Health Promotion through Monetary Incentives: Evaluating the Impact of Different Reinforcement Schedules on Engagement Levels with a mHealth App

Background: Financial rewards can be employed in mHealth apps to effectively promote health behaviors. However, the optimal reinforcement schedule—with a high impact, but relatively low costs—remains unclear. Methods: We evaluated impact of different schedules on engagement levels with app six-week, three-arm randomized intervention trial, while taking into account personality differences. Participants (i.e., university staff and students, N = 61) were awarded virtual points for performing health-related activities. Their performance was displayed via dashboard, leaderboard, newsfeed. Additionally, participants could win financial rewards. These distributed using fixed schedule first study arm, variable other arms. Furthermore, payouts immediate two arms, whereas third arm delayed. Results: All three had similar user engagement, although reported have lowest cost per participant. affected by personal characteristics. Especially, individuals that triggered greater ability defer gratification. Conclusion: When employing apps, are preferred from perspective impact.