, Volume 3, Issue 4, pp 357-369
Date: 08 May 2013

Implementation and evaluation of an incentivized Internet-mediated walking program for obese adults

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ABSTRACT

In response to rising health care costs associated with obesity rates, some health care insurers are adopting incentivized technology-enhanced wellness programs. The purpose of this study is to evaluate the large-scale implementation of an incentivized Internet-mediated walking program for obese adults and to examine program acceptance, adherence, and impact. A mixed-methods evaluation was conducted to investigate program implementation, acceptance, and adherence rates, and physical activity rates among program participants. Program implementation was shaped by national and state policies, data security concerns, and challenges related to incentivizing participation. Among 15,397 eligible individuals, 6,548 (43 %) elected to participate in the walking program, achieving an average of 6,523 steps/day (SD 2,610 steps). Participants who uploaded step counts for 75 % of days for a full year (n = 2,885) achieved an average of 7,500 steps (SD 3,093). Acceptance and participation rates in this incentivized Internet-mediated walking program suggest that such interventions hold promise for engaging obese adults in physical activity.

Implications

Practice: Insurance-incentivized Internet-mediated walking programs are acceptable to many obese adults and enable them to meet modest physical activity goals; however, some may perceive the financial incentives as coercive.
Policy: The Affordable Care Act’s incentivized wellness program policies should be evaluated to determine how such policies affect program adoption and implementation, and whether the policies successfully lead to improved health behaviors at a population level.
Research: Future research is needed to determine the impact of incentivized Internet-mediated walking programs on health outcomes and medical care costs.