1
|
Zhang J, Li Q, Zhang J, Zhao X, Jiang M, Huang X, Liu D, Yan Y, Li X, Chen J, Ma ZF, Zhang X, Ming WK, Wong TH, Yan G, Wu Y. Chinese university students' preferences for physical activity incentive programs: a discrete choice experiment. Front Public Health 2023; 11:1281740. [PMID: 38026342 PMCID: PMC10646335 DOI: 10.3389/fpubh.2023.1281740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This study aims to explore and compare Chinese university students' preferences for various physical activity motivation programs. Patients and methods A cross-sectional study was conducted in China from February 25 to March 25, 2022. Participants anonymously completed an online questionnaire based on a DCE. A total of 1,358 university students participated in the survey. The conditional logit model (CLM), willingness to accept (WTA), and propensity score matching (PSM) were used to assess college students' preferences for different attributes and levels of physical activity incentive programs. Results Respondents identified the number of bonus, exercise time, and academic rewards as the three most significant attributes of the athletic incentive program. The importance of each attribute varied based on individual characteristics such as gender and BMI. In CLM, college students displayed a preference for a "¥4" bonus amount (OR: 2.04, 95% CI 1.95-2.13), "20 min" of exercise time (OR: 1.85, 95% CI 1.79-1.92), and "bonus points for comprehensive test scores" as academic rewards (OR: 1.33, 95% CI 1.28-1.37). According to the WTA results, college students were willing to accept the highest cost to obtain academic rewards tied to composite test scores. Conclusion The number of bonus, exercise time, and academic rewards emerge as the three most crucial attributes of physical activity incentive programs. Furthermore, college students with different characteristics exhibit heterogeneity in their preferences for such programs. These findings can guide the development of programs and policies aimed at motivating college students to engage in physical activities.
Collapse
Affiliation(s)
- Jingbo Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Qing Li
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Jinzi Zhang
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Xianqi Zhao
- School of Public Health, Shandong University, Jinan, China
| | - Maomin Jiang
- School of Public Affairs, Xiamen University, Xiamen, China
| | - Xincheng Huang
- School of Economics and Management, Beijing Institute of Graphic Communication, Beijing, China
| | - Diyue Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Yupei Yan
- Department of Humanities, Arts and Media, Changzhi Medical College, Changzhi, China
| | - Xialei Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Zheng Feei Ma
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, United Kingdom
| | - Xiyue Zhang
- Alliance Manchester Business School, University of Manchester, Manchester, United Kingdom
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Tak-hap Wong
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Guanyun Yan
- School of Humanities and Social Sciences, Harbin Medical University, Harbin, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| |
Collapse
|
2
|
Buis L, Lee U. Loss-Framed Adaptive Microcontingency Management for Preventing Prolonged Sedentariness: Development and Feasibility Study. JMIR Mhealth Uhealth 2023; 11:e41660. [PMID: 36705949 PMCID: PMC9919499 DOI: 10.2196/41660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A growing body of evidence shows that financial incentives can effectively reinforce individuals' positive behavior change and improve compliance with health intervention programs. A critical factor in the design of incentive-based interventions is to set a proper incentive magnitude. However, it is highly challenging to determine such magnitudes as the effects of incentive magnitude depend on personal attitudes and contexts. OBJECTIVE This study aimed to illustrate loss-framed adaptive microcontingency management (L-AMCM) and the lessons learned from a feasibility study. L-AMCM discourages an individual's adverse health behaviors by deducting particular expenses from a regularly assigned budget, where expenses are adaptively estimated based on the individual's previous responses to varying expenses and contexts. METHODS We developed a mobile health intervention app for preventing prolonged sedentary lifestyles. This app delivered a behavioral mission (ie, suggesting taking an active break for a while) with an incentive bid when 50 minutes of uninterrupted sedentary behavior happened. Participants were assigned to either the fixed (ie, deducting the monotonous expense for each mission failure) or adaptive (ie, deducting varying expenses estimated by the L-AMCM for each mission failure) incentive group. The intervention lasted 3 weeks. RESULTS We recruited 41 participants (n=15, 37% women; fixed incentive group: n=20, 49% of participants; adaptive incentive group: n=21, 51% of participants) whose mean age was 24.0 (SD 3.8; range 19-34) years. Mission success rates did not show statistically significant differences by group (P=.54; fixed incentive group mean 0.66, SD 0.24; adaptive incentive group mean 0.61, SD 0.22). The follow-up analysis of the adaptive incentive group revealed that the influence of incentive magnitudes on mission success was not statistically significant (P=.18; odds ratio 0.98, 95% CI 0.95-1.01). On the basis of the qualitative interviews, such results were possibly because the participants had sufficient intrinsic motivation and less sensitivity to incentive magnitudes. CONCLUSIONS Although our L-AMCM did not significantly affect users' mission success rate, this study configures a pioneering work toward adaptively estimating incentives by considering user behaviors and contexts through leveraging mobile sensing and machine learning. We hope that this study inspires researchers to develop incentive-based interventions.
Collapse
Affiliation(s)
| | - Uichin Lee
- School of Computing, Korea Advanced Institute of Science & Technology, Daejeon, Republic of Korea
| |
Collapse
|
3
|
Measuring “Nudgeability”: Development of a Scale on Susceptibility to Physical Activity Nudges among College Students. Behav Sci (Basel) 2022; 12:bs12090318. [PMID: 36135122 PMCID: PMC9495621 DOI: 10.3390/bs12090318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 12/03/2022] Open
Abstract
Background: The current college lifestyle create more opportunities for students to develop unhealthy behaviors, especially physical inactivity. Nudging could be an effective tool to improve physical activity behaviors by changing college settings. One-nudge-fits-all leads to ineffective nudges, so it is necessary to develop a reliable and valid instrument capable of measuring the “nudgeability” of physical activity nudges for college students, which is for a higher level of nudge efficacy. Method: Developing the College Physical Activity Nudges Susceptibility Scale (CPANSS) that integrated the nudge method with the Likert scale, which is the first attempt to measure the susceptibility to nudges directly by a scale. There are four steps for developing CPANSS, including Scale Dimensions, Item Generation, Exploratory Factor Analysis (n = 294), and Confirmatory Factor Analysis (n = 293) with appropriate procedures. Results: The five-factor 21-item CPANSS with good reliability and validity fitted the data reasonably well. Conclusion: The CPANSS was to provide a new tool for policymakers to design effective nudges in changing and promoting physical activity in college settings, and to provide a method for scholars to promote other healthy behaviors for different target groups.
Collapse
|
4
|
Ehlers AP, Vitous CA, Chao GF, Stricklen A, Ross R, Kullgren JT, Ghaferi AA. Female Patient Perceptions on Financial Incentives to Promote Follow-Up After Bariatric Surgery. J Surg Res 2022; 276:195-202. [PMID: 35366424 DOI: 10.1016/j.jss.2022.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Financial incentives to promote recommended behaviors have been applied in many healthcare settings, but to our knowledge, have never been tested as a strategy to improve patient follow-up after bariatric surgery. Given that females make up majority of bariatric surgery patients, our goal was to explore female patient perceptions on the effects of a financial incentive program designed to increase follow-up after bariatric surgery. METHODS This was an exploratory qualitative study of patient participants in a pilot program investigating financial incentives. We performed qualitative interviews with female patients to include personal experiences with bariatric surgery, progress toward goals, and concerns related to post-surgical behaviors. The data was analyzed iteratively through inductive thematic analysis. RESULTS Twenty-one female patients who had undergone bariatric surgery and enrolled in the financial incentive program participated in this study. Participants had generally positive impressions of the financial incentive program. Participants described the utility of the program in helping to pay for expenses associated with bariatric surgery; feeling that participation was their way of demonstrating that they were compliant with post-surgical recommendations; and that it provided additional motivation. All patients stated that even without the financial incentive they would have continued to follow-up. CONCLUSIONS While financial incentives can provide additional motivation for patients following bariatric surgery, they are not the primary reason that patients choose to follow-up. Understanding the motivation of patients who choose to follow-up (or not) may better inform investigations intended to improve follow-up rates after bariatric surgery.
Collapse
Affiliation(s)
- Anne P Ehlers
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan; Michigan Bariatric Surgery Collaborative, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan.
| | - C Ann Vitous
- Michigan Bariatric Surgery Collaborative, Ann Arbor, Michigan
| | - Grace F Chao
- Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan; National Clinician Scholars Program, Veterans Affairs Ann Arbor, Michigan; Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | | | - Rachel Ross
- Michigan Bariatric Surgery Collaborative, Ann Arbor, Michigan
| | - Jeffrey T Kullgren
- Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan; Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan; Departments of Internal Medicine and Health Management and Policy, Michigan Medicine, Ann Arbor, Michigan
| | - Amir A Ghaferi
- Department of Surgery, Michigan Medicine, Ann Arbor, Michigan; Michigan Bariatric Surgery Collaborative, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan
| |
Collapse
|
5
|
Behavioral Interventions to Improve Home-Based Office-Workers’ Health. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC8754544 DOI: 10.1007/s43076-021-00122-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many organizations have traditionally supported their employees’ physical and mental health through a variety of office-based programs and interventions. The shift from in-office work to working from home, which has been accelerated by the COVID-19 pandemic, requires organizations to update their toolbox to continue supporting a healthy and happy workforce. In this paper, we review research on successful, evidence-based interventions in four key areas of physical and mental health: physical activity and sedentary behavior, nutrition, loneliness, and stress. We show how organizations could adapt these interventions to a home-based office environment and conclude by highlighting areas of future research, as well as by discussing the role of health professionals and policymakers in designing effective interventions for the future of work.
Collapse
|
6
|
Keadle SK, Meuter L, Phelan S, Phillips SM. Charity-based incentives motivate young adult cancer survivors to increase physical activity: a pilot randomized clinical trial. J Behav Med 2021; 44:682-693. [PMID: 33825070 DOI: 10.1007/s10865-021-00218-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 03/25/2021] [Indexed: 12/24/2022]
Abstract
To determine the feasibility, acceptability and preliminary efficacy of an eHealth intervention with charity-based incentives to increase physical activity (PA) among young adult cancer survivors. Participants were randomized into two groups: PA (N = 25; Fitbit, step goal, electronic weekly newsletter) or PA + Charity (N = 26; same as PA plus charity donation if step goal achieved). At baseline and 12 weeks, steps/day were assessed using an activPAL. Motivation (e.g., BREQ-3) and patient reported outcomes (e.g., sleep quality, fatigue) were self-reported. The mean age was 36.8 years, 56.9% were Non-Hispanic White. We retained 82% (42/51) of participants. The PA + Charity vs. PA group had significantly higher satisfaction with intervention experience (100% vs 85%), greater increases in steps/day (1689 vs 516) and increases in overall self-determination score (13.5 vs 2.2). Both groups significantly improved sleep quality and reduced fatigue. A low-intensity eHealth intervention with charity-based incentives was feasible, acceptable, increased PA and self-determination.Trial registration Clinicaltrials.gov NCT03322059.
Collapse
Affiliation(s)
- Sarah Kozey Keadle
- Department of Kinesiology and Public Health, California Polytechnic State University, 1 Grand Ave, San Luis Obispo, CA, 93407, USA.
| | - Leah Meuter
- Department of Kinesiology and Public Health, California Polytechnic State University, 1 Grand Ave, San Luis Obispo, CA, 93407, USA
| | - Suzanne Phelan
- Department of Kinesiology and Public Health, California Polytechnic State University, 1 Grand Ave, San Luis Obispo, CA, 93407, USA
| | - Siobhan M Phillips
- Division of Behavioral Medicine, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Drive, Chicago, IL, 60611, USA
| |
Collapse
|
7
|
Abstract
Evidence supports exercise as a first-line option for many chronic diseases. Although recommendations suggest 150 to 300 minutes a week of moderate-intensity or 75 to 150 minutes a week of vigorous-intensity aerobic activity, replacing sedentary behaviors with light-intensity activities reduces risks of all-cause mortality, and cardiovascular disease (CVD) mortality and incidence of CVD and type 2 diabetes mellitus. Exercise has positive effects on brain function, cognition, and depressive symptoms. Based on such evidence, health care providers should incorporate evaluation of physical activity into patient care. Patients should be evaluated for readiness and ability to exercise and encouraged to increase activity level.
Collapse
Affiliation(s)
- Leigh Ann McInnis
- School of Nursing, Middle Tennessee State University, 1500 Greenland Drive, Box 81, Murfreesboro, TN 37132, USA.
| | - Angela Morehead
- School of Nursing, Middle Tennessee State University, 1500 Greenland Drive, Box 81, Murfreesboro, TN 37132, USA
| |
Collapse
|
8
|
Returnable reciprocity: Returnable gifts are more effective than unreturnable gifts at promoting virtuous behaviors. ORGANIZATIONAL BEHAVIOR AND HUMAN DECISION PROCESSES 2020. [DOI: 10.1016/j.obhdp.2020.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
9
|
Rummo PE, Elbel B. Using Multiple Financial Incentive Structures to Promote Sustainable Changes in Health Behaviors. JAMA Netw Open 2019; 2:e199859. [PMID: 31441932 DOI: 10.1001/jamanetworkopen.2019.9859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pasquale E Rummo
- Section on Health Choice, Policy and Evaluation, Department of Population Health, New York University School of Medicine, New York
| | - Brian Elbel
- Section on Health Choice, Policy and Evaluation, Department of Population Health, New York University School of Medicine, New York
- Wagner Graduate School of Public Service, New York University, New York
| |
Collapse
|