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Identifying Financial Incentive Designs to Enhance Participation in Weight Loss Programs

Ali Hashemi, Wen You, Kevin J. Boyle, Christopher F. Parmeter, Barbara Kanninen and Paul A. Estabrooks

Background: Financial incentives are routinely recommended to attract participants to weight loss programs; however there is a paucity of research that uses a systematic approach to determine incentive packages that may be most beneficial in increasing program reach or participation. Methods: The purpose of this study was to determine monetary incentive designs (in terms of magnitude, form, and timing of payment) that could increase the likelihood of participation in weight loss programs. Participants (n=863) completed surveys to collect stated preferences regarding to the magnitude, timing, and form of monetary incentives as well as willingness to participate in a weight loss program. Results: The results of our model show that, as expected, higher values of monetary incentive will increase the participation. Additionally, more flexible forms of payments (cash or grocery card as compared to gym pass or copay waiver) and more immediate payments (monthly as compared to quarterly payments) will enhance the participation in a weight loss program. Further, our second model, with respondent demographic interaction terms, shows significant differences between various groups of male participants (healthy, overweight, and obese males). This simply means that each group of male participants requires different incentive design to achieve a desired level of participation. The results do not show significant differences in incentive preference across women in different weight categories, which implies that the same monetary incentive design could be used for all women to achieve a given participation rate in a weight loss program. Conclusion: It is critical to carefully construct incentive packages offered in weight loss programs to enhance program reach. A one-size-fit-all weight loss program incentive design that ignores potential nuances in participation decisions are unlikely to be as successful in maximizing programs’ reach as programs that provide customized designs to attract different cohorts of people.