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. '

确定治疗肥胖症的有效策略既是临床挑战，也是公共卫生的重点。 超过70％的美国人口超重或肥胖，NNIDDLE时代的肥胖症转化为更高 住院率。老年人的医疗保险支出，残疾和死亡率风险。而a 多种方法成功地实现了初始体重减轻，维护初始体重的技术 减肥在很大程度上没有成功。这个三臂随机对照试验将比较亲戚 （1）基于彩票的激励措施的有效性和成本效益，（2）传统直接付款和（3） 每日反馈没有激励措施，他们在6个月内成功损失了至少5公斤的患者 参与体重观察者（阶段），将向某些研究参与者提供激励措施 在6个月之后（I阶段），将遵循6个月的受试者，以检查效果。 停止激励措施（第二阶段）。共有188名参与者将被随机分为3臂。具体的 目的是评估在阶段损失5公斤或更多基线体重的参与者中：（1） 相对于通常的护理小组，每天基于彩票的财务激励措施的有效性 在随后的6个月内减肥； （2）直接付款激励相对于 通常的护理小组OH维持体重减轻； （3）基于彩票和 在第一阶段结束时维持减肥的直接付款经济激励措施（第12个月）。在 此外，我们将评估干预组中与 停止干预措施后通常的护理小组，我们将评估成本效益 维持体重减轻的激励措施。这项研究将以我们的成功努力为基础 在健康激励措施中心有经验的团队之间的伙伴关系中减肥的激励措施和 伦纳德·戴维斯卫生经济学研究所（LDI Chibe）的行为经济学 宾夕法尼亚州和杜克大学。 相关性（请参阅说明）： 这项研究将为创新策略的有效性提供宝贵的知识，以改善 维持中年和老年人的体重减轻。这是降低发病率的核心 老年人的死亡率和更广泛的美国人口的健康 由于肥胖在美国人中极为普遍。 '