title: The Feasibility of Financial Incentives to Increase Exercise Among Canadian Cardiac Rehabilitation Patients.
abstract: OBJECTIVE
  To examine the feasibility of conducting a randomized controlled trial investigating the effectiveness of financial incentives for exercise self-monitoring in cardiac rehabilitation (CR).
  
  
  METHODS
  A 12-week, 2 parallel-arm, single-blind feasibility study design was employed. A volunteer sample of CR program graduates was randomly assigned to an exercise self-monitoring intervention only (control; n = 14; mean age ± SD, 62.7 ± 14.6 years), or an exercise self-monitoring plus incentives approach (incentive; n = 13; mean age ± SD, 63.6 ± 11.8 years). Control group participants received a "home-based" exercise self-monitoring program following CR program completion (exercise diaries could be submitted online or by mail). Incentive group participants received the "home-based" program, plus voucher-based incentives for exercise diary submissions ($2 per day). A range of feasibility outcomes is presented, including recruitment and retention rates, and intervention acceptability. Data for the proposed primary outcome of a definitive trial, aerobic fitness, are also reported.
  
  
  RESULTS
  Seventy-four CR graduates were potentially eligible to participate, 27 were enrolled (36.5% recruitment rate; twice the expected rate), and 5 were lost to followup (80% retention). Intervention acceptability was high with three-quarters of participants indicating that they would likely sign up for an incentive program at baseline. While group differences in exercise self-monitoring (the incentive "target") were not observed, modest but nonsignificant changes in aerobic fitness were noted with fitness increasing by 0.23 mL·kg-·min- among incentive participants and decreasing by 0.68 mL·kg-·min- among controls.
  
  
  CONCLUSIONS
  This preliminary study demonstrates the feasibility of studying incentives in a CR context, and the potential for incentives to be readily accepted in the broader context of the Canadian health care system.
authors.affiliation: Faculty of Kinesiology and Physical Education, University of Toronto (Mr Mitchell and Drs Goodman and Faulkner), Toronto Rehabilitation Institute, University Health Network (Mr Mitchell and Drs Alter and Oh), Institute for Clinical Evaluative Sciences (Dr Alter), Toronto, Ontario, Canada; and Department of Allied Health Services, University of Connecticut, Storrs (Dr Leahey).
authors.forename: Marc S
authors.initials: MS
authors.lastname: Mitchell
authors.forename: Jack M
authors.initials: JM
authors.lastname: Goodman
authors.forename: David A
authors.initials: DA
authors.lastname: Alter
authors.forename: Paul I
authors.initials: PI
authors.lastname: Oh
authors.forename: Tricia M
authors.initials: TM
authors.lastname: Leahey
authors.forename: Guy E J
authors.initials: GE
authors.lastname: Faulkner
mesh_terms: D000368:Aged; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010101:Oxygen Consumption; D012201:Reward; D016037:Single-Blind Method