Financial Motivation Undermines Maintenance in an Intensive Diet and Activity Intervention

Abstract EN

Financial incentives are widely used in health behavior interventions.

However, self-determination theory posits that emphasizing financial incentives can have negative consequences if experienced as controlling.

Feeling controlled into performing a behavior tends to reduce enjoyment and undermine maintenance after financial contingencies are removed (the undermining effect).

We assessed participants’ context-specific financial motivation to participate in the Make Better Choices trial—a trial testing four different strategies for improving four health risk behaviors: low fruit and vegetable intake, high saturated fat intake, low physical activity, and high sedentary screen time.

The primary outcome was overall healthy lifestyle change; weight loss was a secondary outcome.

Financial incentives were contingent upon meeting behavior goals for 3 weeks and became contingent upon merely providing data during the 4.5-month maintenance period.

Financial motivation for participation was assessed at baseline using a 7-item scale (α=.97).

Across conditions, a main effect of financial motivation predicted a steeper rate of weight regained during the maintenance period, t(165)=2.15, P=.04.

Furthermore, financial motivation and gender interacted significantly in predicting maintenance of healthy diet and activity changes, t(160)=2.42, P=.016, such that financial motivation had a more deleterious influence among men.

Implications for practice and future research on incentivized lifestyle and weight interventions are discussed.