Effectiveness of Goal-Directed and Outcome-Based Financial Incentives for Weight Loss in Primary Care Patients With Obesity Living in Socioeconomically Disadvantaged Neighborhoods: A Randomized Clinical Trial
An erratum to this article was published (JAMA Intern Med, 1 Apr 2023 ↗)
Authors' conclusion
In this randomized clinical trial, outcome-based and goal-directed financial incentives were similarly effective, and both strategies were more effective than providing resources only for clinically significant weight loss in low-income populations with obesity. Future studies should evaluate cost-effectiveness and long-term outcomes.
Study context
- Population
- Adults with obesity living in low-income neighborhoods, 3 hospital-based clinics in New York City and Los Angeles; mean age 47.7 years, 81.0% women, 72.6% Hispanic, 14.8% Black; mean BMI 37.951,280 invited
- Participants
- 668 adults
- Comparison
- Goal-directed or outcome-based financial incentives plus resources vs resources only
- Primary endpoint
- Proportion of patients achieving ≥5% weight loss
- Follow-up
- 6 months
Methodological detailsthree-group, multicentre, Conducted November 2017 to May 2021
- Three-group
- Multicentre
- Conducted November 2017 to May 2021
Primary result
As reported in the abstract
≥5% weight loss (adjusted proportion)
Difference, percentage points (95% CI)
Outcome-basedvs Goal-directed
10.08(1.31–18.85)
Outcome-basedvs Resources-only
27.03(18.20–35.86)
Goal-directedvs Resources-only
16.95(8.18–25.72)
Further findings
| Outcome | Goal-directed | Outcome-based |
|---|---|---|
| Mean earned incentives | mean 440.44 $ | mean 303.56 $ |
Mean percentage of weight loss
- Mean percentage of weight loss was similar in the incentive arms
Mean earned incentives
- Incentives did not improve financial well-being
Original publication
Effectiveness of Goal-Directed and Outcome-Based Financial Incentives for Weight Loss in Primary Care Patients With Obesity Living in Socioeconomically Disadvantaged Neighborhoods: A Randomized Clinical Trial. JAMA Intern Med. Published 1 January 2023. doi:10.
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