Financial vs. Non-Financial Rewards for Weight Loss and Weight Maintenance

NCT02957539 | Completed Results

• 1 other identifier: IIR 15-459
• Study Type: interventional
• Target: 274
• Locations: 1 country
• Sites: 1

Brief Summary

Three of every four Veterans are overweight or obese, and weight loss is associated with reduced morbidity and mortality. The VA MOVE! program for weight loss is moderately effective but only reaches a small percentage of overweight Veterans. This proposed study will test whether a patient incentive program that gives Veterans non-financial incentives, such as Seattle Mariners baseball tickets, for losing one pound per week over 16 weeks is effective. An effective patient-incentive program could help more Veterans lose weight without requiring a substantial increase in VA staff.

Conditions

Obesity

Keywords

motivation; patient incentives

Outcome Measures

Primary Outcomes (1)

• Weight Change From Baseline to Week 32

  The primary outcome is weight measured in pounds at week 32 minus the weight at baseline.

  32 weeks

Secondary Outcomes (11)

• Self Efficacy

  Change form baseline to 16 weeks

• Self Efficacy

  Change form baseline to 32 weeks

• Self Efficacy

  Change form baseline to 52 weeks

• Intrinsic Motivation

  Change form baseline to 16 weeks

• Intrinsic Motivation

  Change form baseline to 32 weeks

Other Outcomes (1)

• Total Intervention Costs for All Participants

  through 16 weeks

Study Arms (3)

No Reward

NO INTERVENTION

At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.

Financial Reward Arm

EXPERIMENTAL

Same as usual care, plus financial rewards that are earned in two ways: an assured and random. For the assured reward, they will receive compensation at the end of each month that they are at or below their target weight on the last day of that period. For the random portion, each week that a participant is at or below their target weight, the patient is entered in random drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning.Over the 17-32 week period, Veterans in this group will receive token rewards for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters his/her weight into the portal, he will have a 1-in-8 chance to earn the token reward, such as a t-shirt or movie tickets. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.

Behavioral: Financial rewards

Non-financial Reward Arm

EXPERIMENTAL

Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.

Behavioral: Non-Financial rewards

Interventions

Financial rewards BEHAVIORAL

Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured portion, and a random portion. For the assured reward, they will receive compensation at the end of each month (defined as a four week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32 week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, s/he will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.

Financial Reward Arm

Non-Financial rewards BEHAVIORAL

Procedures for the non-financial rewards arm are identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each weekly random drawing will be for 20 points. Veterans will choose non-financial rewards associated with the number of points they earn.

Non-financial Reward Arm

Eligibility Criteria

• Age: 18 Years - 69 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Veteran
• BMI\>=30 at enrollment
• weigh less than 390lbs
• Active patient in primary care or women's clinic (1+ visit in last year)
• Access to a text capable phone in the Veteran's household or active email address
• live in Seattle area the entire year
• access to the internet

You may not qualify if:

• behavioral flag
• serious mental illness or anti-psychotic medication
• eating disorder and/or sexual trauma
• MOVE! participation in past 4 months
• pregnant or planning to become pregnant
• prisoner/employee/student
• inability to independently stand
• inability to read
• insulin dependent
• impaired decision making
• no access to a cell phone or phone that can receive text messages
• inability to remove socks \& shoes
• \>5% of body weight lost in last 6 months (clinical data and self-report)
• unable to pass cognitive screening

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

VA Puget Sound Health Care System Seattle Division, Seattle, WA

Seattle, Washington, 98108-1532, United States

Location

MeSH Terms

Conditions

Obesity

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Limitations and Caveats

The enrollment goal for the study was 280 participants. Enrollment and study recruitment was terminated on 3/4/2020 with 274 participants due to the COVID-19 pandemic.

Results Point of Contact

• Title: Paul Hebert
• Organization: VA Puget Sound Health Care System

paul.hebert2@va.gov

2062774165

Study Officials

• Paul L. Hebert, PhD BA

  VA Puget Sound Health Care System Seattle Division, Seattle, WA

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 1, 2016
• First Posted: November 7, 2016
• Study Start: March 21, 2018
• Primary Completion: March 5, 2021
• Study Completion: July 30, 2021
• Last Updated: July 28, 2023
• Results First Posted: March 31, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will share

Locations

US (1)