Butsch W Scott, Ard Jamy D, Allison David B, Patki Amit, Henson C Suzanne, Rueger Miriam M, Hubbert Katherine A, Glandon Gerry L, Heimburger Douglas C
Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 439, 1675 University Blvd., Birmingham, AL 35294-3360, USA.
Obesity (Silver Spring). 2007 Nov;15(11):2733-8. doi: 10.1038/oby.2007.325.
The objective was to examine the effect of offering a reimbursement incentive on the percentage of inquirers who enrolled in a weight control program and on weight loss and program attendance among enrollees.
We used a sequential control-intervention design to observe how inquirers of the University of Alabama at Birmingham EatRight Lifestyle Program responded to an enrollment incentive for potential 50% ($150) reimbursement of the total program fee if they attended 10 of 12 classes and lost at least 6% of their current body weight. Inquirers had to be adults with a BMI >or=30 kg/m(2), seeking information about a weight control program, and informed of the program cost. Outcomes included proportion of inquirers enrolled, overall number of classes attended, and weight loss.
Of the 401 people who inquired during the study periods, 24.5% and 25.0% enrolled in the intervention and control periods, respectively. There was a trend toward higher attendance in the intervention group, compared with the control group; there were no differences in percentage of weight loss. The odds of attending >or=10 classes were 2.4 times as high, and both losing >6% body weight and attending >or=10 classes were three times as high in the intervention subjects compared with controls, although non-significant.
The potential of earning a performance-based reimbursement incentive did not affect enrollment in the EatRight Lifestyle Program. Performance-based incentives may be an ideal mechanism for extending coverage of weight-loss interventions by insurers because of limited financial risk and improved adherence.
本研究旨在探讨提供报销激励措施对报名参加体重控制项目的咨询者比例、参加项目者的体重减轻情况及项目出勤率的影响。
我们采用了序贯对照-干预设计，以观察阿拉巴马大学伯明翰分校健康饮食生活方式项目的咨询者对一项报名激励措施的反应。该激励措施为：若参加者在12节课中出席10节且体重减轻至少6%，则可获得相当于总项目费用50%（150美元）的报销。咨询者必须为成年人，体重指数（BMI）≥30kg/m²，正在寻求体重控制项目的相关信息，且已被告知项目费用。研究结果包括咨询者的报名比例、参加课程的总节数以及体重减轻情况。
在研究期间咨询的401人中，干预组和对照组的报名比例分别为24.5%和25.0%。与对照组相比，干预组的出勤率有升高趋势；体重减轻百分比无差异。干预组参加10节及以上课程的几率是对照组的2.4倍，干预组体重减轻超过6%且参加10节及以上课程的几率是对照组的3倍，尽管差异无统计学意义。
基于表现的报销激励措施的可能性并未影响健康饮食生活方式项目的报名情况。由于财务风险有限且依从性提高，基于表现的激励措施可能是保险公司扩大减肥干预覆盖范围的理想机制。
