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Effects of Loss and Gain Incentives on Adherence in Pediatric Weight Management: Preliminary Studies and Economic Evaluation of a Theoretical Trial

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Listed:
  • Robert Siegel

    (The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
    Department of Pediatrics, College of Medine, University of Cincinnati, Cincinnati, OH 45267, USA)

  • Meghan E. McGrady

    (Department of Pediatrics, College of Medine, University of Cincinnati, Cincinnati, OH 45267, USA
    Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA)

  • Linda Dynan

    (James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
    Department of Economics, Northern Kentucky University, Highland Heights, KY 41099, USA)

  • Roohi Kharofa

    (The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
    Department of Pediatrics, College of Medine, University of Cincinnati, Cincinnati, OH 45267, USA)

  • Kristin Stackpole

    (The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA)

  • Paula Casson

    (The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA)

  • Francesca Siegel

    (The University of Cincinnati Medical Center, Cincinnati, OH 45219, USA)

  • Nadine A. Kasparian

    (The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
    Department of Pediatrics, College of Medine, University of Cincinnati, Cincinnati, OH 45267, USA
    Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA)

Abstract

Pediatric weight management is often hampered by poor engagement and adherence. Incentives based on loss have been shown to be more effective than gain-based incentives in improving outcomes among children with health conditions other than obesity. In preparation for a clinical trial comparing loss-framed to gain-framed incentives, a survey of youth and caregiver attitudes on weight management incentives, reasons for program attendance, and an economic evaluation of a theoretical trial were conducted. Ninety of 835 (11%) surveys were completed by caregiver and child. The economic evaluation showed that loss-framed incentives had a preferable incremental cost-effectiveness ratio (a lower value is considered preferable) than gain-based incentives. Most youth and caregivers felt a gain incentive would be superior, agreed that the full incentive should go to the youth (vs. the caregiver), and identified “improving health” as a top reason for pursuing weight management.

Suggested Citation

  • Robert Siegel & Meghan E. McGrady & Linda Dynan & Roohi Kharofa & Kristin Stackpole & Paula Casson & Francesca Siegel & Nadine A. Kasparian, 2022. "Effects of Loss and Gain Incentives on Adherence in Pediatric Weight Management: Preliminary Studies and Economic Evaluation of a Theoretical Trial," IJERPH, MDPI, vol. 20(1), pages 1-14, December.
    • Handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:584-:d:1019188
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    References listed on IDEAS

    as
    1. Jaime Moore & Matthew Haemer & Nazrat Mirza & Ying Z Weatherall & Joan Han & Caren Mangarelli & Mary Jane Hawkins & Stavra Xanthakos & Robert Siegel, 2019. "Pilot Testing of a Patient Decision Aid for Adolescents with Severe Obesity in US Pediatric Weight Management Programs within the COMPASS Network," IJERPH, MDPI, vol. 16(10), pages 1-12, May.
    2. Amos Tversky & Daniel Kahneman, 1991. "Loss Aversion in Riskless Choice: A Reference-Dependent Model," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1039-1061.
    3. Kevin R Short & Jennifer Q Chadwick & Tamela K Cannady & Dannielle E Branam & David F Wharton & Mary A Tullier & David M Thompson & Kenneth C Copeland, 2018. "Using financial incentives to promote physical activity in American Indian adolescents: A randomized controlled trial," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-20, June.
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