scholarly journals A Pragmatic Intervention Using Financial Incentives for Pregnancy Weight Management: Feasibility Randomized Controlled Trial

10.2196/30578 ◽  
2021 ◽  
Vol 5 (12) ◽  
pp. e30578
Author(s):  
Rebecca Krukowski ◽  
Brandi Johnson ◽  
Hyeonju Kim ◽  
Saunak Sen ◽  
Riad Homsi
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Treatment Engagement ◽  
First Trimester ◽  
Adult Women ◽  
First Trimester Of Pregnancy

Background Excessive gestational weight gain (GWG) is common and can result in maternal and child health complications. Pragmatic behavioral interventions that can be incorporated into standard obstetric care are needed, and financial incentives are a promising approach. Objective The aim of this study is to evaluate the feasibility of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, in a behavioral program. The program provided small incentives for meeting behavioral goals of self-weighing and physical activity as well as larger outcome incentives for meeting GWG goals. Methods We recruited 40 adult women in their first trimester of pregnancy from February 2019 to September 2019 at an obstetric clinic. Participants were randomized to 3 intervention components using a 2×2×2 factorial design: daily incentives for self-weighing (lottery vs certain loss), incentives for adhering to the Institute of Medicine’s GWG guidelines based on BMI category (monthly vs overall), and incentives for reaching physical activity goals (yes vs no). Participants were asked to complete daily weigh-ins using the Withings Body wireless scale provided by the study, as well as wear a physical activity tracker (Fitbit Flex 2). Feasibility outcomes of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, were assessed. Weight assessments were conducted at baseline, 32-week gestation, and 36-week gestation. Results Participants were enrolled at, on average, 9.6 (SD 1.8) weeks’ gestation. Of the 39 participants who were oriented to their condition and received the intervention, 24 (62%) were Black or African American, 30 (77%) were not married, and 29 (74%) had an annual household income of less than US $50,000. Of the 39 participants, 35 (90%) completed the follow-up data collection visit. Participants were generally quite positive about the intervention components, with a particular emphasis on the helpfulness of, and the enjoyment of using, the e-scale in both the quantitative and qualitative feedback. Participants who received the loss incentive, on average, had 2.86 times as many days of self-weighing as those who received the lottery incentive. Participants had a relatively low level of activity, with no difference between those who received a physical activity incentive and those who did not. Conclusions A financial incentive–based pragmatic intervention was feasible and acceptable for pregnant women for promoting self-weighing, physical activity, and healthy GWG. Participants were successfully recruited early in their first trimester of pregnancy and retained for follow-up data collection in the third trimester. Participants demonstrated promising engagement in self-weighing, particularly with loss-based incentives, and reported finding the self-weighing especially helpful. This study supports further investigation of pragmatic, clinic-based financial incentive–based interventions for healthy GWG behaviors. Trial Registration ClinicalTrials.gov NCT03834194; https://clinicaltrials.gov/ct2/show/NCT03834194

scholarly journals A Pragmatic Intervention Using Financial Incentives for Pregnancy Weight Management: Feasibility Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Rebecca Krukowski ◽  
Brandi Johnson ◽  
Hyeonju Kim ◽  
Saunak Sen ◽  
Riad Homsi
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Treatment Engagement ◽  
First Trimester ◽  
Adult Women ◽  
First Trimester Of Pregnancy

BACKGROUND Excessive gestational weight gain (GWG) is common and can result in maternal and child health complications. Pragmatic behavioral interventions that can be incorporated into standard obstetric care are needed, and financial incentives are a promising approach. OBJECTIVE The aim of this study is to evaluate the feasibility of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, in a behavioral program. The program provided small incentives for meeting behavioral goals of self-weighing and physical activity as well as larger outcome incentives for meeting GWG goals. METHODS We recruited 40 adult women in their first trimester of pregnancy from February 2019 to September 2019 at an obstetric clinic. Participants were randomized to 3 intervention components using a 2×2×2 factorial design: daily incentives for self-weighing (lottery vs certain loss), incentives for adhering to the Institute of Medicine’s GWG guidelines based on BMI category (monthly vs overall), and incentives for reaching physical activity goals (yes vs no). Participants were asked to complete daily weigh-ins using the Withings Body wireless scale provided by the study, as well as wear a physical activity tracker (Fitbit Flex 2). Feasibility outcomes of recruitment, randomization, and retention, as well as treatment engagement and intervention satisfaction, were assessed. Weight assessments were conducted at baseline, 32-week gestation, and 36-week gestation. RESULTS Participants were enrolled at, on average, 9.6 (SD 1.8) weeks’ gestation. Of the 39 participants who were oriented to their condition and received the intervention, 24 (62%) were Black or African American, 30 (77%) were not married, and 29 (74%) had an annual household income of less than US $50,000. Of the 39 participants, 35 (90%) completed the follow-up data collection visit. Participants were generally quite positive about the intervention components, with a particular emphasis on the helpfulness of, and the enjoyment of using, the e-scale in both the quantitative and qualitative feedback. Participants who received the loss incentive, on average, had 2.86 times as many days of self-weighing as those who received the lottery incentive. Participants had a relatively low level of activity, with no difference between those who received a physical activity incentive and those who did not. CONCLUSIONS A financial incentive–based pragmatic intervention was feasible and acceptable for pregnant women for promoting self-weighing, physical activity, and healthy GWG. Participants were successfully recruited early in their first trimester of pregnancy and retained for follow-up data collection in the third trimester. Participants demonstrated promising engagement in self-weighing, particularly with loss-based incentives, and reported finding the self-weighing especially helpful. This study supports further investigation of pragmatic, clinic-based financial incentive–based interventions for healthy GWG behaviors. CLINICALTRIAL ClinicalTrials.gov NCT03834194; https://clinicaltrials.gov/ct2/show/NCT03834194

A Randomized, Controlled Trial of Lottery-Based Financial Incentives to Increase Physical Activity Among Overweight and Obese Adults

2018 ◽  
Vol 32 (7) ◽  
pp. 1568-1575 ◽  
Author(s):  
Mitesh S. Patel ◽  
Kevin G. Volpp ◽  
Roy Rosin ◽  
Scarlett L. Bellamy ◽  
Dylan S. Small ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Controlled Trial ◽  
University Of Pennsylvania ◽  
Obese Adults ◽  
Randomized Controlled ◽  
Steps Per Day

Purpose: To evaluate the effect of lottery-based financial incentives in increasing physical activity. Design: Randomized, controlled trial. Setting: University of Pennsylvania Employees. Participants: A total of 209 adults with body mass index ≥27. Interventions: All participants used smartphones to track activity, were given a goal of 7000 steps per day, and received daily feedback on performance for 26 weeks. Participants randomly assigned to 1 of the 3 intervention arms received a financial incentive for 13 weeks and then were followed for 13 weeks without incentives. Daily lottery incentives were designed as a “higher frequency, smaller reward” (1 in 4 chance of winning $5), “jackpot” (1 in 400 chance of winning $500), or “combined lottery” (18% chance of $5 and 1% chance of $50). Measures: Mean proportion of participant days step goals were achieved. Analysis: Multivariate regression. Results: During the intervention, the unadjusted mean proportion of participant days that goal was achieved was 0.26 in the control arm, 0.32 in the higher frequency, smaller reward lottery arm, 0.29 in the jackpot arm, and 0.38 in the combined lottery arm. In adjusted models, only the combined lottery arm was significantly greater than control ( P = .01). The jackpot arm had a significant decline of 0.13 ( P < .001) compared to control. There were no significant differences during follow-up. Conclusions: Combined lottery incentives were most effective in increasing physical activity.

scholarly journals SCIMITAR+ Trial: A randomised study within a trial (SWAT) of a contingent financial reward to improve trial follow-up

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1937
Author(s):  
Catherine Arundel ◽  
Elizabeth Coleman ◽  
Caroline Fairhurst ◽  
Emily Peckham ◽  
Della Bailey ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Financial Incentive ◽  
Retention Rate ◽  
Controlled Trial ◽  
Cox Proportional Hazards ◽  
The Body ◽  
Due Date ◽  
Study Within A Trial ◽  
Breath Measurement

Background: To evaluate the effectiveness of a contingent financial incentive (£10 note in addition to a routinely provided £10 voucher) versus no contingent financial incentive, on improving the retention rate in a randomised controlled trial (RCT). Methods: A two arm ‘Study within a Trial’ (SWAT) embedded within a host RCT (SCIMITAR+). Participants were randomised to the SWAT using a 2:1 (intervention:control) allocation ratio. The primary outcome measure was the proportion of participants completing a CO breath measurement at the first SCIMITAR+ follow up time point (6 months). Secondary outcomes were withdrawing from follow-up after contact and time from assessment due date to completion.  Analyses were conducted using logistic or Cox Proportional Hazards regression as appropriate. Results: A total of 434 participants were randomised into this SWAT. Completion of the CO breath measurement at 6 months was 88.5% (n=247) in the intervention arm of the SWAT and 85.4% (n=123) in the control arm. The difference (3.1%) was not statistically significant (p=0.36; OR 1.29, 95% CI 0.71-2.33, p=0.41). There was also no evidence of a difference in the proportion of participants withdrawing from follow-up after contact (intervention n=7 (2.5%), control n=5 (3.5%); OR 0.76, 95% CI 0.23-2.44, p=0.64), nor in terms of proximity of 6-month visit completion to due date (HR 1.07, 95% CI 0.86-1.33, p=0.55). Conclusion: Contingent financial incentives did not statistically significantly increase rates of face-to-face follow-up completion within the SCIMITAR+ trial population. However, the sample size of this SWAT was constrained by the size of the host trial and power was limited. This SWAT adds to the body of evidence for initiatives to increase response rates in trials.

scholarly journals Effects of social network incentives and financial incentives on physical activity and social capital among older women: a randomized controlled trial

2020 ◽  
Author(s):  
Ryo Yamashita ◽  
Shinji Sato ◽  
Ryoichi Akase ◽  
Tatsuo Doi ◽  
Shigeki Tsuzuku ◽  
...  
Keyword(s):  
Physical Activity ◽  
Social Capital ◽  
Social Network ◽  
Older Women ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Peer Pressure ◽  
Incentive Group ◽  
The Impact

Abstract Background Financial incentives have been used to increase physical activity. However, the benefit of financial incentives is lost when an intervention ends. Thus, for this study, we combined social network incentives that leverage the power of peer pressure with financial incentives. Few reports have examined the impact of physical activity on social capital. Therefore, the main goal of this study was to ascertain whether a combination of two incentives could lead to more significant changes in physical activity and social capital during and after an intervention. Methods The participants were 39 older women over 65 years of age in Kumamoto, Japan. The participants were randomly divided into a financial incentive group (FI group) and a social network incentive plus financial incentive group (SNI+FI group). Both groups underwent a three-month intervention. Measurements of physical activity and social capital were performed before and after the intervention. Additionally, the effects of the incentives on physical activity and social capital maintenance were measured six months postintervention. The financial incentive group received a payment ranging from US$4.40 to US$6.20 per month, depending on the number of steps taken during the intervention. For the other group, we provided a social network incentive in addition to the financial incentive. The SNI+FI group walked in groups of three people to use the power of peer pressure. Results A two-way ANOVA revealed that in terms of physical activity, there was a statistically significant interaction between group and time (p=0.017). The FI group showed no statistically significant improvement in physical activity during the observation period. In terms of social capital, the change in trust approached significance ( p =0.08). Conclusion Our results suggest that social network incentives, in combination with financial incentives, are more effective for promoting physical activity than financial incentives alone among older women and that these effects can continue after an intervention. In the meantime, further studies should be conducted on the effect of physical activity on social capital.

scholarly journals The effectiveness of a contingent financial incentive to improve trial follow up; a randomised study within a trial (SWAT)

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1937
Author(s):  
Catherine Arundel ◽  
Elizabeth Coleman ◽  
Caroline Fairhurst ◽  
Emily Peckham ◽  
Della Bailey ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Financial Incentive ◽  
Retention Rate ◽  
Controlled Trial ◽  
Cox Proportional Hazards ◽  
The Body ◽  
Due Date ◽  
Study Within A Trial ◽  
Breath Measurement

Objectives To evaluate the effectiveness of a contingent financial incentive (£10 note in addition to a routinely provided £10 voucher) versus no contingent financial incentive, on improving the retention rate in a randomised controlled trial (RCT). Methods A two arm ‘Study within a Trial’ (SWAT) embedded within a host RCT (SCIMITAR+). Participants were randomised to the SWAT using a 2:1 (intervention:control) allocation ratio. The primary outcome measure was the proportion of participants completing a CO breath measurement at the first SCIMITAR+ follow up time point (6 months). Secondary outcomes were withdrawing from follow-up after contact and time from assessment due date to completion.  Analyses were conducted using logistic or Cox Proportional Hazards regression as appropriate. Results A total of 434 participants were randomised into this SWAT. Completion of the CO breath measurement at 6 months was 88.5% (n=247) in the intervention arm of the SWAT and 85.4% (n=123) in the control arm (Difference 3.1%, OR 1.29, 95% CI 0.71-2.33, p=0.41). There was also no evidence of a difference in the proportion of participants withdrawing from follow-up after contact (intervention n=7 (2.5%), control n=5 (3.5%); OR 0.76, 95% CI 0.23-2.44, p=0.64), nor in terms of proximity of 6-month visit completion to due date (HR 1.07, 95% CI 0.86-1.33, p=0.55). Conclusion It is unclear if contingent financial incentives increased rates of face-to-face follow-up completion within the SCIMITAR+ trial population. However, the sample size of this SWAT was constrained by the size of the host trial and power was limited. This SWAT adds to the body of evidence for initiatives to increase response rates in trials.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

scholarly journals Perceptions of a food benefit program that includes financial incentives for the purchase of fruits and vegetables and restrictions on the purchase of foods high in added sugar

2021 ◽  
pp. 1-24
Author(s):  
Fatima A Fagbenro ◽  
Tessa Lasswell ◽  
Sarah A Rydell ◽  
J Michael Oakes ◽  
Brian Elbel ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Fruits And Vegetables ◽  
Financial Incentive ◽  
Control Group ◽  
Added Sugar ◽  
Program Satisfaction ◽  
Food Purchasing ◽  
Households With Children ◽  
Participant Perspectives

ABSTRACT Objective To report perspectives of participants in a food benefit program that includes FAS restrictions and FAS restrictions paired with F/V incentives. Design Randomized experimental trial in which participant perspectives were an exploratory study outcome. Setting Participants were randomized into one of three SNAP-like food benefit program groups - (1) Restriction: not allowed to buy FAS with benefits; (2) Restriction paired with incentive: not allowed to buy FAS with benefits and 30% financial incentive on eligible F/V purchased using benefits; or (3) Control: Same food purchasing rules as SNAP. Participants were asked questions to assess program satisfaction. Participants Adults in the Minneapolis-St. Paul, MN metropolitan area, eligible for but not currently participating in SNAP who completed baseline and follow-up study measures (n=254). Results Among remaining households in each group, most found the program helpful in buying nutritious foods (88.2%-95.7%) and were satisfied with the program (89.1%-93.0%). Sensitivity analysis results indicate that reported helpfulness and satisfaction with the program may in some instances be lower among the Restriction and the Restrictions paired with Incentive groups in comparison to the control group. Conclusions A food benefit program that includes restriction on purchase of FAS or restriction paired with a financial incentive for F/V purchases may be acceptable to most SNAP-eligible households with children.

scholarly journals 71 Ultrasound directed reduction of Colles’ type distal radial fractures in ED (UDiReCT): a feasibility randomized controlled trial

2020 ◽  
Vol 37 (12) ◽  
pp. 835.3-836
Author(s):  
Hamza Malik ◽  
Andrew Appelboam ◽  
Gordon Taylor ◽  
Daryl Wood ◽  
Karen Knapp
Keyword(s):  
Data Collection ◽  
Controlled Trial ◽  
Wrist Fracture ◽  
Recruitment Rate ◽  
Feasibility Trial ◽  
Point Of Care Ultrasound ◽  
Distal Radial Fractures ◽  
Definitive Trial ◽  
Randomised Controlled

Aims/Objectives/BackgroundWrist fractures are among the commonest injuries seen in the emergency department (ED). Around 25% of these injuries have Colles’ type fracture displacement and undergo manipulation in the ED. In the UK, these manipulations are typically done ‘blind’ without real time imaging and recent observational studies show that over 40% of the injuries go on to require surgical fixation (due to inadequate initial reduction or re-displacement). Point of care ultrasound has been used to guide and improve wrist fracture reductions but it’s effect on subsequent outcome is not established. We set up and ran the UK’s first randomised controlled feasibility trial comparing standard and ultrasound guided ED wrist fracture manipulations to test a definitive trial protocol, data collection and estimate recruitment rate towards a future definitive trial.Methods/DesignWe conducted a 1:1, single blind, parallel group, randomised controlled feasibility trial in two UK hospitals. Adults with Colles’ type distal radial fractures requiring manipulation in the ED were recruited by supervising emergency physicians supported by network research nurses. Participants were randomised to ultrasound directed fracture manipulation (intervention) or standard care with sham ultrasound (controls). The trial was run through Exeter Clinical Trials Unit and consent, randomisation and data collection conducted electronically in REDCap cloud. All participants were followed up at 6 weeks to record any surgical intervention and also underwent baseline and 3 month quality of life (EQ-5D-5L) and wrist function (Patient Rated Wrist Evaluation (PRWE) assessments.Results/ConclusionsWe recruited 47 patients in total, with 23 randomised to the interventional arm and 24 randomised to the control arm. We were able to follow up 100% of the patients for the 6 week follow up. Data analysis and results will be presented at the time of the conference.

‘No one ever asked us’: a feasibility study assessing the co-creation of a physical activity programme with adolescent girls

2019 ◽  
Vol 27 (3) ◽  
pp. 34-43
Author(s):  
Méabh Corr ◽  
Elaine Murtagh
Keyword(s):  
Physical Activity ◽  
Data Collection ◽  
Behaviour Change ◽  
Adolescent Girls ◽  
Retention Rate ◽  
Controlled Trial ◽  
Activity Level ◽  
Health Concern ◽  
Post Intervention ◽  
Behaviour Change Wheel

Background: Globally, the poor activity level of adolescent girls is a public health concern. Little research has involved adolescents in the design of interventions. This study assessed the feasibility of involving girls in the co-creation of an activity programme. Methods: Thirty-one students (15–17 years old) were recruited from a post-primary school. The Behaviour Change Wheel guided intervention design, providing insights into participants’ capability, opportunity and motivation for change. Step counts and self-reported physical activity levels were recorded pre- and post-intervention. Feasibility benchmarks assessed recruitment, data collection, acceptability and adherence. Results: Activity and educational sessions were delivered for six weeks during physical education class. Average attendance was 87% (benchmark = 80%). Eligibility was 61% (benchmark = 60%). There was a 100% retention rate (benchmark = 90%). All participants ( n = 31) completed baseline measures and 71% ( n = 22) completed post-measures. 54% ( n = 17) of students completed pedometer measurements, with 32% ( n = 10) having complete data. Average daily steps were 13,121 pre-intervention and 14,128 post-intervention ( p > 0.05). Data collection was feasible, receiving a mean score > 4/5 (benchmark > 3.5/5). Conclusions: The Behaviour Change Wheel can be used to co-create an activity programme with adolescent girls. Predetermined benchmarks, except for pedometer recordings, were reached or exceeded, providing evidence for the need of a randomised controlled trial to test effectiveness.

scholarly journals Randomised controlled trial of a financial incentive for increasing the number of daily walking steps: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026086
Author(s):  
Yasutake Tomata ◽  
Fumiya Tanji ◽  
Dieta Nurrika ◽  
Yingxu Liu ◽  
Saho Abe ◽  
...  
Keyword(s):  
Financial Incentives ◽  
Primary Outcome ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Intervention Group ◽  
Sample Size Calculation ◽  
Community Dwelling ◽  
Control Group ◽  
Modifiable Factors ◽  
Randomised Controlled

IntroductionPhysical activity is one of the major modifiable factors for promotion of public health. Although it has been reported that financial incentives would be effective for promoting health behaviours such as smoking cessation or attendance for cancer screening, few randomised controlled trials (RCTs) have examined the effect of financial incentives for increasing the number of daily steps among individuals in a community setting. The aim of this study is to investigate the effects of financial incentives for increasing the number of daily steps among community-dwelling adults in Japan.Methods and analysisThis study will be a two-arm, parallel-group RCT. We will recruit community-dwelling adults who are physically inactive in a suburban area (Nakayama) of Sendai city, Japan, using leaflets and posters. Participants that meet the inclusion criteria will be randomly allocated to an intervention group or a waitlist control group. The intervention group will be offered a financial incentive (a chance to get shopping points) if participants increase their daily steps from their baseline. The primary outcome will be the average increase in the number of daily steps (at 4–6 weeks and 7–9 weeks) relative to the average number of daily steps at the baseline (1–3 weeks). For the sample size calculation, we assumed that the difference of primary outcome would be 1302 steps.Ethics and disseminationThis study has been ethically approved by the research ethics committee of Tohoku University Graduate School of Medicine, Japan (No. 2018-1-171). The results will be submitted and published in a peer-reviewed scientific journal.Trial registration numberUMIN000033276; Pre-results.

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