Less carrot more stick: promoting health behavior change with deposit contracts

Two types of financial incentives can help improve healthy lifestyles: carrots (a reward where one can gain something) and sticks (a deposit contract where one can lose something). In a deposit contract, participants deposit own money and can lose or earn it back depending on lifestyle changes. We studied the potential of deposit contracts to stimulate a healthy lifestyle.A smartphone app was developed together with the Swiss university ETH Zurich to conduct experimental research into the effects of deposit contracts. In addition, we collaborated with the American company WayBetter to observe the effects of commercially available deposit contracts. Finally, the opinion of people with cardiovascular disease and healthcare professionals regarding financial incentives and deposit contracts for lifestyle change was investigated.The results show that deposit contracts can have strong effects on exercise behavior (daily step counts) in the short term. The results also show that voluntary participation in deposit contracts is limited, but can be increased by doubling the amount deposited and by allowing participants to determine the amount themselves. Finally, healthcare providers think it is a good idea to use financial incentives, but people with cardiovascular disease themselves are skeptical about the use of deposit contracts.Studies published in this dissertation were supported by The Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation, CVON2016-12 BENEFIT, ZonMw (The Netherlands Organization for Health Research and Development), Leiden University and the members of the BENEFIT consortium. This work was performed in the framework of the Medical Delta program eHealth & selfmanagement for a healthy society. Medical Delta is gratefully acknowledged for financial support for the printing costs of this thesis.Health and self-regulatio

Financial incentives for healthy living for patients with cardiac disease from the perspective of health care professionals: interview study

Health and self-regulatio

Investigating rewards and deposit contract financial incentives for physical activity behavior change using a smartphone app: randomized controlled trial

Health and self-regulatio

Facilitating creative idea selection: The combined effects of self-affirmation, promotion focus and positive affect

Contains fulltext : 175175.pdf (publisher's version ) (Open Access)Generating creative ideas in a brainstorm session is a crucial part of innovation. However, for actual implementation, the most creative ideas must be selected from a pool of ideas. To date, idea selection has remained relatively unexplored and validated instruments to measure idea selection performance are not systematically employed. This study aimed to improve creative idea selection performance in a field study. In this study, an idea pool of 18 ideas was used, and participants had to select the 5 most creative ideas from the idea pool. Right before participants performed the idea selection task, in the experimental condition, a promotion focus and positive affect was induced in combination with a self-affirmation task. Participants in the control condition performed corresponding filler tasks. The selection of the 5 most creative ideas from the idea pool of 18 ideas was performed individually. Participants in the experimental condition selected ideas that were more creative than did participants in the control condition. These findings provide first evidence that the selection of creative ideas can be enhanced through a combined induction of promotion-focus, positive mood and self-affirmation.8 p

Cardiovascular disease patients’ views on using financial incentives for health behavior change: Are deposit contracts acceptable?

Background: There is an urgent need to find new approaches that improve long-term adherence to a healthy lifestyle for people with cardiovascular disease (CVD). Deposit contracts (a financial incentive in which the participant deposits own money) are inexpensive and effective, but acceptability among CVD patients is unclear. This study investigated the acceptability of a deposit contract intervention for physical activity among CVD patients. Methods: We approached CVD patients through the Harteraad patient panel of the Dutch CVD patient organization and asked them to fill in an online survey. In total (N = 659) CVD patients with a mean age of 66.2 years completed the survey. The survey assessed acceptability of deposit contracts, responses to a concrete example of a deposit contract for physical activity behavior change, and suitable moments for implementation. Results: Overall, half of the participants (45.6%) confirmed needing extra commitment to maintain lifestyle change. Yet, a small part of the sample was convinced by the idea that losing money could be motivating (18.8%) and indicated that they would be willing to deposit money themselves (13.2%). Responding to a concrete example of a deposit contract for physical activity, a quarter of the sample (26.2%) reported there was a chance they would participate. Furthermore, 27.1% of the participants found the deposit contract effective and 27.4% found it acceptable. Exploratory analyses showed that a subgroup of younger and lower educated participants responded more favorably. Opinions on when to start with a deposit contract were mixed. Conclusions: Because acceptability was generally found to be low, future research should also investigate strategies to leverage commitment principles for CVD patients without a cash deposit requirement. When deposit contracts are offered to CVD patients in practice, we recommend offering them as an optional, additional element to existing interventions that patients can opt-in to

Lifestyle support preferences of patients with cardiovascular diseases: what lifestyle support might work best for whom?

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Values of importance to patients with cardiovascular disease as a foundation for ehealth design and evaluation: mixed methods study

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