Using Behavioral Economics to Promote Exercise among Inactive Overweight Adults

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 DESCRIPTION (provided by applicant): Approximately 60% of the U.S. population is overweight or obese, and obesity has been linked to numerous health problems. Physical activity has been recommended for overweight and obese adults to enhance weight- loss and/or weight-maintenance, and to reduce risk of chronic disease, including heart disease and cancers of the breast and colon. Despite the benefits of exercise, only 20% of overweight or obese adults meet the minimum national recommendations (150 minutes/week of moderate intensity exercise-e.g., brisk walking), and drop out in the first few months of exercise programs is as high as 50%. Given these data, there is a need to improve adherence to exercise programs, especially for overweight and obese adults. We propose to conduct a pilot study to test feasibility and proof-of-concept for two incentive programs to promote exercise among low-active overweight and obese adults. To address weaknesses in the literature, the programs will be (a) conducted in a community setting by the Greater Providence YMCAs and (b) financially sustainable, such that they do not require removal of the incentives after a specified period of time. In both incentive programs, participants will pay the standard monthly YMCA membership fee of $49/month. In the Rebate incentive program, participants will have the opportunity to earn $1/day in rebates on their membership fee for each day that they attend the YMCA (verified by objective swipe-card data), with a maximum of $5/week. In the Donation incentive program, participants will have the opportunity to earn $1/day (using the same incentive schedule) in donations to a registered local charity of the participant's choice. Thus, the proposed study will compare three experimental conditions: (a) Rebate incentives (n=25); (b) Donation incentives (n=25); and (c) Control (i.e., no incentives) (n=25). Our Primary Aims are to test (1) feasibility f the two incentive programs, (2) feasibility of the research methods to evaluate the preliminary efficacy of the two incentive programs, and (3) proof-of- concept for the two incentive programs (relative to control), through comparison of average number of incented sessions/week over one year. Secondary outcomes will be self-reported minutes per week of exercise over one year. The proposed research will provide a preliminary investigation into two community-based, financially sustainable incentive programs to promote exercise for adults who are at increased risk for cancer. Following demonstration of feasibility and proof-of-concept we plan to apply for an R01 to test the incentive programs in an RCT. Positive findings from such a trial would provide a fast-track for a community-based ready-to- implement exercise promotion intervention. Additionally, such findings would have significant implications for the use of financially sustainable incentive programs for exercise through other community organizations (e.g., privately-owned health clubs), healthcare organizations, or employers (e.g., employer fitness facilities), as well as providing a model for incentive programs for other health-related behaviors (e.g., smoking cessation, weight loss).