Trial Outcomes & Findings for Financial vs. Non-Financial Rewards for Weight Loss and Weight Maintenance (NCT NCT02957539)
NCT ID: NCT02957539
Last Updated: 2023-07-28
Results Overview
The primary outcome is weight measured in pounds at week 32 minus the weight at baseline.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
274 participants
Primary outcome timeframe
32 weeks
Results posted on
2023-07-28
Participant Flow
A total of 274 subjects consented to participate in the study, but 23 subjects did not complete the online baseline survey and did not respond to requests to complete the survey. Since randomization occurred after completion of the survey, only 251 subjects were randomized.
Participant milestones
| Measure |
No Reward
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial Reward Arm
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-financial Reward Arm
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
Non-Financial rewards: Procedures for the non-financial rewards arm are identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each weekly random drawing will be for 20 points. Veterans will choose non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Baseline to Week 16
STARTED
|
73
|
91
|
87
|
|
Baseline to Week 16
COMPLETED
|
51
|
77
|
66
|
|
Baseline to Week 16
NOT COMPLETED
|
22
|
14
|
21
|
|
Week 16 to 32
STARTED
|
51
|
77
|
66
|
|
Week 16 to 32
COMPLETED
|
40
|
67
|
60
|
|
Week 16 to 32
NOT COMPLETED
|
11
|
10
|
6
|
|
Week 32 to Week 52
STARTED
|
40
|
67
|
60
|
|
Week 32 to Week 52
COMPLETED
|
29
|
50
|
33
|
|
Week 32 to Week 52
NOT COMPLETED
|
11
|
17
|
27
|
Reasons for withdrawal
| Measure |
No Reward
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial Reward Arm
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-financial Reward Arm
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
Non-Financial rewards: Procedures for the non-financial rewards arm are identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each weekly random drawing will be for 20 points. Veterans will choose non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Baseline to Week 16
Lost to Follow-up
|
8
|
10
|
16
|
|
Baseline to Week 16
Withdrawal by Subject
|
14
|
4
|
5
|
|
Week 16 to 32
Withdrawal by Subject
|
3
|
3
|
1
|
|
Week 16 to 32
Lost to Follow-up
|
8
|
7
|
5
|
|
Week 32 to Week 52
Lost to Follow-up
|
11
|
16
|
27
|
|
Week 32 to Week 52
Withdrawal by Subject
|
0
|
1
|
0
|
Baseline Characteristics
Financial vs. Non-Financial Rewards for Weight Loss and Weight Maintenance
Baseline characteristics by cohort
| Measure |
No Reward
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial Reward Arm
n=91 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-financial Reward Arm
n=87 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
Non-Financial rewards: Procedures for the non-financial rewards arm are identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each weekly random drawing will be for 20 points. Veterans will choose non-financial rewards associated with the number of points they earn.
|
Total
n=251 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Continuous
|
48.1 years
STANDARD_DEVIATION 12.6 • n=99 Participants
|
48.5 years
STANDARD_DEVIATION 12.6 • n=107 Participants
|
49.6 years
STANDARD_DEVIATION 12.4 • n=206 Participants
|
48.8 years
STANDARD_DEVIATION 12.4 • n=7 Participants
|
|
Sex: Female, Male
Female
|
21 Participants
n=99 Participants
|
28 Participants
n=107 Participants
|
23 Participants
n=206 Participants
|
72 Participants
n=7 Participants
|
|
Sex: Female, Male
Male
|
52 Participants
n=99 Participants
|
63 Participants
n=107 Participants
|
64 Participants
n=206 Participants
|
179 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
10 Participants
n=99 Participants
|
20 Participants
n=107 Participants
|
3 Participants
n=206 Participants
|
33 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
63 Participants
n=99 Participants
|
71 Participants
n=107 Participants
|
84 Participants
n=206 Participants
|
218 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
0 Participants
n=7 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
0 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Asian
|
3 Participants
n=99 Participants
|
1 Participants
n=107 Participants
|
5 Participants
n=206 Participants
|
9 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
0 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Black or African American
|
15 Participants
n=99 Participants
|
9 Participants
n=107 Participants
|
17 Participants
n=206 Participants
|
41 Participants
n=7 Participants
|
|
Race (NIH/OMB)
White
|
43 Participants
n=99 Participants
|
70 Participants
n=107 Participants
|
52 Participants
n=206 Participants
|
165 Participants
n=7 Participants
|
|
Race (NIH/OMB)
More than one race
|
6 Participants
n=99 Participants
|
5 Participants
n=107 Participants
|
9 Participants
n=206 Participants
|
20 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
6 Participants
n=99 Participants
|
6 Participants
n=107 Participants
|
4 Participants
n=206 Participants
|
16 Participants
n=7 Participants
|
|
Region of Enrollment
United States
|
73 participants
n=99 Participants
|
91 participants
n=107 Participants
|
87 participants
n=206 Participants
|
251 participants
n=7 Participants
|
|
Self Efficacy
|
6.6 units on a scale
STANDARD_DEVIATION 1.96 • n=99 Participants
|
6.3 units on a scale
STANDARD_DEVIATION 2.20 • n=107 Participants
|
6.3 units on a scale
STANDARD_DEVIATION 2.06 • n=206 Participants
|
6.4 units on a scale
STANDARD_DEVIATION 2.08 • n=7 Participants
|
|
Intrinsic Motivation
|
4.0 units on a scale
STANDARD_DEVIATION 1.56 • n=99 Participants
|
3.9 units on a scale
STANDARD_DEVIATION 1.58 • n=107 Participants
|
4.4 units on a scale
STANDARD_DEVIATION 1.35 • n=206 Participants
|
4.1 units on a scale
STANDARD_DEVIATION 1.52 • n=7 Participants
|
|
PHQ-8 Depression Score
|
10.5 units on a scale
STANDARD_DEVIATION 5.68 • n=99 Participants
|
10.5 units on a scale
STANDARD_DEVIATION 5.56 • n=107 Participants
|
10.4 units on a scale
STANDARD_DEVIATION 5.16 • n=206 Participants
|
10.5 units on a scale
STANDARD_DEVIATION 5.44 • n=7 Participants
|
PRIMARY outcome
Timeframe: 32 weeksPopulation: Eligible Veterans at the VA Puget Sound Health Care Center who were age 18 to 69, had access to a text-capable mobile phone and had a BMI\>=30. Exclusion criteria included conditions that affect the ability to participate in the trial (eating disorders, blindness, dementia, inability to read and weight\>=390 lbs, which was the limit of the scales used); end-stage disease; pregnancy; and the use of antipsychotic medication.
The primary outcome is weight measured in pounds at week 32 minus the weight at baseline.
Outcome measures
| Measure |
Control
n=40 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=67 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=60 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Weight Change From Baseline to Week 32
|
-1.8 pounds
Interval -5.2 to 1.7
|
-6.3 pounds
Interval -9.9 to 2.7
|
-6.8 pounds
Interval -10.5 to -3.2
|
SECONDARY outcome
Timeframe: Change form baseline to 16 weeksPopulation: Two participants with missing data at baseline were dropped
Measured by survey responses to the Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF).Scale goes from 0 (not at all confident) to 10 (very confident). Higher scores mean better outcomes. Missing values at follow-up were imputed using multiple imputation by chained equations (MICE)
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Self Efficacy
|
-.7 units on a scale
Interval -1.5 to 0.1
|
-.1 units on a scale
Interval -0.8 to 0.6
|
-.4 units on a scale
Interval -1.2 to 0.3
|
SECONDARY outcome
Timeframe: Change form baseline to 32 weeksPopulation: Missing values were imputed using multiple imputation by chained equations. Two participants were dropped for missing data at baseline survey.
Measured by survey responses to the Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF).Scale goes from 0 (not at all confident) to 10 (very confident).
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Self Efficacy
|
-.4 units on a scale
Interval -1.4 to 0.6
|
-.2 units on a scale
Interval -1.0 to 0.5
|
.1 units on a scale
Interval -0.7 to 0.9
|
SECONDARY outcome
Timeframe: Change form baseline to 52 weeksPopulation: Missing values were imputed using multiple imputation by chained equations. Two participants were dropped for missing data at baseline survey.
Measured by survey responses to the Weight Efficacy Lifestyle Questionnaire Short Form (WEL-SF).Scale goes from 0 (not at all confident) to 10 (very confident).
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Self Efficacy
|
-1.4 units on a scale
Interval -2.5 to -0.4
|
.1 units on a scale
Interval -0.7 to 0.9
|
-.3 units on a scale
Interval -1.1 to 0.5
|
SECONDARY outcome
Timeframe: Change form baseline to 16 weeksPopulation: Two participants were dropped because of missing baseline data
Measured by patient survey responses to the Regulation of Eating Behavior Scale. Scale from 1 (does not agree at all) to 7 (agrees exactly). Higher values represent greater intrinsic motivation
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Intrinsic Motivation
|
-.4 units on a scale
Interval -0.9 to 0.2
|
-.1 units on a scale
Interval -0.5 to 0.2
|
-.3 units on a scale
Interval -0.7 to 0.0
|
SECONDARY outcome
Timeframe: Change form baseline to 32 weeksPopulation: Missing values were imputed using multiple imputation by chained equations. Two participants were dropped for missing data at baseline survey.
Measured by patient survey responses to the Regulation of Eating Behavior Scale. Scale from 1 (does not agree at all) to 7 (agrees exactly). Higher values represent greater intrinsic motivation
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Intrinsic Motivation
|
-.7 units on a scale
Interval -1.3 to 0.0
|
-.1 units on a scale
Interval -0.7 to 0.4
|
0 units on a scale
Interval -0.6 to 0.5
|
SECONDARY outcome
Timeframe: Change form baseline to 52 weeksPopulation: Missing values were imputed using multiple imputation by chained equations. Two participants were dropped for missing data at baseline survey.
Measured by patient survey responses to the Regulation of Eating Behavior Scale. Scale from 1 (does not agree at all) to 7 (agrees exactly). Higher values represent greater intrinsic motivation
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Intrinsic Motivation
|
-.6 units on a scale
Interval -1.6 to 0.4
|
-.1 units on a scale
Interval -0.7 to 0.5
|
0 units on a scale
Interval -0.7 to 0.7
|
SECONDARY outcome
Timeframe: Change from baseline to week 16Population: Two subjects were dropped because they did not complete the baseline survey
Measured by patient survey responses to the Personal Health Questionnaire Depression Scale (PHQ-8). The scale ranges from 0 to 24. Higher scores mean more severe depression.
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
PHQ-8 Depression Score
|
-.2 units on a scale
Interval -2.2 to 1.9
|
.1 units on a scale
Interval -1.1 to 1.3
|
.6 units on a scale
Interval -0.7 to 1.8
|
SECONDARY outcome
Timeframe: change from baseline to 32 weeksPopulation: Missing values were imputed using multiple imputation by chained equations. Two participants were dropped for missing data at baseline survey.
Measured by patient survey responses to the Personal Health Questionnaire Depression Scale (PHQ-8). The scale has the following options: not at all, several days, more than half the days, nearly every day. Scores range from 0 to 24. Higher scores represent more severe depression.
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
PHQ-8 Depression Score
|
-1.7 units on a scale
Interval -4.2 to 0.8
|
-.3 units on a scale
Interval -2.1 to 1.5
|
.5 units on a scale
Interval -1.4 to 2.4
|
SECONDARY outcome
Timeframe: change from baseline to 52 weeksPopulation: Missing values were imputed using multiple imputation by chained equations. Two participants were dropped for missing data at baseline survey.
Measured by patient survey responses to the Personal Health Questionnaire Depression Scale (PHQ-8). Measured by patient survey responses to the Personal Health Questionnaire Depression Scale (PHQ-8). The scale ranges from 0 to 24. Higher scores mean more severe depression.
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=90 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=86 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
PHQ-8 Depression Score
|
.8 units on a scale
Interval -2.3 to 3.9
|
-.3 units on a scale
Interval -2.3 to 1.8
|
1.1 units on a scale
Interval -0.9 to 3.1
|
SECONDARY outcome
Timeframe: 16 weeksPopulation: Eligible Veterans at the VA Puget Sound Health Care Center who were age 18 to 69, had access to a text-capable mobile phone and had a BMI\>=30. Exclusion criteria included conditions that affect the ability to participate in the trial (eating disorders, blindness, dementia, inability to read and weight\>=390 lbs, which was the limit of the scales used); end-stage disease; pregnancy; and the use of antipsychotic medication.
A secondary outcome is weight measured in pounds at week 16 minus the weight at baseline.
Outcome measures
| Measure |
Control
n=51 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=77 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=66 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Weight Change From Baseline
|
-2.4 weight in pounds
Interval -5.0 to 0.3
|
-5.6 weight in pounds
Interval -8.0 to -3.1
|
-7.0 weight in pounds
Interval -9.4 to -4.5
|
SECONDARY outcome
Timeframe: 52 weeksPopulation: Eligible Veterans at the VA Puget Sound Health Care Center who were age 18 to 69, had access to a text-capable mobile phone and had a BMI\>=30. Exclusion criteria included conditions that affect the ability to participate in the trial (eating disorders, blindness, dementia, inability to read and weight\>=390 lbs, which was the limit of the scales used); end-stage disease; pregnancy; and the use of antipsychotic medication.
A secondary outcome is weight measured in pounds at week 52 minus the weight at baseline.
Outcome measures
| Measure |
Control
n=29 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=50 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=33 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Weight Change From Baseline
|
-5.4 weight in lbs
Interval -10.2 to 0.6
|
-3 weight in lbs
Interval -7.8 to 1.8
|
-9 weight in lbs
Interval -13.6 to 4.3
|
OTHER_PRE_SPECIFIED outcome
Timeframe: through 16 weeksPopulation: All patients enrolled at baseline
The investigators will collect data on the cost of the intervention.
Outcome measures
| Measure |
Control
n=73 Participants
At enrollment, participants randomized to usual care will be given the MOVE! workbook that serves both as an information resource on diet and exercise, a resource for tools to achieve weight loss goals, and a log of participants' goals, motivations, and outcomes. Each participant will be given a chart with a personalized target weight for a loss of 1lb. per week for 16 weeks. Participants will be given a digital scale or wireless scale and counseled to weigh themselves daily. Participants will enter their weight weekly into an online portal. They will also complete the surveys in the portal. They will receive text message reminders to enter their weight.
|
Financial
n=91 Participants
Financial rewards: Veterans in the financial reward arm receive all of the services of the usual care arm, plus rewards that are earned in two ways: an assured, and random. For the assured reward, they will receive compensation at the end of each month (defined as a four-week period) that they are at or below their target weight. For the random portion, each week that a participant is at or below their target weight, the patient is entered into a drawing to win additional compensation. Over the first eight weeks the patient has a 1-in-8 chance of winning. Over the 17-32-week period, Veterans in this group will receive token incentives for tracking and reporting their weekly weights regardless of whether it was on target. Each week that the patient enters their weight into the portal, they will have a 1-in-8 chance to earn the token incentive, such as a t-shirt or movie ticket. The participant will receive reminder text messages.
|
Non-Financial
n=87 Participants
Procedures for the non-financial rewards arm is identical to procedures for the financial reward arm, except that the Veteran will earn points rather than cash. Each week a random drawing will be for 20 points, each monthly weigh in is worth 5 points. Veterans will be given non-financial rewards associated with the number of points they earn.
|
|---|---|---|---|
|
Total Intervention Costs for All Participants
|
0 dollars
|
21559 dollars
|
21754 dollars
|
Adverse Events
No Reward
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Financial Reward Arm
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Non-financial Reward Arm
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place