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Using financial incentives to promote physical activity in American Indian adolescents: A randomized controlled trial

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  • Kevin R Short
  • Jennifer Q Chadwick
  • Tamela K Cannady
  • Dannielle E Branam
  • David F Wharton
  • Mary A Tullier
  • David M Thompson
  • Kenneth C Copeland

Abstract

American Indians (AI) have high prevalence of diabetes in youth and may benefit from increasing physical activity as a strategy to improve metabolic health. We tested whether financial incentives would elicit greater frequency and/or duration of exercise in AI youth at high risk for developing diabetes. Overweight/obese AI boys and girls, 11–20 years old, were instructed to exercise on 3 days/week for 48 weeks at a tribal wellness center. The program was divided into three, 16-week-long phases to test different financial incentive strategies. Within each phase participants were randomly assigned to one of two groups that received different payments for exercise. Phase 1 was designed to test whether the size of the incentive would affect exercise frequency. In Phase 1, the number of exercise sessions did not differ between the group receiving a modest fixed-value payment per exercise session and the group receiving enhanced incentives to exercise more frequently (26 ± 3 versus 28 ± 2 sessions, respectively, p = 0.568). In Phase 2, the provision of an enhanced financial incentive to increase exercise duration resulted longer sessions, as the incentivized and standard payment groups exercised 38 ± 2 versus 29 ± 1 minutes per session (p = 0.002), respectively. In Phase 3, the effect of reducing the incentives on maintenance of exercise behaviors was inconclusive due to high participant withdrawal. Aerobic fitness increased 10% during Phase 1 but was unchanged thereafter. Insulin sensitivity and body composition were unchanged during the study. In conclusion, enhanced financial incentives increased the duration of exercise sessions, but had minimal effects on exercise participation. These results indicate that financial incentives hold promise in motivating previously sedentary, overweight/obese adolescents to exercise longer, but motivating them to sustain an exercise program remains the major challenge.Trial Registration: ClinicalTrials.gov NCT01848353.

Suggested Citation

  • Kevin R Short & Jennifer Q Chadwick & Tamela K Cannady & Dannielle E Branam & David F Wharton & Mary A Tullier & David M Thompson & Kenneth C Copeland, 2018. "Using financial incentives to promote physical activity in American Indian adolescents: A randomized controlled trial," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-20, June.
    • Handle: RePEc:plo:pone00:0198390
    DOI: 10.1371/journal.pone.0198390
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    References listed on IDEAS

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    1. Gary Charness & Uri Gneezy, 2009. "Incentives to Exercise," Econometrica, Econometric Society, vol. 77(3), pages 909-931, May.
    2. repec:aph:ajpbhl:10.2105/ajph.2017.303904_4 is not listed on IDEAS
    3. Bullock, A. & Sheff, K. & Moore, K. & Manson, S., 2017. "Obesity and overweight in American indian and Alaska native children, 2006-2015," American Journal of Public Health, American Public Health Association, vol. 107(9), pages 1502-1507.
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    Cited by:

    1. Lilian Golzarri-Arroyo & Xiwei Chen & Stephanie L Dickinson & Kevin R Short & David M Thompson & David B Allison, 2020. "Corrected analysis of ‘Using financial incentives to promote physical activity in American Indian adolescents: A randomized controlled trial’ confirms conclusions," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-4, June.
    2. Robert Siegel & Meghan E. McGrady & Linda Dynan & Roohi Kharofa & Kristin Stackpole & Paula Casson & Francesca Siegel & Nadine A. Kasparian, 2022. "Effects of Loss and Gain Incentives on Adherence in Pediatric Weight Management: Preliminary Studies and Economic Evaluation of a Theoretical Trial," IJERPH, MDPI, vol. 20(1), pages 1-14, December.

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