control group participants (mean between-group difference, 2.9 kg [CI, 0.5 to 5.3 kg]; P = 0.016) but not greater than individual-incentive participants (mean between-group difference, 2.7 kg [CI, 0.4 to 5.0 kg]; P = 0.024).
Single employer and short follow-up.
A group-based financial incentive was more effective than an individual incentive and monthly weigh-ins at promoting weight loss among obese employees at 24 weeks.
National Institute on Aging.
Kullgren JT, Troxel AB, Loewenstein G, et al. Individual- Versus Group-Based Financial Incentives for Weight Loss: A Randomized, Controlled Trial. Ann Intern Med. 2013;158:505–514. doi: https://doi.org/10.7326/0003-4819-158-7-201304020-00002
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© 2019
Published: Ann Intern Med. 2013;158(7):505-514.
DOI: 10.7326/0003-4819-158-7-201304020-00002
Healthcare Delivery and Policy, Obesity.
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