A randomized trial of financial incentives for maintenance of weight loss

维持减肥的经济激励的随机试验

• 批准号: 8733510
• 负责人: KEVIN G VOLPP
• 金额: $ 30.81万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8733510
• 关键词: Adult; Age; American; American Medical Association; Behavioral; Body Weight Changes; Body Weight decreased; Body mass index; Clinical; Control Groups; Economics; Effectiveness; Elderly; Expenditure; Feedback; Gender; Goals; Health; Health behavior; Hospitalization; Incentives; Institutes; Instruction; Intervention; Journals; Kilogram; Knowledge; Life; Maintenance; Medicare; Morbidity - disease rate; Obesity; Overweight; Participant; Patients; Pennsylvania; Phase; Population; Prevalence; Publishing; Randomized; Randomized Controlled Trials; Relative (related person); Research; Risk; Subgroup; Techniques; Testing; Translating; Treatment outcome; Universities; Weight; Woman; Work; arm; base; comparative effectiveness; cost effectiveness; disability; experience; financial incentive; group intervention; health economics; improved; innovation; men; middle age; mortality; obesity treatment; payment; programs; public health priorities; randomized trial; treatment as usual; weight maintenance; young adult

Identifying effective strategies for treating obesity is both a clinical challenge and a public health priority. Over 70% of the U.S. population is overweight or obese, and obesity in nniddle age translates into higher rates of hospitalization. Medicare expenditures, disability, and mortality risk among older adults. While a variety of approaches are successful in achieving initial weight loss, techniques for maintenance of initial weight loss have largely been unsuccessful. This 3- arm randomized controlled trial will compare the relative effectiveness and cost-effectiveness of (1) lottery-based incentives, (2) traditional direct payments, and (3) daily feedback without incentives among patients who successfully lost at least 5 kg over 6 months during participation in Weight Watchers (Pre Phase), incentives will be provided to some study participants for the following 6 months (Phase I), and subjects will be followed for 6 more months to examine effects following cessation of incentives (Phase II). A total of 188 participants will be randomized into the 3 arms. Specific Aims will be to assess among participants who lose 5kg or more of baseline weight during Pre Phase: (1) the effectiveness of a daily lottery-based financial incentive, relative to the usual care group, on maintenance of weight loss over the ensuing 6 months; (2) the effectiveness of a direct payment incentive relative to the usual care group oh maintenance of weight loss; (3) the comparative effectiveness of lottery based and direct payment financial incentives on maintenance of weight loss at the end of Phase I (month 12). In addition, we will assess the degree to which weight loss is maintained in the intervention groups compared to the usual care group following cessation ofthe interventions, and we will assess the cost-effectiveness of incentives for maintenance of weight loss. This study will build on our successful efforts using lottery-based incentives for weight loss in partnership between experienced teams at the Center for Health Incentives and Behavioral Economics ofthe Leonard Davis Institute of Health Economics (LDI CHIBE) at the University of Pennsylvania and at Duke University. RELEVANCE (See instructions): This study will contribute valuable knowledge about the effectiveness of innovative strategies to improve maintenance of weight loss among middle aged and older Americans. This is central to reducing morbidity and mortality rates among older Americans and improving the health ofthe US population more broadly since obesity is extremely common among Americans. '

确定治疗肥胖的有效策略既是临床挑战，也是公共卫生优先事项。 超过 70% 的美国人口超重或肥胖，中年时期的肥胖会转化为更高的体重 住院率。老年人的医疗保险支出、残疾和死亡风险。虽然一个 各种方法都成功地实现了最初的减肥，维持最初体重的技术 减肥基本上没有成功。这项三组随机对照试验将比较相对 (1) 彩票激励措施，(2) 传统直接支付，以及 (3) 的有效性和成本效益 在 6 个月内成功减掉至少 5 公斤的患者中，在没有激励的情况下进行每日反馈 参与慧俪轻体（预阶段），将为一些研究参与者提供奖励 接下来的 6 个月（第一阶段），受试者将被跟踪 6 个月以上，以检查以下效果 停止激励措施（第二阶段）。总共 188 名参与者将被随机分为 3 个组。具体的 目的是评估在前期阶段体重减轻 5 公斤或以上的参与者：(1) 相对于常规护理组，基于每日抽签的经济激励对于维持 随后 6 个月内体重减轻； (2) 直接支付激励措施的有效性 平时护理组哦，减肥维持； (3) 抽奖和抽奖的比较效果 在第一阶段（第 12 个月）结束时，对维持减肥的直接支付经济奖励。在 此外，我们将评估干预组与对照组相比维持体重减轻的程度 停止干预后，我们将评估常规护理组的成本效益 维持减肥的激励措施。这项研究将建立在我们使用基于彩票的成功努力的基础上 健康激励中心经验丰富的团队合作提供减肥激励措施 伦纳德·戴维斯健康经济研究所 (LDI CHIBE) 的行为经济学 宾夕法尼亚州和杜克大学。 相关性（参见说明）： 这项研究将提供有关创新策略有效性的宝贵知识，以提高 维持中年和老年美国人的减肥效果。这是降低发病率的核心 老年人的死亡率和死亡率，并更广泛地改善美国人口的健康 因为肥胖在美国人中极为普遍。 '