Initiation and Maintenance of Regular Exercise in an Employer Wellness Program

描述（由申请人提供）：经常锻炼对健康和经济有重要的好处。健康计划，包括针对运动的计划，在提供健康保险的雇主中很普遍。《病人保护和平价医疗法》中的规定预计将进一步扩大以雇主为基础的保健方案的传播。然而，有一个有限的证据基础，告知雇主决策如何设计或针对这些方案，以最大限度地提高其有效性，影响个人的开始和维持锻炼。拟议的多学科项目将研究健身奖励计划（FRP）的效果，这是明尼苏达大学于2008年推出的一项以激励为基础的健康倡议，旨在促进锻炼行为。通过三年的管理数据和严格的分析方法，本研究从四个方面帮助我们理解激励策略对锻炼行为的有效性。首先，通过对个人每月锻炼行为的理论分析，研究将利用个人人口统计学，健康状况和健康信念的详细信息来识别和区分影响行为开始的因素和影响维持的因素，这是一个相对未探索的问题。其次，这项研究将深入了解干预策略的类型，这些策略增强了启动和维持健康行为的动机，有助于降低某些慢性和急性疾病的风险。第三、 通过研究个体特征对激励的行为反应如何不同，我们的结果将为实施基于激励的策略以促进运动的开始和维持时的目标群体的决策提供信息。最后，通过关注一个庞大的、多样化的以雇主为基础的人群，我们的分析将产生关于个人在反映大多数激励计划实施的实际环境条件下的行为反应的见解。这项研究的结果将产生证据，雇主和研究人员可以用来通知决策的设计，实施和评估的激励为基础的，健康计划-包括决策的参与，运动频率要求，设施的访问，和激励结构。

DESCRIPTION (provided by applicant): Regular exercise has important health and economic benefits. Wellness programs, including initiatives that target exercise, are prevalent among employers that offer health insurance. Provisions within the Patient Protection and Affordable Care Act are expected to increase further the diffusion of employer-based wellness programs. Yet, there is a limited evidence base to inform employer decision-making about how to design or target these programs to maximize their effectiveness for influencing individuals' initiation and maintenance of exercise. The proposed multidisciplinary project will examine the effect of the Fitness Rewards Program (FRP), an incentive-based wellness initiative, launched by the University of Minnesota in 2008, to promote exercise behavior. Using three years of administrative data and rigorous analytic methods, this research contributes in four ways to our understanding of the effectiveness of incentive-based strategies on exercise behavior. First, through a theoretically-grounded analysis of individuals' monthly exercise behavior, the research will utilize detailed information on individuals' demographics, health status, and health beliefs to identify and differentiate the factors that affect the initiation of behavior from thosethat affect maintenance, an issue relatively unexplored. Second, this study will generate insights into the types of intervention strategies that augment motivation to initiate and maintain health behaviors that contribute to the reduction of risk for certain chronic and acute conditions. Third, by examining how behavioral responses to the incentive differ by individuals' characteristics, our results will inform decisions regarding which groups to target when implementing incentive-based strategies to promote the initiation and maintenance of exercise. Finally, by focusing on a large, diverse employer-based population, our analyses will generate insights regarding the behavioral responses of individuals under conditions that reflect the actual environment in which most incentive-based programs are being implemented. Results from this study will generate evidence that employers and researchers can use to inform decision-making about the design, implementation, and evaluation of incentive-based, wellness programs -- including decisions about participation, exercise frequency requirements, facility access, and incentive structure.