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BehaviorNCT04747327

Incentives & Motivation for Behavior Change:

A study testing mandate public, employer mandate and incentive reward in people with Behavior and Intention, run by University of Pennsylvania at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

In a series of controlled, randomized experiments, we will systematically manipulate exposure to health-related messages and/or survey methods to examine the effects on behavioral intention. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Behavior, Intention
What is being tested?
mandate public, employer mandate and incentive reward
Could I receive a placebo?
No, everyone receives an active treatment
How many people
4,000 participants
Where
1 siteUnited States
Study dates
7 Feb 2021to 30 Dec 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 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Adults (18 years or older)
  • residing in the US
  • unvaccinated for COVID-19

Who cannot join

  • children
  • those living outside the US
  • vaccination

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Center for Mental Health. Perelman School of Medicine

    Philadelphia, Pennsylvania, 19104

Other trials in United States

About this study

Official title: Incentives & Motivation for Behavior Change: Survey-embedded Experiments

In a series of controlled, randomized experiments, we will systematically manipulate exposure to health-related messages and/or survey methods to examine the effects on behavioral intention.

There are various strategies used to influence health-related decision making and the effects of health behavior have had mixed results. In particular, incentive-based interventions have often failed to increase healthy behavior. We will examine 1) the role of behavioral motivation to increase sleep or exercise and 2) current levels of sleep or exercise when predicting who is interested in a mock RCT invitation to increase each behavior using financial or social incentives.

In addition to the above focus on sleep and exercise, we will also examine another important health behavior: vaccination. Embedded within experiments studying effects of incentives on vaccination decisions, will conduct methodological tests. In particular, we will estimate the effects of using different methods of measuring the study outcome (vaccine intention).

Read the detailed description

Incentives for Sleep and Exercise:

This experiment will estimate enrollment bias for randomized clinical trials offering to incentivize behavior change. In this experiment, we will test whether those who are most motivated to change behavior are also most likely to enroll in a (hypothetical) RCT when offering financial or social incentives for behavior change.

We hypothesize that those most likely to enroll are already motivated to change their behavior prior to enrollment, which could be bias trials towards the null. We will test this hypothesis by estimating if motivation to change a behavior predicts interest in joining RCT targeting that behavior. We will also test if baseline behavior predicts interest in joining these RCT.

We will conduct this experiment using mock invitations to learn about and potentially join a RCT. The study outcome will be responses to this invitation. We will not offer invitations to an actual trial, but the stimuli (mock invitations to a "ghost" trial) and task (response to the invitation) fundamentally resemble a trial's counterparts. The invitations will specify an opportunity to earn financial or social incentives for improving a healthy behavior.

We will invite participants to earn financial or non-financial incentives for increasing their sleep or exercise. In this study, the primary outcome will measure if they were "not interested," "slightly interested," or "very interested" in participating.

Prior to receiving their invitation, they will complete an online questionnaire measuring their motivation to increase each behavior, plus their recent behavior and socio-demographics.

Separate analyses will be conducted for financial and social incentives and for sleep vs exercise trial invitations. We will report point estimates and 95% confidence intervals (CI) for behavior and motivation.

The analyses will examine if their interest in joining the RCT is predicted by 1) their baseline behavior (i.e., amount of sleep or exercise), or 2) their motivation to change the specific behavior. As noted above, we hypothesize the their level of motivation to change a specific behavior will predict interest in a trial targeting that behavior.

Testing Relative Large and Small Vaccination Incentives:

Using a separate sample, this experiment will test whether policies offering large or small financial incentives are likely to strengthen COVID-19 vaccine intention. This experiment will randomize individuals to one of four study arms that include 1) a control condition, 2) an educational message, 3) a message about the relatively large financial incentive, or 4) a message about the relatively small financial incentive. The goal of this study is to estimate if either type of incentive policy is likely to have negative effects on vaccine intention, as some experts have warned.

When analyzing the effects of relatively large and small financial incentives on vaccination intentions, we will report point estimates and 95% CIs for the overall sample and demographic sub-groups. We will also report summary statistics for all the overall sample and sub-populations. We will test whether, compared to a control condition, either of the financial incentives increase, decrease, or have no effect on the percentage who want to vaccinate. In a fourth study arm, subjects will receive an educational message that will also be compared to the control condition.

Testing Vaccine Incentives Plus Different Measures of Vaccine Intention:

In a related experiment, we will separately test the effects of 10 experimental conditions, with a counter-balanced experimental manipulation using an FDA approval message, plus a control condition. The goal of this study is to compare the effects of a wider variety of vaccine interventions that experts have proposed, including incentives and mandates.

In addition, we will also randomize individuals to questionnaires using different methods of measuring vaccine intention, the study outcome.

Comparing different methods of estimating vaccine intention: Embedded within the experiment testing different proposed vaccine policies, we will test if methodological differences in the response option for the primary outcome effect the percent reporting "yes". To do this, we will test 2 (Yes and No) vs 3 (Yes, No and Unsure) level response options and randomly order both sets.

This methodological experiment will examine whether the proportion responding "yes" to the same question (about whether they want to vaccinate soon) varies depending on the order of response options and whether they include a maybe/unsure option. We will run cross tabs and chi-square tests for the 2 vs 3 response levels and the order. The instrumentation tests will be conducted for COVID-19 vaccination boosters, the initial shots, plus vaccination against influenza.

When testing the effects of potential vaccine policies, the control group, with no vaccine policy presented will be compared to: cash incentives for $1000, $200, or $100; a $1,000 tax credit; lotteries for $100,000, $200,000, or $1 million; $1,000 tax on the unvaccinated; and mandates by employers or airlines, bars, and restaurants. The main outcome is whether they would want to get vaccinated soon given the hypothetical vaccine policy.

(Those assigned to the employer mandate condition will be excluded from analyses if they report being unlikely to have an employer.)

OLS specification will be our main result and the other measures are provided as robustness checks.

The OLS model can exclude all the demographic controls and run the binary dependent variable on the treatment variables. (Note that this approach is legitimate because the treatments are being randomized across respondents.) The treatments include the financial policies (incentives and penalties of different amounts and types) and mandates (of different types) being noted in a message.

Type of model: We will perform pairwise t tests of percent of respondents answering "Yes" comparing those treated with an incentive to the control group. We will perform these pairwise tests on subsets by race, gender, income, education, and other socio-demographics.

Additionally, we will conduct these pairwise tests on by type of treatment. Comparing lottery to cash incentive, comparing positive incentive vs. penalty, comparing size of incentive, and comparing employer mandates against the control.

We will also conduct regression analyses on the pooled dataset where the left-hand side observations are individual responses where those answering "Yes" will be coded as 1 and those answering, "No" or "Unsure" will be coded zero. We will include a set of controls (race, gender, income, education, etc) as well as an indicator variable reflecting whether the respondent received a treatment. Regression models will include ordinary least squares, probit, nearest neighbor matching, and propensity score matching. We will also run these regressions where the treatment variable is split up into several indicator variables reflecting the type of treatment provided as well as an indicator for FDA approval.

We will estimate a model-alternatively using ordinary least squares and logistic regression-with a binary-outcome dependent variable (equal to one if the respondent wanted to be vaccinated, and otherwise equal to zero). For explanatory variables, we include dummy variables for each of the ten treatment arms.

Criteria for statistical significance: We will use .05 as our threshold for statistical significance.

Sample size calculation for the survey experiment comparing 10 different vaccine policies: We estimate that if the final sample sizes for each condition include at least 300 subjects, we can detect about 5% or larger difference. We plan to double the allocation for the control and $1000 conditions to allow for planned comparisons.

All experiments: Each subject will be randomized to a condition. Participants will be randomized to reduce the chance that observed effects are due to unmeasured factors. In addition, all study procedures were automated, which improves the control over how the experiment is conducted, allowing all procedures to be consistently standardized.

The studies will enroll national, theory-based samples recruited through MTurk and/or Prolific platforms. To reduce enrollment bias, recruitment and enrollment materials will describe the research in vague terms (e.g., "we are interested in learning your opinions and preferences related to health). Each experiment will also measure socio-demographic variables for descriptive purposes.

Recommended data cleaning procedures for each experiment: Attention checks can identify those who should be excluded from the main analyses. (Regardless of performance on the attention check, all participants will be compensated for their time.) Analyses will exclude those with duplicate IDs or a high fraud score, We will conduct analyses that include and exclude those who finished the fastest (fastest 5%).

Replication studies will include the same study design and procedures.

Conditions
Behavior, Intention
Being tested
mandate public, employer mandate, incentive reward, penalty, incentive lottery small
Keywords
decision, RCT enrollment, incentives, mandates, message effects, intention, methods, instrumentation effects, vaccine hesitancy, sleep, exercise physical activity behaviors
Medical subject headings
Behavior, Vaccination Hesitancy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • mandate publicBehavioural

    mandate by airlines, bars, restaurants

  • employer mandateBehavioural

    your employer requires vaccination

  • incentive rewardBehavioural

    $1,000 tax credit

  • penaltyBehavioural

    $1000 tax penalty

  • incentive lottery smallBehavioural

    100,000 smaller monetary amount

  • incentive lottery mediumBehavioural

    200,000 mid monetary amount

  • incentive lottery largeBehavioural

    1 million dollar lottery

  • cash smallBehavioural

    smaller guaranteed cash amount

  • cash mediumBehavioural

    mid sized quarenteed cash amount

  • cash largeBehavioural

    large quarenteed cash amount

  • invitation for exercise financial incentive studyBehavioural

    financial incentives earned when increasing exercise behaviors

  • invitation for exercise social incentive studyBehavioural

    social incentives earned when increasing exercise behaviors

  • invitation for sleep social incentive studyBehavioural

    social incentives earned when increasing sleep

  • invitation for sleep financial incentiveBehavioural

    Financial incentives earned when increasing sleep

Study groups in NCT04747327
Study groupRoleWhat they receive
specific vaccine policy 1ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: mandate public
specific vaccine policy 2ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: employer mandate
specific vaccine policy 3ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: incentive reward
Specific vaccine policy 4ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: cash large
specific vaccine policy 5ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: penalty
specific vaccine policy 6ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: incentive lottery small
specific vaccine policy 7ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: incentive lottery medium
specific vaccine policy 8ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: incentive lottery large
specific vaccine policy 9ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: cash small
specific vaccine policy 10ExperimentalThose in this arm will learn about a specific financial incentive or mandate policy.
Receives: Behavioral: cash medium
sleep financial incentiveExperimentalThose in this arm will invite adults to join an RCT that uses financial incentives to reward those who increase their sleep.
Receives: Behavioral: invitation for sleep financial incentive
sleep social incentiveExperimentalThose in this arm will invite adults to join an RCT that uses social (gamification) incentives to reward those who increase their sleep.
Receives: Behavioral: invitation for sleep social incentive study
exercise financial incentiveExperimentalThose in this arm will invite adults to join an RCT that uses financial incentives to reward those who increase their exercise.
Receives: Behavioral: invitation for exercise financial incentive study
exercise social incentiveExperimentalThose in this arm will invite adults to join an RCT that uses social incentives to reward those who increase their exercise.
Receives: Behavioral: invitation for exercise social incentive study

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. measure of whether they are interested in RCT enrollment (for sleep or exercise)

    subjects will select a response option to indicate if they are "not interested," "slightly interested," or "very interested"

    Measured: through the duration of the experiment: less than 1 day

  2. measure of decision (vaccine intention)

    subjects select a response option from a 2 ("yes" or "no") or 3 (yes, no, unsure) level response set

    Measured: through the duration of the experiment: less than 1 day

Secondary outcomes (1)
  1. likelihood of behavior

    measures their perceived likelihood of performing the behavior

    Measured: through the duration of the experiment: less than 1 day

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Feb 2021
  2. Study start7 Feb 2021
  3. Primary completion30 Dec 2023
  4. Study completion30 Dec 2023

Resources

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
participants will be randomized to receive a message related to a behavior and a behavior change intervention (e.g., type of incentive).
Masking
Single blind
Who is masked
Participant
Enrolment
4,000 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04747327
Sponsor's protocol ID
834772
Status last verified
Feb 2024
First submitted
2 Feb 2021
Last updated
15 Feb 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: no plans to share IPD at this time

Questions about this trial

What is this clinical trial studying?

A study testing mandate public, employer mandate and incentive reward in people with Behavior and Intention, run by University of Pennsylvania at 1 site in United States.

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 3 inclusion and 3 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 15 Feb 2024. 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 United States. 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?

measure of whether they are interested in RCT enrollment (for sleep or exercise) (time frame: through the duration of the experiment: less than 1 day). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 15 Feb 2024.

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