Effects of Loss and Gain Incentives on Adherence in Pediatric Weight Management: Preliminary Studies and Economic Evaluation of a Theoretical Trial

Robert Siegel (), Meghan E. McGrady, Linda Dynan, Roohi Kharofa, Kristin Stackpole, Paula Casson, Francesca Siegel and Nadine A. Kasparian
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Robert Siegel: The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
Meghan E. McGrady: Department of Pediatrics, College of Medine, University of Cincinnati, Cincinnati, OH 45267, USA
Linda Dynan: James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
Roohi Kharofa: The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
Kristin Stackpole: The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
Paula Casson: The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
Francesca Siegel: The University of Cincinnati Medical Center, Cincinnati, OH 45219, USA
Nadine A. Kasparian: The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA

IJERPH, 2022, vol. 20, issue 1, 1-14

Abstract: Pediatric weight management is often hampered by poor engagement and adherence. Incentives based on loss have been shown to be more effective than gain-based incentives in improving outcomes among children with health conditions other than obesity. In preparation for a clinical trial comparing loss-framed to gain-framed incentives, a survey of youth and caregiver attitudes on weight management incentives, reasons for program attendance, and an economic evaluation of a theoretical trial were conducted. Ninety of 835 (11%) surveys were completed by caregiver and child. The economic evaluation showed that loss-framed incentives had a preferable incremental cost-effectiveness ratio (a lower value is considered preferable) than gain-based incentives. Most youth and caregivers felt a gain incentive would be superior, agreed that the full incentive should go to the youth (vs. the caregiver), and identified “improving health” as a top reason for pursuing weight management.

Keywords: childhood obesity; loss incentive; gain incentive; cost-effectiveness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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