Want to motivate healthy lifestyle choices? Show me the money!

The Root of All Health

I have seen the future of health care, and it was right under our noses all along.

If all your attempts at dieting haven’t worked, or if you’ve tried in vain to make exercise a part of your daily routine, or if nothing in the world has been able to part you from your cigarettes, there’s one thing left that just might work: cold cash.

Show me the money

Handing out money to encourage healthy habits might seem farfetched, but the results of two recent studies say otherwise. And these studies didn’t appear in The Journal of Desperate Last Ditch Health Schemes – they were published in the Journal of the American Medical Association and the New England Journal of Medicine, no less.

Seriously. This is not an early April fool.

Both studies were conducted by a diverse team of researchers led by Kevin Volpp, M.D., of the Center for Health Equity Research and Promotion in Philadelphia.

In the NEJM study, nearly 900 General Electric employees – all dedicated smokers – were divided into two groups: One group received information about smoking-cessation programs, while the other group received the same information…plus bucks: $100 for completion of a smoking-cessation class, $250 for six months smoke-free, and $400 for an additional six months without a cigarette. (A biochemical test was used to determine genuine abstinence.)

Results: In the information-only group, five percent of the subjects quit smoking for at least one year. In the information-plus-money group, nearly 15 percent quit smoking.

Keep on giving

In the second study, which appeared in a December 2008 issue of Journal of the American Medical Association, Dr. Volpp’s team applied cash to the obesity problem.

Nearly 60 obese subjects were divided into three groups: One group simply participated in monthly weigh-ins, while subjects in the other two groups were eligible to earn cash based on their performance. I don’t have to tell you where this is going: Subjects in the two incentive groups lost significantly more weight than subjects in the weigh-in group.

The follow-up here is predictable: After the 16-week intervention period, incentive group subjects regained at least some of their weight. The authors write: “The longer-term use of incentives should be evaluated.”

Absolutely! Take away the incentives and all you have is another backsliding diet. But gradually increase incentives, and you just might have a diet/exercise/smoking-cessation plan that works. And I speak from first-hand experience.

In the e-Alert “Warm in the Tropics” (1/26/04) I told you about a long-term incentive plan that helped me quit smoking. And I can tell you that when you’re doing something that difficult “for your own good,” a well-placed incentive, followed by another and another makes a very big difference.

This coming March 14, Saturday, at about 10:00 AM, I’ll be smoke-free for 16 years.

Hey, but who’s counting?

Sources:
“A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation” The New England Journal of Medicine, Vol. 360, No. 7, 2/12/09, content.nejm.org
“Financial Incentive-Based Approaches for Weight Loss” Journal of the American Medical Association, Vol. 300, No. 22, 12/10/09, jama.ama-assn.org