How Financial Incentives Influence Weight Change - Essay Example

System Analysis: How Financial Incentives Influence Weight Change System Analysis: How Financial Incentives Influence Weight Change Introduction All over the world, weight has been considered important in determining fitness and beauty, with some cultures favoring heavy weights and others slim people. In a quest to fit in with the expectations of the environment around, one seeks to either gain weight or loose. On the rise, has been the opinion that lighter people, are better looking. More importantly though, there are health concerns that come with the weight of an individual. The biggest concern about weight has not been gain, rather its loss. Health concerns such as obesity, hypertension and arteriosclerosis have not gone to help this obsession with weight loss. People have come up with different ways to lose weight, some of which are legit, and others not (Cawley and Price, 2013). Information has been posted in the internet and is available to all. But, is it that easy to find? In a bid to discern whether weight loss has anything to do with money as has been proposed, a research needed to be done. A financial incentive involves motivation of an action by monetary gain that would not otherwise happen in absence of the money. So many sources in the internet were available to use and it was necessary to carry out a research to determine the trustworthy sources from which the information could be obtained and thus the research objective. In order to provide trustworthy sources from which this information can be obtained. Method The search was conducted in the worldwide population because one country would be limited in the information it has, and that all over the world, financial incentives would be a motivator, suffice to say that what causes one to put effort to lose weight in one country is the same everywhere (Cawley and Price, 2013). Six databases were searched including CINAHL, Medline, PsychInfo, Science Direct, Web of Science and Pub Med. The phrase searched within the databases was ‘Financial incentives and weight loss and adults’. The databases were chosen for different reasons. PubMed (national library of medicine) was chosen because it is a national institute of health and thus contains a wide catalogue and variety of articles on health, which works for the health related topic. It is also widely used and well known (Cawley and Price, 2013). Science Direct was chosen because it contains a large pool of information, is a very broad and commonly used database containing a wide variety of different scientific disciplines including health. The aim was to draw information from a different pool of resources to cross analyze it with more specific databases. CINAHL database was chosen because it offers a different view to information and variety even though it is closely related to PubMed. PsychInfo was selected because other databases linked to it implying confidence in their content and so it was added to the choice databases. Medline was chosen because it contains citations to journals and abstracts with biomedical literature from all over the world. On searching from the databases, all the citations totaled to four thousand four hundred and twenty two citations. The number of citations from each database is indicated in the included methodology flowchart. Due to the high numbers of citations, it was necessary to apply filters even though it would have been better to work with no filters (Cawley and Price, 2013). The filters applied removed for instance citations that did not meet certain criteria such as, those that were not freely available in full text, and selected journal entries. The remaining articles were scanned for eligibility by title. Those articles containing titles that seemed unrelated to the subject at hand were removed, after which the remaining articles were scanned to remove duplicates (Cawley and Price, 2013). After duplicates were removed, the articles were then scanned through use of the abstract, to determine how relevant the content of the articles as described in the abstract were. Those deemed irrelevant were removed and the remaining articles separated on the basis of ease of access. The title was used to test for eligibility because, usually as one writes, they title their article with a name that is most relevant and true to the content of the article. If the titles showed no relevance to the topic, or proved to be too broad to cover it substantially, then the articles were eliminated. Sometimes in an electronic search, web nodes can be opened twice, and they will then be tallied as different articles even though they are actually the same, or others have content so alike that there is no sense in having both, thus the duplicates being removed. Abstract eligibility was next to be considered. The abstract contains a short sneak peak at what is contained in article. Whereas the title may have misled, it is difficult to so do when the abstract is read. Therefore, based on relevance, those articles deemed to qualify were selected. Ease of access was the last check point. Whereas some citations may have good content relevant to the subject if they are unavailable then they are of little or no value at all. In order to be included in the study, the source had to show weight change as those not showing were of no value as the interest was weight change; it had to be of a large audience due to the universality of the search topic, it had to have a relevant abstract and title to the research question, the full texts or articles had to be available for free and they had to be gold standard. The standard though was not possible as there were no enough articles found (Lawrence and Hensrud, 2013). Articles with people of up to seventeen years old were not included in the research due to the lack of enough information concerning the same and parental consent which would have been an issue. Also, the fact that they have less control over their lifestyle in terms of aspects such as diet and exercise was also a reason for exclusion (Cawley and Price, 2013). A teenager for example, is dependent on the parent for support and therefore, the food they eat would be decided by the parent. Those with preexisting healthcare issues already were also not included in the research. However, not all healthcare issues were a cause for exclusion. For instance, how one with a metabolic disorder is likely to respond is different from the response of one whose healthcare issue is diabetes. The last category not included were articles that had financial incentives that did not offer rewards. Articles considered were to have information on two factors studied which included interventions(in terms of changing ones diet or engaging exercise in a bid to lose weight,) and incentives involved (such as coupons, financial incentives and reimbursements offered) studied against variance in BMI, the length intervention as well as the weight change observed(Cawleyand Price, 2013).The undesirable factors that would have been studied were such as age, gender, the size of sample that was used, the health conditions in the individuals of study, the socioeconomic factors, culture, religion, location, attrition as well as adherence. The relationship between the interventions applied and the length of interventions would be affected by factors such as length of intervention and adherence. For instance, if a 40 year old were to partake of a particular diet for a given length of time as a 20 year old, the weight change would be different even if all the conditions other than age were kept constant (Cawley and Price, 2013). Similarly, two people under the same conditions but one adheres to the prescribed diet while the other doesn’t would give different results. This explains why factors such as age and adherence were considered extraneous variables and had to be considered when selecting articles to be used for the research. Articles that included these factors were considered better when compared to those that only dealt with the dependent and independent variables only. This was a criterion considered during elimination by testing eligibility based on the abstract. The articles relied heavily on age, and this the main reason they are very vital resource for the research. It is also important to know that aged people are not as active as young people and this poses a big challenge to them in reference to weight related issues. In order to minimize bias, the same key was used for all the databases and filters were applied only when the results were found to be too broad and the filters were uniformly put for instance, for the PubMed database, selected were articles that offered a free full text, or journals sources whereas for the Direct Science database, journal entries, physical activity, weight loss among others were considered valid (Cawley and Price, 2013). They did not segregate to a specific location or socioeconomic status. Results Table 1: results obtained after first search after filter after title eligibility after removing duplicates abstract eligibility able to access PsychInfo 5 5 3 2 2 1 web of science 43 27 15 6 6 4 CINAHL 1 1 1 1 1 1 Science Direct 4317 351 12 11 10 5 Medline 5 5 3 2 2 2 PubMed 53 14 6 6 4 4 total 4422 403 40 28 25 17 From the table, Science direct had the largest number of citations because of the scope of topics which it covers and the large population that is considered in information collection. It was followed by PubMed by a very large margin while the web of science came in third. Filtering helped to reduce the number of citations to a number that could then be manageable as can be seen. CINAHL provided only one source that passed all the tests to which it was subjected. From the results obtained, it is clear that a lot of information is readily available in the electronic media even though not all of it is useful for research on particular topics (Cawley and Price, 2013). This implies that during research through the use of the same, one needs to be diligent in order to be able to access quality information on the same topics (Lawrence and Hensrud, 2013). It also shows the need for more reliable information sources that are easy to access and free. That leaves professionals with a challenge to embrace the electronic media and present their works for access by other professionals in order to enhance knowledge. The system used in coming up with these results proved to be good even though it had some loopholes such as the probability of having limited the information by locking out articles that were not freely available in full text. The chart can however be used by researchers who desire to produce work that is quality in terms of universality (Cawley and Price, 2013). The obtained citations were from different sources all over the world and the chances that the information acquired applies to people across racial, state and socio economic boundaries are very high. Table 2: citation results and content source content Henson, C. S., Rueger, M. M., Hubbe, ...Heimburger, D. C. (2007). Intervention- EatRight Lifestyle Program Incentive-50% reimbursement of entry fee. 10- 12 classes, loose 6% body weight. adults with a BMI ≥30 kg/m2 sample size -401 people method- weights- first class sessions in light clothing without shoes by a Tanita digital scale, Heights- without shoes using a freestanding stadiometer. BMI was calculated as weight (kg)/ height (m)2. study design-sequential control-intervention design. Cawley, J., & Price, J. A. (2013) financial incentives for weight loss. Sample size- 2635 workers, 24 worksites. Incentives- fixed payments and forfeitable bonds. Jeffrey, T. K., Andrea, B. T., George, L., David, A. A., Laurie, A. N., Lisa, W., Yuanyuan, T., Kevin, G. V. (2013) Individual- Versus Group-Based Financial Incentives for Weight Loss: A Randomized, Controlled Trial.  Design-random, controlled trial Incentive- BMI- 30-40 Intervention-diet changes Analysis method-intend-to-treat John, L. K., Loewenstein, G., Troxel, A. B., Norton, L., Fassbender, J. E., &Volpp, K. G. (2011). Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial.  Lawrence, D. S., &Hensrud, D. (2013). Financial incentives for weight loss: a one-year randomized controlled clinical trial. Sample size-390 obese adults Intervention- usual care, weight education and lifestyle counseling. Adherence-86%completed 2 year trial Mean weight loss-1.7±0.7 Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Cook, A. T., Berthon, B., Mitchell, S., & Callister, R. (J2011). Efficacy of a workplace-based weight loss program for overweight male shift workers: the Workplace POWER (Preventing Obesity Without Eating like a Rabbit) randomized controlled trial.  Intervention- 75 min information session, website study and weight loss resources. Incentive- money given to those loosing high weight Results- average 5% weight loss Adherence-28% Pope, L., & Harvey-Berino, J. (2013). Burn and earn: A randomized controlled trial incentivizing exercise during fall semester for college first-year students.  Sample size-117 first year students Incentive- $10 to $38.75 for meeting researcher-set fitness-center use goals Adherence-63% Result- average BMI increase 0.6kg/m2 Relton, C., Strong, M., & Li, J. (2011). The Pounds for Pounds weight loss financial incentive scheme: an evaluation of a pilot in NHS Eastern and Coastal Kent. Incentives-from £70 to £425 per year. Sample size-402 participants BMI≥30 KG/M2 Rothberg, A. E., McEwen, L. N., Fraser, T., Burant, C. F., & Herman, W. H. (2013). The impact of a managed care obesity intervention on clinical outcomes and costs: A prospective observational study. Design method- observational study Sample size-1138 adults BMI- 32kg/m2  Adherence-79%, 1 year Tucker, R. M., May, C., Bennett, R., Hymer, J., &McHaney, B. (2004). A Gym-Based Wellness Challenge for People With Type 2 Diabetes: Effect on Weight Loss, Body Composition, and Glycemic Control.  Volpp, K. G., John, L. K., Troxel, A. B., Norton, L., Fassbender, J., &Loewenstein, G. (2008). Financial Incentive–Based Approaches for Weight Loss. Discussions/conclusions From some of the summary results shown above, it is evident that the citations obtained were reliable and information obtained thereof could be considered valid. It is also clear that there exists a relationship between the financial incentives given to an individual and how they lose weight even though other factors such as how one adheres to the intervention are also role players. This information can be applied by people offering weight loss programs through exercise or even diets. Throwing in a financial benefit for the enrollees of one’s program is a big add to it and not only ensures that the results obtained are as desired but also serves to draw people to enroll and one gets to contribute to healthier lifestyles while still earning an income. Weight counseling (enhanced) helps only 33.3% of the obese patients to achieve a weight loss that is significant clinically (Lawrence et al, 2013). Even though this percentage appears small, it is significantly large in a population where increasing number of people are obese. Weekly financial incentives resulted in more first year students losing weight (Pope et al, 2013). This suggests that they can be used to encourage students to join fitness centers and lose weight. Other non-medical weight loss interventions also yield an average of 4kg weight loss as do the medical (Relton et al, 2011). This suggests that for weight loss, one can also apply other interventions such as exercise or enrolling in gym programs. In future perhaps, research can be conducted on the extent to which these non-clinical interventions influence weight loss specifically, as compared to the clinical in order to suggest the better option. Over 1 year, a medical program for obese people who adhered to it yielded to lower rates of cardiovascular diseases and decreased the expenses on medical care (Rothberg et al, 2013). This, can be recommended for obese people in order to help them improve their lives. Evidently, the relationship between financial incentives and weight loss is not so straight forward as it is influenced by many other factors. Therefore, to conclude that providing a monetary incentive without stating the other conditions and factors would be erroneous. References Butsch, W. S., Ard, J. D., Allison, D. B., Patki, A., Henson, C. S., Rueger, M. M., Hubbert, K. A., ...Heimburger, D. C. (2007). Effects of a Reimbursement Incentive on Enrollment in a Weight Control Program. Obesity, 15(11), 2733-2738. Top of Form Cawley, J., & Price, J. A. (2013). A case study of a workplace wellness program that offers financial incentives for weight loss. Journal of Health Economics, 32(5), 794-803.Bottom of Form Top of Form Finkelstein, E. A., Linnan, L. A., Tate, D. F., &Birken, B. E. (2007). A pilot study testing the effect of different levels of financial incentives on weight loss among overweight employees. Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine, 49 (9), 981-9.Bottom of FormBottom of Form Top of Form Top of Form Forster, J. L., Jeffery, R. W., Schmid, T. L., & Kramer, F. M. (1988). Preventing weight gain in adults: A pound of prevention. Health Psychology, 7(6), 515-525. Top of Form Jeffrey, R. W., & Wing, R. R. (1995). Long-term effects of interventions for weight loss using food provision and monetary incentives. Journal of Consulting and Clinical Psychology, 63 (5), 793-796.Bottom of Form Top of Form Jeffrey, R. W., Wing, R. R., Thorson, C., & Burton, L. R. (1998). Use of personal trainers and financial incentives to increase exercise in a behavioral weight-loss program. Journal of Consulting and Clinical Psychology, 66 (5), 777-83.Bottom of Form Top of Form Jeffrey, T. K., Andrea, B. T., George, L., David, A. A., Laurie, A. N., Lisa, W., Yuanyuan, T., ... Kevin, G. V. (2013). Individual- Versus Group-Based Financial Incentives for Weight Loss: A Randomized, Controlled Trial. Annals of Internal Medicine, 158 (7), 505-514.Bottom of Form Top of Form John, L. K., Loewenstein, G., Troxel, A. B., Norton, L., Fassbender, J. E., &Volpp, K. G. (2011). Financial Incentives for Extended Weight Loss: A Randomized, Controlled Trial. Journal of General Internal Medicine, 26 (6), 621-626. Top of Form Lawrence, D. S., &Hensrud, D. (2013). Financial incentives for weight loss: a one-year randomized controlled clinical trial. Journal of the American College of Cardiology, 61 (10).Bottom of Form Top of Form Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Cook, A. T., Berthon, B., Mitchell, S., & Callister, R. (J2011). Efficacy of a workplace-based weight loss program for overweight male shift workers: the Workplace POWER (Preventing Obesity Without Eating like a Rabbit) randomized controlled trial. Preventive Medicine, 52 (5), 317-25.Bottom of Form Top of Form Pope, L., & Harvey-Berino, J. (2013). Burn and earn: A randomized controlled trial incentivizing exercise during fall semester for college first-year students. Preventive Medicine, 56, 197-201.Bottom of FormBottom of Form Top of Form Top of Form Relton, C., Strong, M., & Li, J. (2011). The Pounds for Pounds weight loss financial incentive scheme: an evaluation of a pilot in NHS Eastern and Coastal Kent. Journal of Public Health, 33 (4), 536-542.Bottom of FormTop of FormBottom of FormBottom of Form Top of Form Rothberg, A. E., McEwen, L. N., Fraser, T., Burant, C. F., & Herman, W. H. (2013). The impact of a managed care obesity intervention on clinical outcomes and costs: A prospective observational study. Obesity, 21 (11), 2157-2162.Bottom of Form Top of Form Tucker, R. M., May, C., Bennett, R., Hymer, J., &McHaney, B. (2004). A Gym-Based Wellness Challenge for People With Type 2 Diabetes: Effect on Weight Loss, Body Composition, and Glycemic Control. Diabetes Spectrum, 17 (3), 176-180. Volpp, K. G., John, L. K., Troxel, A. B., Norton, L., Fassbender, J., &Loewenstein, G. (2008). Financial Incentive–Based Approaches for Weight Loss.Jama, 300(22), 2631. Top of Form Bottom of Form Bottom of Form Read More