一项比较损失与收益激励措施以提高青少年肥胖治疗干预依从性的随机对照试验。

A Randomized Controlled Trial Comparing Loss versus Gain Incentives to Improve Adherence to an Obesity Treatment Intervention in Adolescents.

机构信息

The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA.

Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.

出版信息

Nutrients. 2024 Oct 3;16(19):3363. doi: 10.3390/nu16193363.

DOI:10.3390/nu16193363

PMID:39408330

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11478643/

Abstract

BACKGROUND/OBJECTIVES: Adherence to pediatric obesity treatment can be challenging. Monetary incentives improve adherence to lifestyle interventions, with incentives framed as loss often more effective than those framed as gain. The objectives of this study were to determine if monetary incentives in the form of gift cards would improve adherence to an obesity treatment intervention and whether framing the incentive as either loss or gain affected adherence.

METHODS

Sixty adolescents with obesity (body mass index of ≥95th percentile for age and sex) were recruited from our pediatric obesity treatment program. They were randomized into one of three groups and given a monthly adherence score (AS) of up to 100 points. These points were based on completing a medical visit, reporting on diet intake, and measuring daily steps on a wearable tracker. The Gain Group (GG), N = 20, started each month with USD 0 in a virtual account and increased their monetary reward up to USD 100 depending on AS. The Loss Group (LG), N = 21, began each month with USD 100 in their virtual account, which decreased based on adherence. The Control Group (CG), N = 19, received USD 10 monthly.

RESULTS

Adherence was highest in the GG, with 66.0 points, compared to the LG, with 54.9 points, and CG, with 40.6 points, with < 0.01. The GG had greater adherence to their step goal (14.6) and dietary reporting (18.7) compared to the LG (10.0 and 13.9) and the CG (3.9 and 8.1), < 0.005.

CONCLUSIONS

Gain-framed incentives are superior to loss-framed ones in improving adherence to pediatric obesity treatments.

摘要

背景/目的：儿童肥胖治疗的依从性可能具有挑战性。金钱激励可以提高生活方式干预的依从性，以损失为框架的激励往往比以收益为框架的激励更有效。本研究的目的是确定以礼品卡形式提供的金钱激励是否会提高肥胖治疗干预的依从性，以及激励措施是以损失还是收益为框架是否会影响依从性。

方法

从我们的儿科肥胖治疗计划中招募了 60 名肥胖青少年（体重指数为年龄和性别第 95 百分位以上）。他们被随机分为三组，并获得每月最高 100 分的依从性评分（AS）。这些分数基于完成医疗访问、报告饮食摄入和使用可穿戴追踪器测量每日步数。收益组（GG），N = 20，从虚拟账户中每月开始有 0 美元，并根据 AS 增加到最高 100 美元的货币奖励。损失组（LG），N = 21，每月从虚拟账户中开始有 100 美元，根据依从性减少。对照组（CG），N = 19，每月获得 10 美元。

结果

GG 的依从性最高，为 66.0 分，其次是 LG，为 54.9 分，CG 为 40.6 分，差异有统计学意义（P < 0.01）。GG 在达到步数目标（14.6）和报告饮食（18.7）方面的依从性明显高于 LG（10.0 和 13.9）和 CG（3.9 和 8.1），差异有统计学意义（P < 0.005）。