Evaluating the Feasibility, Acceptability, and Effects of Deposit Contracts With and Without Daily Feedback to Promote Physical Activity

Abstract

Background: Despite interest in financial incentive programs, evidence regarding the feasibility, acceptability, and effectiveness of deposit contracts (ie, use of participants’ own money as a financial reward) for increasing physical activity (PA) is limited. Furthermore, evidence regarding the use of feedback within incentive programs is limited. Purpose: To evaluate: (1) the feasibility and acceptability of deposit contracts for increasing objectively measured PA and (2) the effects of deposit contracts with or without ongoing feedback on PA. Methods: Participants (n = 24) were exposed to 3 conditions (1) self-monitoring, (2) incentive, and (3) incentive with feedback in an ABACABAC design, with the order of incentive conditions counterbalanced across participants. Results: Effect sizes suggest that individuals had a modest increase in PA during the incentive conditions compared with self-monitoring. Presentation order moderated results, such that individuals exposed to incentives with feedback first performed more poorly across both incentive conditions. In addition, individuals often cited the deposit contract as a reason for not enrolling, and those who did participate reported inadequate acceptability of the incentives and feedback. Conclusions: Results suggest that while deposit contracts may engender modest increases in PA, this type of incentive may not be feasible or acceptable for promoting PA.

Technology‐based versus in‐person deposit contract treatments for promoting physical activity

“…The results of this study provided additional evidence that deposit contracts can effectively promote short‐term improvements in physical activity (Donlin Washington et al, 2016; Kerrigan et al, 2019). Relative to initial baseline step counts, individuals increased their physical activity by an average of 2,384 steps per day across treatment weeks in which they participated, and 83% of all step count goals were met.…”

“…The mobile and in‐person deposit contracts that were evaluated included identical treatment components (i.e., goal‐setting, deposits, monitoring, feedback, and deposit returns) and differed only in the modality by which the components were delivered. This was also one of only a few studies to evaluate the effectiveness and acceptability of deposit contracts (involving participants' own money) for increasing physical activity (Donlin Washington et al, 2016; Kerrigan et al, 2019). Participants received goals to increase their activity by an average of 2,000 steps per day, and they were asked to make small deposits of $10 each week over four total treatment weeks.…”

“…Step count goals were held constant at 2,000 above baseline to compare and replicate the comparison between the mobile and in‐person deposit contracts, as well as to provide a safe and effective goal over our 5‐day experimental conditions. Other physical activity CM studies have typically included gradually increasing step count goals (e.g., Donlin Washington et al, 2014; Donlin Washington et al, 2016; Kurti & Dallery, 2013) or an immediate goal of at least 10,000 daily steps (Budworth et al, 2019; Burns & Rothman, 2018; Kerrigan et al, 2019). Requiring more steps in the present study may have produced more visually detectable changes in step counts relative to baseline conditions.…”

“…However, technology‐based procedures have not been experimentally isolated in the context of deposit contracts, and it is unclear whether technology‐based procedures, per se, have been responsible for favorable rates of participation recently observed. Authors of a recent technology‐based physical activity deposit contract study (Kerrigan et al, 2019) observed low participation rates and mixed posttreatment acceptability ratings. Although participants primarily cited the specific feedback procedures used in the study as the most negative aspect, some also cited the deposit requirement.…”

“…For example, participants in Donlin Washington et al (2016) had to attend two to three in‐person meetings each week, so researchers could charge the Fitbits and upload data. The studies by Dallery et al (2008), Donlin Washington et al, and Kerrigan et al (2019) also included in‐person deposits and refunds. Aside from acceptability considerations, it is unclear whether technology‐based deposit contracts would be equally as effective without the inclusion of in‐person procedures.…”