Effectiveness of Financial Incentives in a Worksite Diabetes Prevention Program

PURPOSE To evaluate the effect of financial incentive in a diabetes prevention weight loss program at worksites. DESIGN Group-level randomized intervention study. SETTING Four long-term care facilities, randomly assigned to "incentive-IG" or "non incentive-NIG" groups. PARTICIPANTS Ninety-nine employees, all overweight or obese (BMI= mean 34.8±7.4 kg/m2) and at risk for type 2 diabetes. INTERVENTION A 16 week weight loss program (diabetes prevention program) with a 3 month follow up. IG could either choose a "standard incentive" to receive cash award when achieving the projected weight loss or to participate in a "standard plus deposit incentive" to get additional money matched with their deposit for projected weight loss. All of the participants received a one-hour consultation for a healthy weight loss at the beginning. MEASURES Weight-loss, diabetes risk score (DRS), and cardiovascular risk outcomes. ANALYSES Linear and logistic regressions for completed cases with adjustments for clustering effect at group level. RESULTS IG lost on average more pounds (p=0.027), reduced BMI (p=0.04), and reduced in DRS (p=0.011) compared to NIG at week 16. At the 12-week follow-up period, those in IG plus deposit subgroup had twice the odds (OR=2.2, p=0.042) and those in the standard IG had three times the odds of achieving weight loss goals than NIG; those in the IG plus deposit group reduced DRS by 0.4 (p=0.045). CONCLUSION Monetary incentives appear to be effective in reducing weight and diabetes risk.