Individual vs. Team-Based Incentives to Increase Physical Activity
Kevin Volpp, MD, PhD
Dylan Small, PhD
Lisa Wesby, MS
National Institute on Aging
Independence Blue Cross
Physical activity is associated with many health benefits, including reduced rates of cardiovascular disease, diabetes, hypertension, and obesity. However, more than 50 percent of adults in the United States don't achieve enough regular physical activity to obtain such benefits.
We designed a six-month randomized controlled trial to compare the effectiveness of individual versus team-based financial incentives to increase physical activity. We partnered with Independence Blue Cross and enrolled 304 employees from an organization in Philadelphia in the study.
Participants formed teams of four and were asked to track 7,000 steps per day for 26 weeks using their smartphones. Each team was randomly assigned to a control group or one of three financial incentive arms (individual, team, or combined) in which drawings were held every other day for the first 13 weeks, where the winning team could receive up to $50 per person.
Participants in the individual incentive arm were eligible to accept earnings if they achieved the step goal. In contrast, those in the team incentive arm could only cash in if everyone on their team reached the goal. Finally, participants in the combined incentive arm were eligible to receive $20 if they achieved the goal and $10 more for each of their teammates who reached the goal. During the second half of the study, participants continued receiving daily feedback on their activity without financial incentives.
Results of the study revealed that participants in the combined incentive arm achieved their goal 35 percent of the time, nearly double the success rate for the control and team incentive arms and considerably higher than the average success rate for participants in the individual incentive arm.
Compared to the control group, participants receiving in the combined incentive arm took approximately 1,446 more steps per day.