UPHS Weight Loss Study

Study Overview
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Brief Summary
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The goal of this study is to compare a novel approach using financial incentives to changes in health benefit design and their impact on employee weight loss.

Detailed Description
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Employers are increasingly looking for opportunities to encourage weight loss among employees. While studies have shown that financial incentives can effectively encourage weight loss, little is known about their use in health benefits design. The goal of this study is to determine whether a financial incentive program delivered to obese University of Pennsylvania Health System employees can effectively encourage weight loss when compared to changes in health benefit design. This is a randomized controlled trial involving financial incentives with four study arms: control, delayed gratification, immediate gratification, and financial incentive with frequent feedback. Participation in this study will last about 12 months. The primary goal of the study is to test the effects of a novel financial incentive program using a lottery with frequent feedback to normal benefit design structures.

Official Title
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UPHS Weight Loss Study: Evaluating Methods to Use Health Benefits Design to Encourage Employee Weight Loss

Conditions
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Obesity

Intervention / Treatment
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* Behavioral: Financial incentive


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults age 18-70 BMI of 30 or above Exclusion Criteria: Inability to consent Illiteracy and/or inability to speak, read, and write English Participation in another research study Conditions that would make participation unsafe: Current treatment for drug or alcohol use Consumption of at least 5 alcoholic drinks per day Myocardial infarction or stroke within the past 6 months Current addiction to prescription medicines or street drugs Serious psychiatric diagnoses (e.g., severe major depressive disorder, bipolar disorder, schizophrenia) Pregnant or currently breastfeeding Diabetic and using any medicine besides metformin to control blood glucose Metastatic cancer Unstable medical conditions that would likely prevent the subject from completing the study Previous diagnosis of an eating disorder History of unsafe weight loss behaviors such as binging or the use of laxatives

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control Arm<br>No other financial incentive other than for enrollment, 6-month weigh in, and completion. | |
| Experimental: Delayed gratification<br>In addition to the standard enrollment, 6-month, and completion incentives, if the subject loses 5% of their initial weight by the end of the study, they will receive an annual discount (distributed across bi-weekly pay periods) for 12 months beginning after the 12-month study ends. Their premium will return to normal price after this 12-month discount ends. | Behavioral: Financial incentive<br> <br> |
| Experimental: Immediate gratification<br>In addition to the standard enrollment, 6-month, and completion incentives, the subject will be told that they can weigh in again any time before the study ends when they think they have lost 5% of their initial body weight. If they did meet their 5% goal, they will begin receiving a bi-weekly premium discount during the next pay period for a total duration of 12 months. Subjects that do not meet the 5% cut off during a weigh in are allowed to re-weigh themselves as many times as they like although they are encouraged to do so when they think they have met their target weight. Their premium goes back to normal price after this 12-month discount ends. | Behavioral: Financial incentive<br> <br> |
| Experimental: Financial incentive with frequent feedback<br>In addition to the standard enrollment, 6-month, and completion incentives, the subject will be asked to weigh in on the IncentaHEALTH scales everyday they are at work. These subjects will participate in a daily lottery with the possibility of winning the same amount as the discount in Arms 2 and 3 over the course of the study. The subject can choose to select or be designated a two digit number that ranges from 00 to 99. Each day a lottery will be held and the subject will be given a 1% chance of matching both digits or an 18% chance of matching one digit. In order to get the lottery winnings, the subject must meet a weight goal that consistently decreases to accumulate to a 5% weight loss by the 6 month mark. After 6 months, the subject will receive the lottery winnings if they maintain that target weight (initial weight minus 5%) until the end of the 12-month study. | Behavioral: Financial incentive<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total pounds of weight lost |  | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight loss of 5% of initial weight |  | 12 months |