Smith School of Business, Queen's University, Kingston, ON, Canada.
Carrot Insights Inc, Toronto, ON, Canada.
J Med Internet Res. 2020 Aug 10;22(8):e16797. doi: 10.2196/16797.
The Carrot Rewards app was developed as part of a public-private partnership to reward Canadians with loyalty points for downloading the app, referring friends, completing educational health quizzes, and health-related behaviors with long-term objectives of increasing health knowledge and encouraging healthy behaviors. During the first 3 months after program rollout in British Columbia, a number of program design elements were adjusted, creating observed differences between groups of users with respect to the potential impact of program features on user engagement levels.
This study examines the impact of reducing reward size over time and explored the influence of other program features such as quiz timing, health intervention content, and type of reward program on user engagement with a mobile health (mHealth) app.
Participants in this longitudinal, nonexperimental observational study included British Columbia citizens who downloaded the app between March and July 2016. A regression methodology was used to examine the impact of changes to several program design features on quiz offer acceptance and engagement with this mHealth app.
Our results, based on the longitudinal app use of 54,917 users (mean age 35, SD 13.2 years; 65.03% [35,647/54,917] female), indicated that the key drivers of the likelihood of continued user engagement, in order of greatest to least impact, were (1) type of rewards earned by users (eg, movies [+355%; P<.001], air travel [+210%; P<.001], and grocery [+140%; P<.001] relative to gas), (2) time delay between early offers (-64%; P<.001), (3) the content of the health intervention (eg, healthy eating [-10%; P<.001] vs exercise [+20%, P<.001] relative to health risk assessments), and (4) changes in the number of points offered. Our results demonstrate that reducing the number of points associated with a particular quiz by 10% only led to a 1% decrease in the likelihood of offer response (P<.001) and that each of the other design features had larger impacts on participant retention than did changes in the number of points.
The results of this study demonstrate that this program, built around the principles of behavioral economics in the form of the ongoing awarding of a small number of reward points instantly following the completion of health interventions, was able to drive significantly higher engagement levels than those demonstrated in previous literature exploring the intersection of mHealth apps and financial incentives. Previous studies have demonstrated the presence of incentive matters to user engagement; however, our results indicate that the number of points offered for these reward point-based health interventions is less important than other program design features such as the type of reward points being offered, the timing of intervention and reward offers, and the content of the health interventions in driving continued engagement by users.
胡萝卜奖励应用程序是作为公私合作伙伴关系的一部分开发的，旨在通过为下载应用程序、推荐朋友、完成健康教育测验以及与健康相关的行为的加拿大人提供忠诚度积分，从而实现长期目标，即提高健康知识和鼓励健康行为。在不列颠哥伦比亚省推出该计划的头 3 个月内，对一些计划设计要素进行了调整，这使得不同用户群体之间在程序功能对用户参与度的潜在影响方面存在明显差异。
本研究考察了随着时间的推移减少奖励规模的影响，并探讨了其他计划功能（如测验时间安排、健康干预内容和奖励计划类型）对移动健康（mHealth）应用程序用户参与度的影响。
本纵向非实验性观察研究的参与者包括 2016 年 3 月至 7 月间下载该应用程序的不列颠哥伦比亚省公民。采用回归方法来检验几项计划设计特征的变化对测验参与度和对这款 mHealth 应用程序的使用情况的影响。
我们的研究结果基于 54917 名用户（平均年龄 35 岁，标准差 13.2 岁；65.03%[35，647/54917]为女性）的纵向应用程序使用情况，结果表明，继续用户参与的关键驱动因素（按影响程度降序排列）为：（1）用户获得的奖励类型（例如，电影[+355%；P<.001]、航空旅行[+210%；P<.001]和杂货[+140%；P<.001]，与汽油相比）；（2）早期优惠之间的时间延迟（-64%；P<.001）；（3）健康干预内容（例如，健康饮食[-10%；P<.001]与运动[+20%，P<.001]，与健康风险评估相比）；以及（4）提供的积分数量的变化。我们的研究结果表明，将特定测验的积分数量减少 10%仅导致参与率降低 1%（P<.001），并且每个其他设计特征对参与者保留的影响都大于积分数量的变化。
本研究结果表明，该计划围绕行为经济学的原则构建，即通过在完成健康干预后立即给予少量的积分，以持续给予奖励，从而能够显著提高参与度，超过了之前探索 mHealth 应用程序和财务激励交叉点的文献中所展示的水平。之前的研究已经证明了激励对用户参与度的重要性；然而，我们的研究结果表明，这些基于奖励积分的健康干预计划提供的积分数量不如其他计划设计特征重要，例如所提供的奖励积分类型、干预和奖励的时间安排以及健康干预内容在推动用户持续参与方面的重要性。
