title: A Randomized Trial of Social Comparison Feedback and Financial Incentives to Increase Physical Activity.
abstract: To compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity.
  
  
  
  Randomized trial (Clinicaltrials.gov number, NCT02030080).
  
  
  
  Philadelphia, Pennsylvania.
  
  
  
  Two hundred eighty-six adults.
  
  
  
  Twenty-six weeks of weekly feedback on team performance compared to the 50th percentile (n = 100) or the 75th percentile (n = 64) and 13 weeks of weekly lottery-based financial incentive plus feedback on team performance compared to the 50th percentile (n = 80) or the 75th percentile (n = 44) followed by 13 weeks of only performance feedback.
  
  
  
  Mean proportion of participant-days achieving the 7000-step goal during the 13-week intervention.
  
  
  
  Generalized linear mixed models adjusting for repeated measures and clustering by team.
  
  
  
  Compared to the 75th percentile without incentives during the intervention period, the mean proportion achieving the 7000-step goal was significantly greater for the 50th percentile with incentives group (0.45 vs 0.27, difference: 0.18, 95% confidence interval [CI]: 0.04 to 0.32; P = .012) but not for the 75th percentile with incentives group (0.38 vs 0.27, difference: 0.11, 95% CI: -0.05 to 0.27; P = .19) or the 50th percentile without incentives group (0.30 vs 0.27, difference: 0.03, 95% CI: -0.10 to 0.16; P = .67).
  
  
  
  Social comparison to the 50th percentile with financial incentives was most effective for increasing physical activity.
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Wharton School, University of Pennsylvania, Philadelphia, PA, USA LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA Center for Health Equity Research and Promotion, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA mpatel@upenn.edu.
authors.forename: Mitesh S
authors.initials: MS
authors.lastname: Patel
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Wharton School, University of Pennsylvania, Philadelphia, PA, USA LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA Center for Health Equity Research and Promotion, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
authors.affiliation: Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA.
authors.forename: Roy
authors.initials: R
authors.lastname: Rosin
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Scarlett L
authors.initials: SL
authors.lastname: Bellamy
authors.affiliation: Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Dylan S
authors.initials: DS
authors.lastname: Small
authors.affiliation: University of Pennsylvania Health System, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Michele A
authors.initials: MA
authors.lastname: Fletcher
authors.affiliation: University of Pennsylvania Health System, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Osman-Koss
authors.affiliation: University of Pennsylvania Health System, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brady
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Haff
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, NY, USA.
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Lee
authors.affiliation: LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wesby
authors.affiliation: LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Hoffer
authors.affiliation: LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Shuttleworth
authors.affiliation: LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Devon H
authors.initials: DH
authors.lastname: Taylor
authors.affiliation: LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Hilbert
authors.affiliation: LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Jingsan
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Xingmei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Wharton School, University of Pennsylvania, Philadelphia, PA, USA LDI Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, USA Center for Health Care Innovation, University of Pennsylvania Health System, Philadelphia, PA, USA Center for Health Equity Research and Promotion, Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
mesh_terms: D000328:Adult; D015444:Exercise; D005246:Feedback; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015143:Philadelphia; D012919:Social Behavior; D016138:Walking
keywords: behavioral economics; connected health; financial incentives; performance feedback; physical activity; social comparison; teams