The researchers say their findings show that the potential of losing a reward is a more powerful motivator for getting employees to exercise more.
The study - from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia - is published in the Annals of Internal Medicine.
It finds that an organization's incentives to increase physical activity in overweight and obese employees were more effective when framed as monetary rewards that could be lost, rather than as opportunities to gain the same amounts of money.
While most people know that physical activity is good for health, more than half of American adults do not meet the recommended guideline of 2.5 hours of moderate intensity aerobic exercise (such as brisk walking) a week.
Mitesh S. Patel, lead author of the new study and assistant professor of Medicine and Health Care Management, says:
"Workplace wellness programs aimed at increasing physical activity and other healthy behaviors have also become increasingly popular, but there's a lack of understanding about how to design incentives within these programs."
Prof. Patel suggests employers use principles from behavioral economics - such as loss aversion - to incentivize employees to get physically active.
Study compares different ways of framing same amount of incentive
For their study - designed as a randomized controlled trial - the researchers enrolled 281 overweight and obese employees (body mass index - BMI - of 27 kg/m2 or more) from a single organization and gave them the goal of achieving 7,000 steps a day for the 26 weeks of the trial.
The researchers explain that 7,000 steps per day is roughly 40% more than the 5,000 steps per day that American adults achieve on average. The participants were able to track their progress on an app that ran in the background on their smartphones.
For the first 13 weeks, the participants were randomly assigned to one of four groups: a gain incentive group, a lottery incentive group, a loss incentive group and a control group. The control group received no financial incentives for achieving the goal.
Participants in the gain incentive group received $1.40 for every day they achieved the goal ($42 per month), while participants in the lottery incentive group were included in a daily lottery each day they met their goal (the prize averaged to $1.40 each day that the goal was achieved).
Participants in the loss incentive group were given $42 at the start of a month and then had $1.40 taken away each day they did not meet their goal.
For the second 13 weeks, the participants continued to receive feedback and progress reports on their smartphones but were not offered any incentives.
Incentive framed as loss of reward got better results
The results showed that the gain incentive group (receiving $1.40 for each day they reached their goal) and the lottery incentive group (lottery chance to win $1.40 for each day they reached their goal) did no better than the control group (no incentives).
In those three groups, participants achieved their daily goal 30-35% of the time.
However, the loss incentive group (that had $1.40 taken away from their $42 monthly pot each time they failed to meet their daily goal) performed much better than the other three groups: they achieved their daily goal 45% of the time. This amounts to a nearly 50% increase on the other groups.
Even 3 months after not having any incentives, the vast majority of participants (96%) were still taking part in the program, note the authors, who say this shows how smartphones can help implement such programs on a large scale.
The authors conclude that how you frame a financial incentive affects its success, as senior author Kevin G. Volpp, professor of Medicine and Health Care Management, explains:
"Our findings demonstrate that the potential of losing a reward is a more powerful motivator and adds important knowledge to our understanding of how to use financial incentives to encourage employee participation in wellness programs."
Meanwhile, employers who rely purely on measuring BMI to assess employees' health status might do well to review their policy. Medical News Today recently reported how researchers are calling for a halt in the use of BMI as a measure of health.
A paper published in the International Journal of Obesity describes a study led by the University of California-Los Angeles, which shows how 75 million healthy Americans are misclassified as unhealthy according to their BMI status.