title: Individual- versus group-based financial incentives for weight loss: a randomized, controlled trial.
abstract: BACKGROUND
  Data on the effectiveness of employer-sponsored financial incentives for employee weight loss are limited.
  
  
  OBJECTIVE
  To test the effectiveness of 2 financial incentive designs for promoting weight loss among obese employees.
  
  
  METHODS
  Randomized, controlled trial. (ClinicalTrials.gov: NCT01208350)
  
  
  METHODS
  Children's Hospital of Philadelphia.
  
  
  METHODS
  105 employees with a body mass index between 30 and 40 kg/m2.
  
  
  METHODS
  24 weeks of monthly weigh-ins (control group; n = 35); individual incentive, designed as $100 per person per month for meeting or exceeding weight-loss goals (n = 35); and group incentive, designed as $500 per month split among participants within groups of 5 who met or exceeded weight-loss goals (n = 35).
  
  
  METHODS
  Weight loss after 24 weeks (primary outcome) and 36 weeks and changes in behavioral mediators of weight loss (secondary outcomes).
  
  
  RESULTS
  Group-incentive participants lost more weight than control participants (mean between-group difference, 4.4 kg [95% CI, 2.0 to 6.7 kg]; P < 0.001) and individual-incentive participants (mean between-group difference, 3.2 kg [CI, 0.9 to 5.5 kg]; P = 0.008). Twelve weeks after incentives ended and after adjustment for 3-group comparisons, group-incentive participants maintained greater weight loss than control group participants (mean between-group difference, 2.9 kg [CI, 0.5 to 5.3 kg]; P = 0.016) but not greater than individual-incentive participants (mean between-group difference, 2.7 kg [CI, 0.4 to 5.0 kg]; P = 0.024).
  
  
  CONCLUSIONS
  Single employer and short follow-up.
  
  
  CONCLUSIONS
  A group-based financial incentive was more effective than an individual incentive and monthly weigh-ins at promoting weight loss among obese employees at 24 weeks.
  
  
  BACKGROUND
  National Institute on Aging.
authors.affiliation: Veterans Affairs Center forClinical Management Research, Veterans Affairs Ann Arbor HealthcareSystem, Ann Arbor, MI 48113-0170, USA. jkullgre@med.umich.edu
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Kullgren
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Troxel
authors.forename: George
authors.initials: G
authors.lastname: Loewenstein
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Norton
authors.forename: Lisa
authors.initials: L
authors.lastname: Wesby
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Tao
authors.forename: Jingsan
authors.initials: J
authors.lastname: Zhu
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D015992:Body Mass Index; D004649:Employee Incentive Plans; D005260:Female; D006126:Group Processes; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D012201:Reward; D015431:Weight Loss
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