Physical ActivityTEH-CNCT04618757
Trial Evaluating Hedonic vs Cash Incentives
A study testing Hedonic Reward, Cash Reward and Fitbit in people with Physical Activity, run by Duke-NUS Graduate Medical School at 1 site in Singapore.
Trial summary
This study aims to determine, using a randomized trial with two parallel arms, whether hedonic rewards (Arm 1) can be more effective than their cash equivalent (Arm 2) in motivating participants to meet step goals. Read more about this study
- Who is it for?
- Ages 21 to 70 yearsHealthy volunteers can take part
- Conditions the study is for
- Physical Activity
- What is being tested?
- Hedonic Reward, Cash Reward and Fitbit
- Type of treatment
- Medical device, Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 310 participants
- Where
- 1 siteSingapore
- Study dates
- 18 Nov 2022to 31 Aug 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 70 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Aged between 21 to 70 years inclusive.
- Singapore resident (residing in Singapore during the study period [up to 5 months])
- English-speaking and English literate
- Smartphone-literate
Who cannot join
- Pregnant or lactating
- Unable to walk up 10 steps (individual steps, not floors) without stopping
- Currently on doctor's advice against engaging in moderate-to-vigorous physical activity (i.e., brisk walking or more intense).
- Currently have a condition(s) that restricts engaging in moderate-to-vigorous physical activity (i.e., brisk walking or more intense).
- Unwilling to be randomized into study arms
- Unwilling to use a Fitbit for the study period (up to 5 calendar months)
Show all 9Show fewer
- Unwilling to pay the $20 enrolment fee
- Does not complete the Consent Form
- Refuses to give consent to participate in the study
Trial locations and contacts
1 site in 1 country.
About this study
This study aims to determine, using a randomized trial with two parallel arms, whether hedonic rewards (Arm 1) can be more effective than their cash equivalent (Arm 2) in motivating participants to meet step goals.
Read the detailed description
The evidence is overwhelming that sustained physical activity reduces risks for non-communicable diseases, increases longevity, and reduces medical costs. Yet, the rates of physical activity have been steadily decreasing such that physical inactivity is now the fourth leading cause of death worldwide. In Singapore, 33% of adults are insufficiently active despite Singapore being a highly walkable city with numerous subsidized community-based physical activity programs. A review of the literature shows that, to date, no study has directly compared cash versus hedonic rewards for health behavior change despite theory suggesting hedonic rewards may work better. Furthermore, hedonic rewards can often be purchased at lower cost than their cash equivalent. This makes hedonic rewards potentially more cost-effective if they are proven to be at least as effective at increasing positive behavior change compared to giving the same value in cash.
Thus, we aim to determine, using a randomized trial with two parallel arms, whether hedonic rewards (Arm 1) can be more effective than their cash equivalent (Arm 2) in promoting increases in physical activity, assessed via step counts measured by a Fitbit physical activity tracker, during a 4-calendar month intervention. We hypothesize that the average proportion of months meeting the incentivized step target across participants will be greater for those in the hedonic incentive arm as compared to those in the cash incentive arm (primary outcome).
- Conditions
- Physical Activity
- Being tested
- Hedonic Reward, Cash Reward, Fitbit
- Medical subject headings
- Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Hedonic RewardBehavioural
A reimbursement credit for hedonic expenses worth up to $50 will be awarded to each participant if they log at least 10,000 daily steps on at least 25 days during the first 28 days of each calendar month on Fitbit activity trackers provided by the study.
Cash RewardBehavioural
A reimbursement credit for $50 in cash will be awarded to each participant if they log at least 10,000 daily steps on at least 25 days during the first 28 days of each calendar month on Fitbit activity trackers provided by the study.
FitbitDevice
Also called Fitbit, wireless pedometer, physical activity tracker
Fitbit devices are wireless pedometers that track the steps of participants, and will be offered in conjunction with a tailored website with customized information for participants.
| Study group | Role | What they receive |
|---|---|---|
| Hedonic Reward | Experimental | Participants' reward for meeting monthly step targets is in the form of reimbursements of up to $50 for expenses on hedonic activities of their choice Receives: Behavioral: Hedonic Reward; Device: Fitbit |
| Cash Reward | Experimental | Participants' reward for meeting monthly step targets is in the form of $50 cash disbursements Receives: Behavioral: Cash Reward; Device: Fitbit |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of months in meeting the step target
The mean proportion of months meeting the incentivized targets (i.e. at least 10,000 daily steps on at least 25 days during the first 28 days of each calendar month via step counts measured by Fitbit, during a 4 calendar month intervention) across participants.
Measured: Months 1-4
Secondary outcomes (4)
Difference in mean daily steps between the 2 intervention arms
Difference in mean daily steps between intervention arms for the first 28 days of each of 4 intervention months, controlling for baseline daily values. These will be measured via step counts measured by Fitbit.
Measured: Months 1-4
Difference in median daily steps between the 2 intervention arms
Difference in median daily steps between intervention arms for the first 28 days of each of 4 intervention months, controlling for baseline daily values. These will be measured via step counts measured by Fitbit.
Measured: Months 1-4
Difference in mean Fitbit fairly and very active minutes between the 2 intervention arms
Difference in mean Fitbit fairly and very active minutes between intervention arms for the first 28 days of each of 4 intervention months, controlling for baseline daily values. The Fitbit fairly and active minutes count towards Fitbit "active minutes", which are determined by Fitbit's proprietary algorithms and are defined as sustained activity of ≥10-minute bouts. These will be measured via step counts measured by Fitbit.
Measured: Months 1-4
Difference in median Fitbit fairly and very active minutes between the 2 intervention arms
Difference in median Fitbit fairly and very active minutes between intervention arms for the first 28 days of each of 4 intervention months, controlling for baseline daily values. The Fitbit fairly and active minutes count towards Fitbit "active minutes", which are determined by Fitbit's proprietary algorithms and are defined as sustained activity of ≥10-minute bouts. These will be measured via step counts measured by Fitbit
Measured: Months 1-4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Nov 2020
- Study start18 Nov 2022
- Primary completion31 Aug 2023
- Study completion31 Aug 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Physical ActivityStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 310 participants (actual)
Sponsor and investigators
- Lead sponsor
- Duke-NUS Graduate Medical School
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Eric A. Finkelstein, Duke-NUS Graduate Medical School
- Investigators
- Eric A Finkelstein, Ph.D, M.H.A, Principal investigator, Duke-NUS Graduate Medical School
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04618757
- Sponsor's protocol ID
- NIHA-2018-002 (Study 1)
- Acronym
- TEH-C
- Status last verified
- Sep 2023
- First submitted
- 2 Nov 2020
- Last updated
- 29 Sep 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Finkelstein EA, Chow MTN, Gandhi M. Are cash incentives always king? A randomized controlled trial evaluating hedonic versus cash incentives (TEH-C). Front Public Health. 2024 Apr 30;12:1354814. doi: 10.3389/fpubh.2024.1354814. eCollection 2024.
PubMed 38745998
Study at a glance
From the registry record, last updated by the sponsor on 29 Sep 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trial Evaluating Hedonic vs Cash Incentives
- ClinicalTrials.gov ID
- NCT04618757
- Acronym / sponsor ID
- TEH-C / NIHA-2018-002 (Study 1)
- Conditions
- Physical Activity
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 310 participants (actual)
- Lead sponsor
- Duke-NUS Graduate Medical SchoolUniversity, hospital or other
- Study start
- 18 Nov 2022 (actual)
- Primary completion
- 31 Aug 2023 (actual)
- Study completion
- 31 Aug 2023 (actual)
- First posted
- 6 Nov 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to determine, using a randomized trial with two parallel arms, whether hedonic rewards (Arm 1) can be more effective than their cash equivalent (Arm 2) in motivating participants to meet step goals.
Detailed description
The evidence is overwhelming that sustained physical activity reduces risks for non-communicable diseases, increases longevity, and reduces medical costs. Yet, the rates of physical activity have been steadily decreasing such that physical inactivity is now the fourth leading cause of death worldwide. In Singapore, 33% of adults are insufficiently active despite Singapore being a highly walkable city with numerous subsidized community-based physical activity programs. A review of the literature shows that, to date, no study has directly compared cash versus hedonic rewards for health behavior change despite theory suggesting hedonic rewards may work better. Furthermore, hedonic rewards can often be purchased at lower cost than their cash equivalent. This makes hedonic rewards potentially more cost-effective if they are proven to be at least as effective at increasing positive behavior change compared to giving the same value in cash.
Thus, we aim to determine, using a randomized trial with two parallel arms, whether hedonic rewards (Arm 1) can be more effective than their cash equivalent (Arm 2) in promoting increases in physical activity, assessed via step counts measured by a Fitbit physical activity tracker, during a 4-calendar month intervention. We hypothesize that the average proportion of months meeting the incentivized step target across participants will be greater for those in the hedonic incentive arm as compared to those in the cash incentive arm (primary outcome).
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Hedonic Reward | Experimental | Behavioral: Hedonic Reward, Device: FitbitParticipants' reward for meeting monthly step targets is in the form of reimbursements of up to $50 for expenses on hedonic activities of their choice |
| Cash Reward | Experimental | Behavioral: Cash Reward, Device: FitbitParticipants' reward for meeting monthly step targets is in the form of $50 cash disbursements |
Who may qualify
- Ages
- 21 to 70 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Aged between 21 to 70 years inclusive.
- Singapore resident (residing in Singapore during the study period [up to 5 months])
- English-speaking and English literate
- Smartphone-literate
Key exclusion criteria (9 listed)
- Pregnant or lactating
- Unable to walk up 10 steps (individual steps, not floors) without stopping
- Currently on doctor's advice against engaging in moderate-to-vigorous physical activity (i.e., brisk walking or more intense).
- Currently have a condition(s) that restricts engaging in moderate-to-vigorous physical activity (i.e., brisk walking or more intense).
- Unwilling to be randomized into study arms
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Hedonic RewardA reimbursement credit for hedonic expenses worth up to $50 will be awarded to each participant if they log at least 10,000 daily steps on at least 25 days during the first 28 days of each calendar month on Fitbit activity trackers provided by the study. | Behavioural | Hedonic Reward |
| Cash RewardA reimbursement credit for $50 in cash will be awarded to each participant if they log at least 10,000 daily steps on at least 25 days during the first 28 days of each calendar month on Fitbit activity trackers provided by the study. | Behavioural | Cash Reward |
| FitbitAlso: Fitbit, wireless pedometer, physical activity trackerFitbit devices are wireless pedometers that track the steps of participants, and will be offered in conjunction with a tailored website with customized information for participants. | Device | Cash Reward, Hedonic Reward |
Primary outcome
Proportion of months in meeting the step target
Time frame: Months 1-4
The mean proportion of months meeting the incentivized targets (i.e. at least 10,000 daily steps on at least 25 days during the first 28 days of each calendar month via step counts measured by Fitbit, during a 4 calendar month intervention) across participants.
4 secondary outcomes
Difference in mean daily steps between the 2 intervention arms
Time frame: Months 1-4
Difference in median daily steps between the 2 intervention arms
Time frame: Months 1-4
Difference in mean Fitbit fairly and very active minutes between the 2 intervention arms
Time frame: Months 1-4
Difference in median Fitbit fairly and very active minutes between the 2 intervention arms
Time frame: Months 1-4
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Sep 2023.
- Derived from this study: PubMed 38745998Finkelstein EA, Chow MTN, Gandhi M. Are cash incentives always king? A randomized controlled trial evaluating hedonic versus cash incentives (TEH-C). Front Public Health. 2024 Apr 30;12:1354814. doi: 10.3389/fpubh.2024.1354814. eCollection 2024.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Eric A Finkelstein, Ph.D, M.H.A principal investigator
Duke-NUS Graduate Medical School
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Hedonic Reward, Cash Reward and Fitbit in people with Physical Activity, run by Duke-NUS Graduate Medical School at 1 site in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion of months in meeting the step target (time frame: Months 1-4). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04618757, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Sep 2023.