title: Burn and earn: a randomized controlled trial incentivizing exercise during fall semester for college first-year students. Use of personal trainers and financial incentives to increase exercise in a behavioral weight-loss program. Strengthening behavioral interventions for weight loss: a randomized trial of food provision and monetary incentives. The effects of self-monitoring and reinforcement on exercise adherence. Effects of a personal trainer and financial incentives on exercise adherence in overweight women in a behavioral weight loss program. A Simple Reinforcement Strategy for Increasing Attendance at a Fitness Facility Preventing weight gain in adults: the pound of prevention study. Work-site cardiovascular risk reduction: a randomized trial of health risk assessment, education, counseling, and incentives. A randomized study of financial incentives to increase physical activity among sedentary older adults. A behavioral approach to achieving initial cocaine abstinence.
abstract: OBJECTIVE To examine the viability of monetary incentives to increase fitness-center use and maintain/improve the Body Mass Indexes ( BMI s ) of first-year students over the fall semester . METHOD R and omized-controlled trial with no-treatment and incentive conditions involving 117 first-year students . For 12 weeks , students in the incentive condition received monetary payments ranging from $ 10 to $ 38.75 for meeting research er-set fitness-center use goals that were identical across conditions . Fitness-center use was monitored through electronic ID-card check-in and check-out records at the campus fitness center . RESULTS 63 % of incentive-condition participants met the weekly fitness-center use goals on average compared to only 13 % of control-condition participants , a significant difference , p<0.001 . Goal achievement significantly decreased over time , p<0.01 and at roughly the same rate in the control and incentive conditions , p=0.23 . Average BMI increases over the fall semester in the control ( 24.2 ( 0.6 ) to 24.6 (0.6)kg/m(2 ) ) versus incentive condition ( 23.1 ( 0.4 ) to 23.5 (0.4)kg/m(2 ) ) were not significantly different ( p=0.70 ) . CONCLUSION Weekly monetary incentives result ed in significantly more first-year students meeting weekly fitness-center use goals . However , the increased fitness-center use by the incentive condition did not prevent an increase in BMI during fall semester Exercise is the best predictor of long-term weight loss . This study evaluated two strategies for improving exercise adherence and long-term weight loss in obese out patients . Obese men and women ( N = 193 ) were r and omized to 1 of 5 treatment groups for 18 months : st and ard behavior therapy ( SBT ) ; SBT with supervised walks ( SW ) 3 times per week ; SBT + SW with personal trainers ( PT ) , who walked with participants , made phone reminders , and did make-up SW ; SBT + SW with monetary incentives ( I ) for completing SW ; and SBT + SW + PT + I. Both PT and I enhanced attendance at SWs , the combination producing the best adherence . Increased walk attendance did not result in higher overall energy expenditure , however , and long-term weight loss was also not improved . Post hoc analyses suggest that the level of exercise needed for successful long-term weight loss is much higher than that usually recommended in behavioral treatment programs Behavioral treatments for obesity seek to modify eating and exercise behaviors by a change in their antecedents and consequences . More direct modification of antecedents and consequences by ( a ) the provision of food to patients and ( b ) the provision of financial rewards for weight loss was hypothesized to improve treatment outcomes . Two hundred two men and women were r and omly assigned to no treatment , st and ard behavioral treatment ( SBT ) , SBT plus food provision , SBT plus incentives , or SBT plus food provision and incentives . The major finding was that food provision significantly enhanced weight loss . Weight losses with  SBT  averaged 7.7 , 4.5 , and 4.1 kg at 6 , 12 , and 18 months , respectively , compared with 10.1 , 9.1 , and 6.4 kg , respectively , at the same intervals with the addition of food . Food provision also enhanced attendance , completion of food records , quality of diet , and nutrition knowledge . We conclude that the provision of food to weight-loss patients is a promising methodology that deserves further exploration Two behavioral techniques were assessed to determine their effects on subjects ' adherence to unsupervised exercise . The subjects were 35 moderately fit persons who had just completed an adult fitness program ( AF group ) and 42 sedentary individuals who were recruited through the campus newspaper ( NEWS group ) . Participants were r and omly assigned to one of three conditions : ( a ) self-monitoring , ( b ) reinforcement supplied by another person , or ( c ) control . All subjects were given instructions on how to exercise and asked to exercise on their own for 18 weeks . Self-monitoring subjects kept written records of their exercise behavior , while reinforcement subjects verbally reported their exercise behavior to another person who periodically administered rewards . Pre- and posttreatment tests on the NEWS group revealed no significant treatment or interaction effects . However , the reinforcement group had an 11 % improvement in predicted max VO2 and a 9 bpm improvement in exercise heart rate compared to 7.8 % , 5 bpm for the self-monitoring ( SM ) group and 5.3 % , 6 bpm for the control group . T-tests indicated that reward and SM groups improved significantly on these variables , whereas the control group did not . SM ( M = 2.07 ) and reinforcement ( M = 2.29 ) groups reported a significantly higher frequency of exercise per week than the control ( M = 1.36 ) group . The AF subjects were able to maintain their fitness level ( with the exception of a small increase in body fat ) over the 18-week period . The behavioral interventions had little differential effect on adherence by AF subjects who were already regular exercisers Exercise is important for long-term weight loss , but few studies have examined ways to improve exercise adherence in overweight subjects participating in a behavioral weight loss program . This paper presents two studies , one conducted at the University of Pittsburgh and one at the University of Minnesota , that sought to improve exercise adherence by exerting more direct control over the environmental antecedents and consequences controlling exercise . Study 1 investigated the use of a personal trainer who called participants regularly and met them at their home or office at scheduled times for a walk . Study 2 investigated the effect of a lottery incentive for exercise adherence . In both studies , the effect of these manipulations was examined in the context of a 24-week st and ard behavioral weight control program with three supervised exercise sessions per week . Neither intervention achieved statistically significant improvements in exercise adherence compared to control conditions , perhaps due in part to the limited statistical power of the studies . Future studies should focus on better underst and ing the barriers to exercise and design ing behavioral interventions that address these barriers The purpose of the present study was to examine the effect of a previously untested reinforcement strategy ( i.e. , 1 month 's free membership ) on attendance at a  fitness facility . Participants were paying members of a fitness facility r and omly assigned to  control ( n = 100 ) , placebo  ( n = 100 ) , and  reinforcement ( n = 100 ) conditions . The control condition received no intervention ; the placebo condition received a letter by mail ; and the reinforcement condition received the same letter by mail , except that it included an additional paragraph instructing them that they could earn 1 month 's free membership if they attended the fitness facility at least 12 times in the next month . Attendance was monitored for I month baseline and postintervention by using the facility 's computer system . Analysis of variance , t tests , and chi-square analysis all revealed that the reinforcement condition had the best attendance record during the intervention period . These preliminary results shed some light on increasing attendance at a fitness facility . Discussion highlighted the practical implication s of the findings and offered directions for future research OBJECTIVES This study examined whether weight gain with age could be prevented through the use of a low-intensity intervention . METHODS Participants , 228 men and 998 women recruited from diverse sources , were r and omized to one of the following groups : ( 1 ) no-contact control , ( 2 ) education through monthly newsletters , or ( 3 ) education plus incentives for participation . All participants were weighed and completed question naires about behaviors and attitudes related to weight at baseline and annually for 3 years thereafter . RESULTS Individuals in intervention groups reported favorable changes over time in frequency of weighting and healthy dieting practice s relative to those in the control group . These behavior changes were in turn related to a reduced rate of weight gain over time . However , weight gain over 3 years did not differ significantly by treatment group . CONCLUSIONS This low-intensity educational approach to weight gain prevention sustained interest over a lengthy time period and was associated positively with behavior change , but it was not strong enough to significantly reduce weight gain with age OBJECTIVES This study reports an efficacy trial of four work-site health promotion programs . It was predicted that strategies making use of behavioral counseling would produce a greater reduction in cardiovascular disease risk factors than screening and educational strategies . METHODS Twenty-eight work sites were r and omly allocated to a health risk assessment , risk factor education , behavioral counseling , or behavioral counseling plus incentives intervention . Participants were assessed before the intervention and at 3 , 6 , and 12 months . RESULTS Compared with the average of the health risk assessment and risk factor education conditions , there were significantly higher vali date d continuous smoking cessation rates and smaller increases in body mass index and estimated percentage of body fat in the two behavioral counseling conditions . The behavioral counseling condition was associated with a greater reduction in mean blood pressure than was the behavioral counseling plus incentives condition . On average among all groups , there was a short-term increase in aerobic capacity followed by a return to baseline levels . CONCLUSIONS Work-site interventions that use behavioral approaches can produce lasting changes in some cardiovascular risk factors and , if implemented routinely , can have a significant public health impact OBJECTIVE Less than half of all U.S. adults meet public health recommendations for physical activity , and even fewer older adults ( aged 50 years and over ) are sufficiently active . Because inactivity increases the risk of costly medical complications , successful efforts to increase physical activity among older adults may potentially be cost-effective . We sought to test if financial incentives for walking could increase physical activity among sedentary older adults . METHODS We conducted a 4-week r and omized controlled study using pedometers .  A total of 51 adults age 50 + from the Raleigh-Durham area of North Carolina participated in the study in April-May 2007 . Individuals were r and omized into one of two arms . The control group received a fixed payment of $ 75 ; the intervention group received a fixed payment of $ 50 plus up to $ 25 more per week depending on the number of weekly aerobic minutes  , defined as 10 + minutes of continuous walking or jogging . RESULTS The control group logged 2.3 h per week , on average . The intervention group logged 4.1 h per week and received an additional weekly payment of $ 17.50 , on average . CONCLUSION Modest financial incentives tied to aerobic minutes are an effective , and potentially cost-effective , approach for increasing physical activity among sedentary older adults OBJECTIVE The aim of this study was to assess the efficacy of a behavioral treatment program for achieving initial cocaine abstinence in individuals enrolled in outpatient treatment for cocaine dependence . METHOD Thirteen consecutively admitted out patients were offered behavioral treatment consisting of contingency management procedures and the community reinforcement approach .  Fifteen consecutively admitted out patients were offered treatment with 12-step counseling . All 13 of the patients who were offered the behavioral treatment accepted it ; 12 of the patients offered 12-step counseling accepted it . RESULTS Eleven of the 13 patients in the behavioral treatment were retained for 12 weeks of treatment , compared with five of the 12 patients given 12-step counseling . Ten of the patients given behavioral therapy achieved 4 weeks of continuous cocaine abstinence , compared with only three of those given 12-step counseling . Six of the patients in the behavioral treatment group achieved 8 weeks , and three achieved 12 weeks ; none of the patients in the 12-step counseling program achieved 8 weeks . CONCLUSIONS The behavioral treatment described in this paper offers promise as an effective intervention for achieving initial cocaine abstinence . A r and omized trial is underway to assess the generality of these findings
target: Assured , or " sure thing , " incentives and objective behavioral assessment in particular appear to moderate incentive effectiveness .
  The effect estimate from the meta- analysis suggests that financial incentives increase exercise session attendance for interventions up to 6 months in duration .
background: CONTEXT Less than 5 % of U.S. adults accumulate the required dose of exercise to maintain health .
  Behavioral economics has stimulated renewed interest in economic-based , population -level health interventions to address this issue .
  Despite widespread implementation of financial incentive-based public health and workplace wellness policies , the effects of financial incentives on exercise initiation and maintenance in adults remain unclear .