Low-Income Participants’ Preference Between Financial Incentives for Behavioral Goals vs Weight Loss Targets and Associations With Behavioral Goal Adherence

Low-Income Participants’ Preference Between Financial Incentives for Behavioral Goals vs Weight Loss Targets and Associations With Behavioral Goal Adherence

Purpose Examine associations between whether participants’ were matched to their preferred financial incentive design and behavioral goal adherence in a weight management intervention. Design Secondary quantitative analysis incorporating qualitative survey data. Setting Primary care clinics in socio...

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Bibliographic Details
Published in:American journal of health promotion Vol. 38; no. 8; pp. 1217 - 1228
Main Authors: Adhiyaman, Akshitha, Jay, Melanie, Chung, Un Young Rebecca, Gronda, Andres N., Tseng, Chi-Hong, Wylie-Rosett, Judith, Wittleder, Sandra, Wali, Soma, Ladapo, Joseph A., Orstad, Stephanie L.
Format: Journal Article
Language:English
Published: Los Angeles, CA SAGE Publications 01-11-2024
American Journal of Health Promotion
Subjects:
Adherence
Behavior
Clinics
Community health services
Demography
Disadvantaged
Financial incentives
Incentives
Intervention
Low income groups
Moderation
Monetary incentives
Obesity
Objectives
Physical activity
Primary care
Psychosocial factors
Quantitative analysis
Regression analysis
Tracking
Weighing
Weight control
Weight loss
weight loss intervention
behavioral adherence
obesity
preference
financial incentives
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Summary:Purpose Examine associations between whether participants’ were matched to their preferred financial incentive design and behavioral goal adherence in a weight management intervention. Design Secondary quantitative analysis incorporating qualitative survey data. Setting Primary care clinics in socioeconomically disadvantaged communities in New York City and Los Angeles. Subjects 668 participants (mean age 47.7 years, 81.0% female, 72.6% Hispanic) with obesity were enrolled in the Financial Incentives foR Weight Reduction (FIReWoRk) intervention. Measures We explored qualitatively participant’s reasons for hypothetically choosing a behavioral goal-directed vs a weight loss outcome-based financial incentive program. Additionally, behavioral adherence to different goals was collected at the 6-month timepoint, categorized by match to preferred financial incentive design. Analysis Logistic regression was used to examine if participants with certain demographic and higher psychosocial factors were more likely to choose goal-directed over outcome-based incentives. Additionally, logistic regression was used to test for associations between preference and behavioral adherence, using incentive type as an interaction term. Results 60.2% of participants preferred the goal-directed incentive, with the majority stating that it was more structured. Married participants were more likely to prefer goal-directed incentives (OR = 1.57, CI = 1.06-2.33, P = .025). Moderation analysis revealed that participants who preferred goal-directed and were matched to goal-directed had greater rates of behavioral adherence for program attendance and self-weighing, but not dietary tracking and physical activity tracking, compared to those who preferred outcome-based and were matched to outcome-based. Conclusion Receiving one’s preferred incentive design may not play a strong role in behavioral goal adherence during financially incentivized weight loss interventions.
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ISSN:0890-1171
2168-6602
2168-6602
DOI:10.1177/08901171241254366