The 'donations for decreased ALT (D4D)' prosocial behavior incentive scheme for NAFLD patients

The 'donations for decreased ALT (D4D)' prosocial behavior incentive scheme for NAFLD patients

Background Physicians often experience difficulties in motivating patients with non-alcoholic fatty liver disease (NAFLD) to undergo lifestyle changes. The aim of this study is to examine whether 'Donations for Decreased alanine aminotransferase (ALT)' (D4D) prosocial behavior incentive ca...

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Published in:Journal of public health (Oxford, England) Vol. 36; no. 4; pp. 629 - 634
Main Authors: Sumida, Yoshio, Yoshikawa, Toshikazu, Tanaka, Saiyu, Taketani, Hiroyoshi, Kanemasa, Kazuyuki, Nishimura, Tekeshi, Yamaguchi, Kanji, Mitsuyoshi, Hironori, Yasui, Kohichiroh, Minami, Masahito, Naito, Yuji, Itoh, Yoshito
Format: Journal Article
Language:English
Published: England Oxford University Press 01-12-2014
Subjects:
Alanine Transaminase - blood
Body Mass Index
Diet
Exercise
Female
Gift Giving
Health Behavior
Humans
Interventions (preventive)
Life Style
Male
Middle Aged
Motivation
Non-alcoholic Fatty Liver Disease - blood
Non-alcoholic Fatty Liver Disease - psychology
Non-alcoholic Fatty Liver Disease - therapy
United Nations
NAFLD
prosocial behavior
intrinsic motivation
World Food Programme
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Summary:Background Physicians often experience difficulties in motivating patients with non-alcoholic fatty liver disease (NAFLD) to undergo lifestyle changes. The aim of this study is to examine whether 'Donations for Decreased alanine aminotransferase (ALT)' (D4D) prosocial behavior incentive can serve as an effective intrinsic motivational factor in comparison with conventional dietary and exercise intervention alone for NAFLD patients. Methods Twenty-five NAFLD patients with elevated ALT were randomly assigned to a control group that received conventional dietary and exercise intervention alone, or a donation group whereby, as an incentive, we would make a monetary donation to the United Nations World Food Programme (WFP) based on the decrease in their ALT levels achieved over 12 weeks, in addition to receiving control intervention. In a donation group, we would donate US$1 to the WFP for every 1 IU/I of decrease in their ALT levels. Results There were no differences of pre-treatment clinical characteristics between the two groups. Significant reductions of ALT levels were achieved only in a donation group, although post-treatment ALT levels were not different between the two groups. These patients raised a total of $316 for the WFP. Conclusions Promoting patients' intrinsic motivation by incorporating 'D4D' prosocial behavior incentive into conventional dietary and exercise intervention may provide a means to improve NAFLD.
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ISSN:1741-3842
1741-3850
DOI:10.1093/pubmed/fdt098