A randomized trial of financial incentives for maintenance of weight loss

确定治疗肥胖症的有效策略既是一个临床挑战，也是一个公共卫生优先事项。 超过70%的美国人超重或肥胖，而中年肥胖转化为更高 住院率。老年人的医疗保险支出、残疾和死亡风险。当一个 有多种方法成功地实现了最初的减肥，维持最初体重的技术 减肥在很大程度上并不成功。这项三组随机对照试验将比较 (1)以彩票为基础的奖励、(2)传统直接付款和(3)的效果和成本效益 在6个月内成功减掉至少5公斤体重的患者的每日反馈没有激励 参加慧俪轻体(前期)，将为部分研究参与者提供奖励 6个月后(阶段I)，受试者将再随访6个月以检查后续效果 停止奖励(第二阶段)。共有188名参赛者将被随机分成3组。特定的 目标是评估在前期阶段体重下降5公斤或更多的参与者：(1) 每日以彩票为基础的财政奖励相对于通常护理小组而言，对维持 在接下来的6个月内减肥；(2)直接付款激励相对于 日常护理组哦，维持减肥；(3)抽奖和抽奖的效果比较 在第一阶段结束时(12个月)直接支付对维持减肥的经济奖励。在……里面 此外，我们将评估与对照组相比，干预组保持减肥的程度。 常规护理组在停止干预后，我们将评估 保持减肥的激励措施。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 健康激励中心有经验的团队合作减肥的激励措施和 伦敦大学伦纳德·戴维斯卫生经济研究所(LDI Chibe)的行为经济学 在宾夕法尼亚州和杜克大学。 相关性(请参阅说明)： 这项研究将对创新战略的有效性提供宝贵的知识，以提高 在中老年美国人中保持减肥。这是减少发病率的核心。 和老年美国人的死亡率以及更广泛地改善美国人口的健康 因为肥胖症在美国人中非常普遍。‘

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. '