Testing an insurance-based monetary incentive program for exercise: RCT design and rationale.
Testing an insurance-based monetary incentive program for exercise: RCT design and rationale.
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测试基于保险的锻炼货币激励计划：RCT 设计和原理。
DOI：
10.1016/j.cct.2023.107382
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发表时间：
2023
影响因子：
2.2
通讯作者：
Galárraga,Omar
中科院分区：
文献类型：
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作者：
Williams,DavidM;Bohlen,LaurenConnell;Dunsiger,Shira;Ayala-Heredia,Viveka;Griffin,Elizabeth;Dionne,Laura;Wilson-Barthes,Marta;Unick,Jessica;LaRowe,LisaR;Galárraga,Omar
参与定期的身体活动（PA）有许多健康益处;然而，当使用基于设备的PA评估时，只有10%的美国成年人符合指南。本文介绍了一个随机对照试验的设计和理由，检查目前至少有三个主要的美国保险公司提供的运动激励计划的有效性，其中参与者必须参加基督教青年会健身设施至少50次在6个月内收到的奖励。在析因设计中，激励金额（200美元，100美元，0美元）与标准增益框架激励计划和损失框架激励条件的比较交叉，其中参与者被告知他们的会员费被扣留，并将根据他们的健身设施出勤率被退还或没收。参与者（N= 330）被随机分配到增益框架$100激励（n= 55）、增益框架$200激励（n= 55）、损失框架$100激励（n= 55）、损失框架$200激励（n= 55）或对照组（n= 110）。每名参与者在相同条件下连续两个6个月入组，每名参与者共12个月。主要结果是每6个月内健身设施的访问次数，通过客观的刷卡数据进行验证。次要结局包括通过加速度计（Actigraph wGT 3x-BT）和自我报告以3个月为间隔评估7天内的总中度至剧烈PA（MVPA）。习惯形成和预期后悔是假定的中介和家庭收入是假定的调解人的激励为基础的计划。从支付者的角度，试验内成本效用分析将量化每（a）获得的质量调整生命年，（B）YMCA出勤率和（c）MVPA变化的增量成本。
Participation in regular physical activity (PA) has numerous health benefits; however, as few as 10% of U.S. adults meet guidelines when device-based assessments of PA are used. The present paper presents the design and rationale for an RCT examining the efficacy of an exercise incentive program currently offered by at least three major US insurance companies, in which participants must attend a YMCA fitness facility at least 50 times within 6 months to receive an incentive. In a factorial design, incentive amount ($200, $100, $0) is crossed with a comparison of the standard gain-framed incentive program and a loss-framed incentive condition in which participants are told their membership fee is being held and will be returned or forfeited depending on their fitness facility attendance. Participants (N= 330) are randomized to gain-framed $100 incentive (n= 55), gain-framed $200 incentive (n= 55), loss-framed $100 incentive (n= 55), loss-framed $200 incentive (n= 55), or control (n= 110). Each participant is enrolled in the same condition for two consecutive 6-month periods for a total of 12 months per participant. The primary outcome is number of visits to the fitness facility over each 6-month period, verified by objective swipe-card data. Secondary outcomes include total moderate-to-vigorous PA (MVPA) over 7-day periods assessed at 3-month intervals through accelerometers (Actigraph wGT3x-BT) and self-report. Habit formation and anticipated regret are putative mediators and household income is a putative moderator of the incentive-based programs. A payer-perspective, within-trial cost-utility analysis will quantify the incremental costs per (a) quality-adjusted life year gained, (b) YMCA attendance, and (c) change in MVPA.