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Article | JAMA Network Open

Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial

by Chethan Bachireddy, Andrew Joung, Leslie K. John, Francesca Gino, Bradford Tuckfield, Luca Foschini and Katherine L. Milkman

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Abstract

Importance: Few adults engage in recommended levels of physical activity. Financial incentives can promote physical activity, but little is known about how their structure influences their effectiveness; for example, whether incentives are more effective if they are disbursed at a constant rate versus increasing or decreasing rates.

Objective: To determine if it is more effective to disburse fixed total incentives at a constant, increasing or decreasing rate to encourage physical activity.

Design: Two-week, four arm randomized controlled trial from June 2, 2014 to June 15, 2014. Data analyses finalized in 2018.

Setting: An online platform that automatically records daily steps of pedometer-wearing users and awards points redeemable for cash.

Participants: 3,515 users of the online platform in the lower 70th percentile of steps taken among all users pre-treatment.

Intervention: Participants were randomized to either a control group or to one of three intervention groups over two weeks. Control participants received a constant daily rate of $0.00001/step. The three intervention groups received a 20-fold incentive increase ($0.00020/step) distributed differently over two weeks—at a constant, increasing or decreasing rate. Reminder emails explaining incentive schedules were sent the day before the intervention and halfway through the two-week intervention.

Main Outcome and Measure: Change in mean daily steps during the two-week intervention and three weeks post-intervention. The study had 80% power to detect a difference of 280 steps/day during the intervention at α=0.05.

Results: During the intervention, compared to control, constant incentives generated 306.7 more steps/day (95% CI [91.5,521.9]; p=0.005), decreasing incentives generated 96.9 more steps/day (95% CI [15.3,178.5]; p=0.020), and increasing incentives generated no change (1.5; 95% CI [-81.6,84.7]; p=0.971). One week post-intervention, compared to control, only constant incentives generated significantly more steps/day (329.5; 95% CI [20.6,638.4]; p=0.037). Two and three weeks post-intervention, there were no significant differences compared to control. Overall, for each dollar spent, constant incentives generated 475.5 more steps than increasing incentives and 429.4 more steps than decreasing incentives.

Conclusions and Relevance: Financial incentives for physical activity are more effective during a payment period if offered at a constant rather than an increasing or decreasing rate. However, this effectiveness dissipates shortly after the incentives are removed.

Trial Registration: Clinicaltrials.gov identifier: NCT02154256
https://clinicaltrials.gov/ct2/show/NCT02154256.

Keywords: physical activity; financial incentives; Motivation and Incentives; Money;

Format: Electronic Find at Harvard Read Now

Citation:

Bachireddy, Chethan, Andrew Joung, Leslie K. John, Francesca Gino, Bradford Tuckfield, Luca Foschini, and Katherine L. Milkman. "Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial." JAMA Network Open 2, no. 8 (August 2019): 1–13.

About the Authors

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Leslie K. John
Marvin Bower Associate Professor
Negotiation, Organizations & Markets

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Francesca Gino
Tandon Family Professor of Business Administration
Unit Head, Negotiation, Organizations & Markets
Negotiation, Organizations & Markets

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More from these Authors

  • Article | Management Science | December 2019

    Communicating with Warmth in Distributive Negotiations Is Surprisingly Counterproductive

    M. Jeong, J. Minson, M. Yeomans and F. Gino

    When entering into a negotiation, individuals have the choice to enact a variety of communication styles. We test the differential impact of being “warm and friendly” versus “tough and firm” in a distributive negotiation, when first offers are held constant and concession patterns are tracked. We train a natural language processing algorithm to precisely quantify the difference between how people enact warm versus tough communication styles. We find that the two styles differ primarily in length and their expressions of politeness (Study 1). Negotiators with a tough communication style achieved better economic outcomes than negotiators with a warm communication style, both in a field experiment (Study 2) and in a laboratory experiment (Study 3). This was driven by the fact that offers delivered in tough language elicited more favorable counteroffers. We further find that the counterparts of warm versus tough negotiators did not report different levels of satisfaction or enjoyment of their interactions (Study 3). Finally, in Study 4 we document that individuals’ lay beliefs are in direct opposition to our findings: participants believe that authors of warmly worded negotiation offers will be better liked and will achieve better economic outcomes.

    Keywords: Negotiation Style; Communication Strategy; Perception; Performance Effectiveness; Outcome or Result;

    Citation:

    Jeong, M., J. Minson, M. Yeomans, and F. Gino. "Communicating with Warmth in Distributive Negotiations Is Surprisingly Counterproductive." Management Science 65, no. 12 (December 2019): 5813–5837.  View Details
    CiteView DetailsFind at Harvard Related
  • Article | Journal of Personality and Social Psychology | December 2019

    It Helps to Ask: The Cumulative Benefits of Asking Follow-up Questions

    Michael Yeomans, Alison Wood Brooks, Karen Huang, Julia A. Minson and Francesca Gino

    In a recent article published in Journal of Personality and Social Psychology (JPSP; Huang, Yeomans, Brooks, Minson, & Gino, 2017), we reported the results of 2 experiments involving “getting acquainted” conversations among strangers and an observational field study of heterosexual speed daters. In all 3 studies, we found that asking more questions in conversation, especially follow-up questions (that indicate responsiveness to a partner), increases interpersonal liking of the question asker. Kluger and Malloy (2019) offer a critique of the analyses in Study 3 of our article. Though their response is a positive signal of engaged interest in our research, they made 3 core mistakes in their analyses that render their critique invalid. First, they tested the wrong variables, leading to conclusions that were erroneous. Second, even if they had analyzed the correct variables, some of their analytical choices were not valid for our speed-dating dataset, casting doubt on their conclusions. Third, they misrepresented our original findings, ignoring results in all 3 of our studies that disprove some of their central criticisms. In summary, the conclusions that Kluger and Malloy (2019) drew about Huang et al. (2017)’s findings are incorrect. The original results are reliable and robust: Asking more questions, especially follow-up questions, increases interpersonal liking. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

    Keywords: question-asking; Conversation; Communication; Relationships; Interpersonal Communication;

    Citation:

    Yeomans, Michael, Alison Wood Brooks, Karen Huang, Julia A. Minson, and Francesca Gino. "It Helps to Ask: The Cumulative Benefits of Asking Follow-up Questions." Journal of Personality and Social Psychology 117, no. 6 (December 2019): 1139–1144.  View Details
    CiteView DetailsFind at Harvard Related
  • Case | HBS Case Collection | November 2019

    Starbucks: Reaffirming Commitment to the Third Place Ideal

    Francesca Gino, Katherine B. Coffman and Jeff Huizinga

    On April 12, 2018, two African American entrepreneurs had scheduled a business meeting at a Starbucks in Philadelphia’s Rittenhouse Square neighborhood. They sat without ordering, waiting for a local businessman to show up for the meeting. The store manager called 911 on them, despite the fact that they were behaving neither violently nor disruptively. When the police arrived soon after the call, they arrested the young men. The incident was viewed by the Starbucks’ leadership team, including the CEO, as “a disheartening situation” and, in the words of John Kelly, the company’s Senior VP of Public Affairs and Social Impact, “a profound failure to live up to our ideals and a violation of our values.” Starbucks, which employed around 175,000 individuals nationwide and served more than 4 million customers daily in its approximately 8,000 U.S. stores, strived to abide by its mission statement: “…To inspire and nurture the human spirit, one cup, one person, one neighborhood at a time.”
    The case describes how the company and its leadership responded to the crisis. To react to the incident, the leadership decided to close down its stores for a day of unconscious bias training, aimed at raising awareness of racial bias and discrimination in particular. The company also started a journey of providing more training and development for the partners, to assure that they lived by the company values on a daily basis, and revised store policy that, the leadership believed, contributed to how the store managers and employees in the Rittenhouse Square store behaved back in April 2018. As the case closes, CEO Steve Johnson reflects on how he could assure that every Starbucks employee not only understood the company mission and values, but truly connected to them emotionally and carry them out daily in their work.

    Keywords: Mission and Purpose; Values and Beliefs; Prejudice and Bias; Crisis Management; Employees; Training;

    Citation:

    Gino, Francesca, Katherine B. Coffman, and Jeff Huizinga. "Starbucks: Reaffirming Commitment to the Third Place Ideal." Harvard Business School Case 920-016, November 2019.  View Details
    CiteView DetailsEducators Related
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