Financial incentive models to improve adherence (II)

Approach or solution
A comparison of two financial incentive models to improve adherence to a physical activity programme, comparing a gain and a loss model.


Organisation or initiative
Research publication:
Hafner, M., Pollard, J., & Van Stolk, C. (2020). Incentives and physical activity: An assessment of the association between Vitality’s Active Rewards with Apple Watch benefit and sustained physical activity improvements. Rand Health Quarterly, 9(1).


URL or reference


Summary of the innovation
This was an independently conducted study by RAND Europe comparing two similar but subtly different financial incentive models for individuals to undertake a sustained healthy lifestyle programme run by a multi-national health insurance company.
The study compared two financial models operated in three countries (US, UK, South Africa) for three years, and involved over 400,000 people. In the classical model, a “gain-framed incentive”, individuals received a financial reward for regularly undertaking healthy lifestyle activities and providing this data on a weekly basis to their health insurer via an mHealth tool. Their achievements, which could be collected through a variety of fitness monitoring devices, were mapped to a points system that was periodically translated into a financial reward. The novel model was a “loss-framed incentive” in which subscribers could purchase an Apple Watch with a very low upfront payment, 10% of its true cost, and a regular instalment plan to pay the balance over two years. The monthly instalments were reduced each time, potentially down to zero, if specified lifestyle activity targets were maintained. This could result in an adhering individual obtaining the Apple Watch for only 10% of its cost.
Although both reward models were successful, the study showed that the loss-framed incentive lead to a greater level of physical activity in all three countries.


Use cases supported
mHealth use cases with a behavioural component
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