Examining Ways to Improve Weight Control Programs' Population Reach and Representativeness: A Discrete Choice Experiment of Financial Incentives

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dc.contributor.authorYou, Wenen
dc.contributor.authorYuan, Yuanen
dc.contributor.authorBoyle, Kevin J.en
dc.contributor.authorMichaud, Tzeyu L.en
dc.contributor.authorParmeter, Chrisen
dc.contributor.authorSeidel, Richard W.en
dc.contributor.authorEstabrooks, Paul A.en
dc.date.accessioned2021-12-13T15:40:50Zen
dc.date.available2021-12-13T15:40:50Zen
dc.date.issued2021-11-10en
dc.description.abstractBackground Both theoretical and empirical evidence supports the potential of modest financial incentives to increase the reach of evidence-based weight control programs. However, few studies exist that examine the best incentive design for achieving the highest reach and representativeness at the lowest cost and whether or not incentive designs may be valued differentially by subgroups that experience obesity-related health disparities. Methods A discrete choice experiment was conducted (n = 1232 participants; over 90% of them were overweight/obese) to collect stated preference towards different financial incentive attributes, including reward amount, program location, reward contingency, and payment form and frequency. Mixed logit and conditional logit models were used to determine overall and subgroup preference ranking of attributes. Using the National Health and Nutrition Examination Survey data sample weights and the estimated models, we predicted US nationally representative participation rates by subgroups and examined the effect of offering more than one incentive design. External validity was checked by using a completed cluster randomized control trial. Results There were significant subgroup differences in preference toward incentive attributes. There was also a sizable negative response to larger incentive amounts among African Americans, suggesting that higher amounts would reduce participation from this population. We also find that offering participants a menu of incentive designs to choose from would increase reach more than offering higher reward amounts. Conclusions We confirmed the existence of preference heterogeneity and the importance of subgroup-targeted incentive designs in any evidence-based weight control program to maximize population reach and reduce health disparities.en
dc.description.notesResearch reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award number 1R21HL097308-01A2. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsoring agencies.en
dc.description.sponsorshipNational Heart, Lung, and Blood Institute of the National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [1R21HL097308-01A2]en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1007/s41669-021-00310-6en
dc.identifier.eissn2509-4254en
dc.identifier.issn2509-4262en
dc.identifier.pmid34757584en
dc.identifier.urihttp://hdl.handle.net/10919/106960en
dc.language.isoenen
dc.rightsCreative Commons Attribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.titleExamining Ways to Improve Weight Control Programs' Population Reach and Representativeness: A Discrete Choice Experiment of Financial Incentivesen
dc.title.serialPharmacoeconomics-Openen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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