Employee Wellness Motivated More by Loss than Gain

A study sheds light on the effect of employer wellness program incentive designs.

Employer wellness program financial incentives framed as a loss are most effective for achieving physical activity goals, a study found.

Researchers from the Perelman School of Medicine at the University of Pennsylvania, and other entities tested the effectiveness of three methods to frame financial incentives to increase physical activity among overweight and obese adults. For 13 weeks, 281 overweight or obese employees at the University of Pennsylvania were given a goal of 7,000 steps per day and were randomly assigned to a control group with daily feedback or to a group with one of three financial incentive programs with daily feedback.

The three financial incentive programs included a gain incentive ($1.40 given each day that the goal was achieved), lottery incentive (daily eligibility [expected value approximately $1.40] if goal was achieved), or loss incentive ($42 allocated monthly upfront and $1.40 removed each day the goal was not achieved). Participants were followed for another 13 weeks with daily performance feedback but no incentives.

People with no financial incentive performed their 7,000 steps for about 30% of days, compared to 35% of days for those in the gain incentive group and 36% in the lottery incentive group. By contrast, the mean proportion of participant-days achieving the goal for the loss incentive group was 45%.

The research notes that in adjusted analyses, only the loss-incentive group had a significantly greater mean proportion of participant-days achieving the goal than the control group.

Commenting on the research, corporate wellness strategist David Roddenberry, CEO of wellness provider HealthyWage, notes, “This study reiterates the importance of the ‘stick’ in the design of a workplace wellness incentive program. We advocate program participants ‘pay to play’ and make an investment out of their own pocket in order to win rewards (in our case large cash prizes) for losing weight and/or getting more active in the program. Instead of only doling out cash incentives for health, employers should utilize both the carrot and the stick, and design voluntary programs that give those interested and ready to make a change the opportunity to be more effective at obtaining their goals with a cash prize.”

The study is published in the Annals of Internal Medicine.