Healthy Weigh Study Results

What strategy works better for weight loss in overweight employees?

  • Financial incentives
  • Environment change strategies
  • A combination of the two,
  • On-your-own weight-loss efforts

 

Drs. Karen Glanz and Kevin Volpp, along with the team at the UPenn PRC, found that participants in all groups lost weight. Incidentally, the financial incentives group lost slightly more weight, but none of the strategies netted significantly greater weight losses than the others. The results from their Healthy Weigh Study are currently published in the September 2021 edition of JAMA Network Open.

 

In 2015, the University of Pennsylvania Prevention Research Center (UPenn PRC) conducted a study to test strategies to achieve weight loss and maintain weight loss in urban worksites in Philadelphia.

First, researchers collected data on participants who earned daily financial rewards, in addition to those guided on positive changes to their environment.

Second, they compared each strategy, separately and together, to see which one helped the participants achieve weight-loss.

Third, the team compared that data to those who tried to lose weight on their own.

Ultimately, the goal of the study was to manage obesity by improving nutrition and physical activity, in order to reduce the risk of cardiovascular disease and other chronic health conditions.

 

 

 

 

JAMA Healthy Weigh_visual

Publication

Glanz K, Shaw P, Kwong P, Choi J, Chung A, Zhu J, Huang Q, Hoffer K, Volpp K. Effect of Financial Incentives and Environmental Strategies on Weight Loss in The Healthy Weigh Study: A Randomized Clinical Trial. JAMA Network Open 2021;4(9): e2124132. doi:10.1001/jamanetworkopen.2021.24132

Linking a Child’s Environment to Obesity

The Issue

There is a global childhood obesity epidemic and researchers in the United States are working toward solutions, including prevention. Compared to adults, there has been relatively little research linking a child’s environment to their weight. This report was published in The Obesity Journal on August 23,2018. It is a continuation of findings from the Neighborhood Impact on Kids (NIK) study, and focuses on both physical activity and nutrition environments. Two factors that can affect a child’s weight, in addition to behavioral factors, like daily energy intake and sedentary behavior.

The Study

A team of researchers gathered data twice over a two year span, in four types of different metropolitan neighborhoods in two large cities. They looked at several factors, like the age of the parents and the proximity of a quality park, then compared these data for each child to the child’s BMI. A favorable neighborhood in the study had a supermarket nearby with good nutrition and a quality park within walking distance of the child’s home. Less favorable neighborhoods had fast food easily accessible, no supermarkets nearby and nowhere for the children to play within a 1/2 mile. The findings looked at whether the neighborhood characteristics predicted the children outcomes going forward over the two years of the study.

As a result, the study showed that children living in less favorable neighborhoods were 41% to 49% more likely to be overweight, and that these effects were found across two years. City planners and developers can use this evidence when designing neighborhoods that support healthy families.

The Importance of Environments

Karen Glanz, PhD, MPH, a co-author on the study, noted “This study is unique and important in that it allowed us to make clear comparisons between ‘healthier’ and ‘less healthy’ food and activity environments over multiple years. The findings underscore how important environments can be in shaping behaviors and the health of children.”

Neighborhoods Impact on Kids (NIK) is an observational study, evaluating cross-sectional and longitudinal associations of neighborhood-level activity and nutrition environments with children’s weight status and obesity. The study is led by Dr. Brian Saelens, currently at Seattle Children’s Hospital.

How Does GPS-Based Exposure to Greenness & Walkability Impact Physical Activity?

A new study in Cancer Epidemiology, Biomarkers, and Prevention by PRC Director Karen Glanz, PhD, MPH, and co-authors supports evidence that individuals may obtain higher levels of physical activity in more walkable environments. Their findings “also suggest that the built environment may be a more important factor than the natural environment when considering routine location-based physical activity. As the popularity of GPS- and accelerometer-enabled smartphones grows alongside accelerometry-based consumer wearable devices (55–58), these novel streams of spatial energetics data will provide translational insights into potential interventions to improve urban planning and green space development to optimize opportunities for physical activity and reduce cancer risk.”

UPenn PRC Impact Symposium – Accelerating Policies & Research on Food Access, Diet, and Obesity Prevention

On Friday, April 28th, the UPenn PRC hosted ” Accelerating Policies & Research on Food Access, Diet, and Obesity Prevention”, a day-long symposium which brought together prevention health researchers and public health advocates to discuss today’s food environment and focus on future directions for this important health topic. Special thanks to the Planning Committee and the UPenn PRC Training Core faculty and staff for their leadership and support in making this event possible.
 
 
 

 

PRC Directors Karen Glanz, PhD, MPH, and Kevin Volpp, MD, MPH, with morning Keynote Speaker Margo Wooten ScD, Center for Science in the Public Interest, who spoke on: Supporting Healthy Eating Through Nutrition Policy
 
 

 

Coming in April!!! PRC Symposium: Accelerating Policies & Research on Food Access, Diet, and Obesity Prevention

 

On Friday, April 28th, the University of Pennsylvania Prevention Research Center is hosting a symposium: “Accelerating Policies & Research on Food Access, Diet, and Obesity Prevention.” This one-day interdisciplinary event highlights the most current research on food access, diet, and obesity.  Distinguished scholars and leaders in the fields of public health and nutrition will focus on bridging the gap between research and practice. For more information and to register, go to:  https://upennprcsymposium.splashthat.com/

 

 

Framing Financial Incentives For the Overweight & Obese – PRC Director Kevin Volpp, MD, PhD

A study by PRC Director Kevin Volpp, MD, PhD, and other health behavior researchers at the University of Pennsylvania shows that financial incentives for increasing physical activity are highly effective among the population of overweight and obese.

“Most workplace wellness programs typically offer the reward after the goal is achieved,” said senior author Kevin G. Volpp, MD, PhD. “Our findings demonstrate that the potential of losing a reward is a more powerful motivator and adds important knowledge to our understanding of how to use financial incentives to encourage employee participation in wellness programs.”

The study was reported on in the Knowridge Science Report and was published in the Annals of Internal Medicine.

 

 

Does Competition Positively Impact Physical Activity? : PRC Researchers Kevin Volpp and David Asch

PRC Director Kevin Volpp, MD, PhD, and PRC Researcher David Asch, MD, MBA, compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity in a study in the July/August issue of the American Journal of Health Promotion.

In one of the first randomized trials to test different combinations of social comparison feedback and financial incentives, the researchers found that social comparison to the median with financial incentives was more effective than social comparison to the top quartile without incentives.  In the social comparison condition, participants, grouped by team,  were provided with feedback on their performance and the performance of other teams.  “By focusing social comparison feedback on performance relative to other teams,” the researchers suggest, “we leverage individuals’ competitive drive to motivate behavior change.” These findings may help to guide larger evaluations of interventions to increase physical activity using social comparison feedback and financial incentives.

 

Read more about this study at LiveScience.

Philly’s New Soda Tax: PRC Director Karen Glanz Evaluates the Implications on Knowledge@Wharton

 

As a guest on Knowledge@Wharton radio, UPenn PRC Director Karen Glanz evaluated the health and financial implications of the Philadelphia’s new “soda tax” passed by City Council on June 16, 2016.

According to Glanz, while a difference in consumption could be seen within a year or two of implementation, the tax’s impact on disease risk factors may not be evident for another three to five years.

New Food Labeling Guidelines: Karen Glanz Unpacks the Facts on Knowledge@Wharton

 

UPenn PRC Director, Karen Glanz, PhD, and Wharton marketing professor, Jason Riis discussed the new Federal food labeling guidelines on the June 13, 2016 edition of Knowledge@Wharton.

Observing that past labeling revisions often were driven by a single concern, such as trans fats or sugar, Glanz sees the shift towards a more comprehensive approach to portion sizes and total calorie intake as beneficial . “If these labels can nudge things in that direction and/or nudge the industry to reformulate the foods that will be less high-calorie, then that could move things without necessarily depending on people’s conscious decision-making,” she said.

“That all hinges on whether people actually read it and understand it, and whether it is easy to see and digest,” Glanz said. Displaying the nutrition information on the front of packs ensures that “consumers don’t have to turn the pack around to see that, or bring out their reading glasses,”

 

USDA Announces $3.8 Million in Grants and Additional $7 Million Available for Critical Research to Prevent Childhood Obesity

The USDA National Institute of Food and Agriculture (NIFA) is seeking research grant funding applications for projects that focus on the “… societal challenge to end obesity among children, the number one nutrition-related problem in the US.”  Read more here.

“Decades of research supports the fact that children who are hungry don’t do well in the classroom and suffer from related health issues like obesity, diabetes and other serious chronic diseases. USDA has invested and will continue to invest in our children so that all of them, no matter where they are born or what their parents’ income levels are, have a shot at a healthy and productive future,” said Secretary Vilsack. “Since implementation of the Healthy, Hunger-Free Kids Act, kids are now eating 16 percent more vegetables and 23 percent more fruit at lunch, more low-income children are benefiting from breakfast and lunch programs, and nearly four million children have access to healthy food in the summer when school is out and meals are scarce. Data show some signs of progress on childhood obesity, particularly among our youngest children, and the projects these researchers are undertaking will ensure we have evidence-based tools to continue moving the dial.”

Team-based Goals Enhance Incentives to Increase Physical Activity

 

 

In the March 15, 2016 issue of Journal of General Internal Medicine,  UPenn PRC Director Kevin Volpp, MD, PhD, UPenn PRC researcher David Asch, MD, MBA, and co-authors reported on a study to compare the effectiveness of individual versus team-based financial incentives to increase physical activity.

304 employees from a Philadelphia-based organization formed 76 four-member teams. Participants received daily feedback on a daily 7,000 step goal during intervention and follow-up periods. A participant on a winning team was eligible for a $50 award if he/she met the goal (individual incentive), a $50 award only if all four team members met the goal (team incentive), or a $20 award if he/she met the goal individually and $10 more for each of three teammates that also met the goal (combined incentive.)  The control group received no other incentive. For the three financial incentive groups, every-other-day drawings were held during the intervention period.

Participants in the combined incentive group achieved their goal 35 percent of the time, nearly double the success rate for the control and team incentive groups (18 and 17 percent, respectively), and still higher than the average success rate for participants rewarded based on individual performance (25 percent). Compared to the control group, participants receiving the combined incentive had 1,446 more steps per day.

“The findings of our study shed light on how financial incentive programs can be used to change people’s behavior towards better health, and how physical activity interventions and wellness programs can be better designed,” said senior author Kevin G. Volpp, MD, PhD, a professor of Medicine and Health Care Management, and director of the Penn Center for Health Incentives and Behavioral Economics. “People are accountable to themselves but also to others and, in this vein, it may not be surprising that the incentive that provided rewards based on individual and was most effective.”

 

Read more here:

http://link.springer.com/article/10.1007/s11606-016-3627-0

Do Financial Incentives for Increasing Physical Activity Work?

In the February 16, 2016 issue of Annals of Internal Medicine,  UPenn PRC Director Kevin Volpp, MD, PhD, UPenn PRC researcher David Asch, MD, MBA, and co-authors reported on a study to test the effectiveness of offering financial incentives to increase physical activity among overweight and obese adults.

Participants were divided among three groups. Researchers found the most powerful incentive was the possibility of losing money that would be taken away if a 7,000-step daily goal was not met.  This finding suggest a new approach which may be helpful to the most sedentary overweight and obese.

Read more here:

http://annals.org/article.aspx?articleid=2491916

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