Exercise for Good

Multiple Principal Investigators
David M. Williams,  PhD
Omar Galarraga,  PhD

Sponsor: National Institutes of Health (NIH)/National Cancer Institute (NCI)

Grant Number: 1R03CA188473-01A1

Using behavioral economics to promote exercise among inactive overweight adults

Approximately 60% of the U.S. population is overweight or obese, and obesity has been linked to numerous health problems. Physical activity has been recommended for overweight and obese adults to enhance weight-loss and/or weight-maintenance, and to reduce risk of chronic disease, including heart disease and cancers of the breast and colon. Despite the benefits of exercise, only 20% of overweight or obese adults meet the minimum national recommendations (150 minutes/week of moderate intensity exercise—e.g., brisk walking), and drop out in the first few months of exercise programs is as high as 50%. Given these data, there is a need to improve adherence to exercise programs, especially for overweight and obese adults.

We propose to conduct a pilot study to test feasibility and proof-of-concept for two incentive programs to promote exercise among low-active overweight and obese adults. To address weaknesses in the literature, the programs will be (a) conducted in a community setting by the Greater Providence YMCAs and (b) financially sustainable, such that they do not require removal of the incentives after a specified period of time. In both incentive programs, participants will pay the standard monthly YMCA membership fee of $49/month. In the Rebate incentive program, participants will have the opportunity to earn $1/day in rebates on their membership fee for each day that they attend the YMCA (verified by objective swipe-card data), with a maximum of $5/week. In the Donation incentive program, participants will have the opportunity to earn $1/day (using the same incentive schedule) in donations to a registered local charity of the participant's choice. Thus, the proposed study will compare three experimental conditions: (a) Rebate incentives (n=25); (b) Donation incentives (n=25); and (c) Control (i.e., no incentives) (n=25).

Our Primary Aims are to test (1) feasibility of the two incentive programs, (2) feasibility of the research methods to evaluate the preliminary efficacy of the two incentive programs, and (3) proof-of-concept for the two incentive programs (relative to control), through comparison of average number of incented sessions/week over one year. Secondary outcomes will be self-reported minutes per week of exercise over one year. The proposed research will provide a preliminary investigation into two community-based, financially sustainable incentive programs to promote exercise for adults who are at increased risk for cancer.

Following demonstration of feasibility and proof-of-concept we plan to apply for an R01 to test the incentive programs in an RCT. Positive findings from such a trial would provide a fast-track for a community-based ready-to-implement exercise promotion intervention. Additionally, such findings would have significant implications for the use of financially sustainable incentive programs for exercise through other community organizations (e.g., privately-owned health clubs), healthcare organizations, or employers (e.g., employer fitness facilities), as well as providing a model for incentive programs for other health-related behaviors (e.g., smoking cessation, weight loss).