Translational Behavioral Medicine

, Volume 3, Issue 4, pp 357–369 | Cite as

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

  • Donna M ZulmanEmail author
  • Laura J. Damschroder
  • Ryan G Smith
  • Paul J. Resnick
  • Ananda Sen
  • Erin L Krupka
  • Caroline R Richardson
Original Research


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.


Obesity Exercise Prevention Internet EHealth 



The authors thank BCN leadership and employees for participating in interviews and Emily Jenchura, Danielle Cohen, and Jill Bowdler for their assistance with manuscript preparation.

Financial Disclosures

Dr. Zulman’s contribution to this study was supported by the Robert Wood Johnson Foundation Clinical Scholars Program and an associated Advanced Fellowship through Veterans Affairs. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests

Dr. Richardson is a scientific advisor to Walkingspree and an unpaid consultant to BCN. She does not receive compensation in these roles and does not have a financial interest in either company. The authors report no other competing interests.


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Copyright information

© Society of Behavioral Medicine 2013

Authors and Affiliations

  • Donna M Zulman
    • 1
    • 2
    Email author
  • Laura J. Damschroder
    • 3
  • Ryan G Smith
    • 4
  • Paul J. Resnick
    • 5
  • Ananda Sen
    • 6
    • 7
  • Erin L Krupka
    • 5
  • Caroline R Richardson
    • 3
    • 6
  1. 1.Center for Health Care EvaluationVA Palo Alto Health Care SystemMenlo ParkUSA
  2. 2.Division of General Medical DisciplinesStanford UniversityStanfordUSA
  3. 3.Health Services Research and Development Center for Clinical Management ResearchAnn Arbor VA Medical CenterAnn ArborUSA
  4. 4.Jefferson Medical CollegePhiladelphiaUSA
  5. 5.School of InformationUniversity of MichiganAnn ArborUSA
  6. 6.Department of Family MedicineUniversity of Michigan Medical SchoolAnn ArborUSA
  7. 7.Department of BiostatisticsUniversity of MichiganAnn ArborUSA

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