6 resultados para Vouchers
em QUB Research Portal - Research Directory and Institutional Repository for Queen's University Belfast
Resumo:
Abstract
Background Physical inactivity is a major public health concern, and more innovative approaches are urgently needed to address it. The UK Government supports the use of incentives and so-called nudges to encourage healthy behaviour changes, and has encouraged business sector involvement in public health through the Public Health Responsibility Deal. To test the effectiveness of provision of incentives to encourage adults to increase their physical activity, we
recruited 406 adults from a workplace setting (office-based) to take part in an assessor-blind randomised controlled trial.
Methods
We developed the physical activity loyalty card scheme, which integrates a novel physical activity tracking system with web-based monitoring (palcard). Participants were recruited from two buildings at Northern Ireland’s main
government offices and were randomly allocated (grouped by building [n=2] to reduce contamination) to either incentive group (n=199) or no incentive group (n=207). We included participants aged 16–65 years, based at the worksite 4 days or more per week and for 6 h or more per day, and able to complete 15 min of moderate-paced walking (self-report). Exclusion criteria included having received specific advice by a general practitioner not to exercise. A statistician not involved in administration of the trial prepared a computer-generated random allocation sequence. Random assignments were placed in individually numbered, sealed envelopes by the statistician to ensure concealment of allocation. Only the assessor was masked to assignment. Sensors were placed along footpaths and the gym in the workplace. Participants scanned their loyalty card at the sensor when undertaking physical activity (eg, walking), which logged activity. Participants in the incentive group monitored their physical activity, collected points, and received rewards (retail vouchers) for minutes of physical activity completed over the 12-week intervention. Rewards were vouchers sponsored by local retailers. Participants in the no incentive group used their loyalty card to self-monitor their physical activity but were not able to earn points or receive rewards. The primary outcome was change in minutes of moderate to vigorous physical activity with the Global Physical Activity Questionnaire, measured at baseline, week 12, and 6 months. Activity was objectively measured with the tracking system over the 12-week intervention. Mann Whitney U tests were done to assess change between groups.
Findings
The mean age of participants was 43·32 years (SD 9·37), and 272 (67%) were women. We obtained follow-up data from 353 (87%) participants at week 12 and 341 (84%) at 6 months. At week 12, participants in the incentive group increased moderate to vigorous physical activity by a median of 60 min per week (IQR –10 to 120) compared with 30 min per week (–60 to 90) in the no incentive group (p=0·05). At 6 months, participants in the incentive group had
increased their moderate to vigorous physical activity by 30 min per week (–60 to 100) from baseline compared with 0 min per week (–115 to 1110) in the no incentive group (p=0·099). We noted no significant differences between groups
for use of loyalty card (p=0·18). Participants in the incentive group recorded a mean of 60·22 min (95% CI 50·90–69·55) of physical activity per week with their loyalty card on week 1 and 23·56 min (17·06–30·06) at week 12, which was similar to that for those in the no incentive group (59·74 min, 51·24–68·23, at week 1; 20·25 min, 14·45–26·06, at week 12; p=0·94 for differences between groups at week 1; p=0·45 for differences between groups at week 12).
Interpretation:
Financial incentives showed a short-term behaviour change in physical activity. This innovative study contributes to the necessary evidence base, and has important implications for physical activity promotion and business engagement in health. The optimum incentive-based approach needs to be established. Results should be interpreted with some caution as the analyses of secondary outcomes were not adjusted for multiple comparisons.
Resumo:
Background: Financial incentives have been advocated by the UK and U.S. governments to encourage adoption of healthy lifestyles. However, evidence to support the use of incentives for changing physical activity (PA) behavior is sparse.
Purpose:To investigate the effectiveness of?nancial incentives to increase PA in adults in the workplace.
Design: Two-arm quasi-experimental design.
Setting/participants: Employees (n¼406) in a workplace setting in Belfast, Northern Ireland, UK.
Intervention: Using a loyalty card to collect points and earn rewards, participants (n¼199) in the Incentive Group monitored their PA levels and received ?nancial incentives (retail vouchers) for minutes of PA completed over the course of a 12-week intervention period. Participants (n¼207) in the comparison group used their loyalty card to self-monitor their PA levels but were not able to earn points or obtain incentives (No Incentive Group).
Main outcome measures:The primary outcome was minutes of PA objectively measured using a novel PA tracking system at baseline (April 2011); Week 6 (June 2011); and Week 12 (July 2011).
Other outcomes, including a self-report measure of PA, were collected at baseline, Week 12, and 6 months (October 2011). Data were analyzed in June 2012.
Results: No signi?cant differences between groups were found for primary or secondary outcomes at the 12-week and 6-month assessments. Participants in the Incentive Group recorded 17.52 minutes of PA/week (95% CI¼12.49, 22.56) compared to 16.63 minutes/week (95% CI¼11.76, 21.51) in the No Incentive Group at Week 12 (p¼0.59). At 6 months, participants in the Incentive Group recorded 26.18 minutes of PA/week (95% CI¼20.06, 32.29) compared to 24.00 minutes/week (95% CI¼17.45, 30.54) in the No Incentive Group (p¼0.45).
Conclusions: Financial incentives did not encourage participants to undertake more PA than selfmonitoring PA. This study contributes to the evidence base and has important implications for increasing participation in physical activity and fostering links with the business sector. (Am J Prev Med 2013;45(1):56–63) © 2013 American Journal of Preventive Medicine
Resumo:
Purpose: To study safety of children’s glasses in rural China, where fear that glasses harm vision is an important barrier for families and policy-makers. Design: Exploratory analysis from a cluster-randomized, investigator-masked, controlled trial.Methods: Among primary schools (n=252) in western China, children were randomized by school to one of three interventions: free glasses provided in class, vouchers for free glasses at a local facility or glasses prescriptions only (Control group). The main outcome of this analysis is uncorrected visual acuity after 8 months, adjusted for baseline acuity.Results: Among 19,934 children randomly selected for screening, 5852 myopic (spherical equivalent refractive error <= -0.5 D) eyes of 3001 children (14.7%, mean age 10.5 years) had VA <= 6/12 without glasses correctable to > 6/12 with glasses, and were eligible. Among these, 1903 (32.5%), 1798 (30.7%), and 2151 (36.8%) were randomized to Control, Voucher and Free Glasses respectively. Intention-to-treat analyses were performed on all 1831 (96.2%), 1699 (94.5%), and 2007 (93.3%) eyes of children with follow-up in Control, Voucher and Free Glasses groups. Final visual acuity for eyes of children in the treatment groups (Free Glasses and Voucher) was significantly better than for Control children, adjusting only for baseline visual acuity (difference of 0.023 logMAR units [0.23 vision chart lines, 95% CI: 0.03, 0.43]) or for other baseline factors as well (0.025 logMAR units [0.25 lines, 95% CI 0.04, 0.45]). Conclusion: We found no evidence that spectacles promote decline in uncorrected vision with aging among children.
Resumo:
Background
Trials depend on good recruitment and retention, but efforts to improve these have had varying success. This may be due to inadequate understanding of what participants would value in return for taking part. An opportunity arose in one trial to investigate the incentives that might help recruit and retain participants to another.
Aim
To determine what adults value as an incentive for involvement in a trial.
Methods
In the PAL Scheme, employees used a ‘loyalty card’ to monitor their physical activity over 12 weeks. The incentive group (n=199) collected points and received rewards for physical activity (1 minute = 1 point, max: 30 pts/day). A comparator group (n=207) self-monitored their physical activity only. Points could be redeemed as retail vouchers. 17 different incentives were available, from 75 pts (£2.50, a sandwich) to 1800 pts (£60, 1 month gym membership).
Results
148 of the 199 intervention participants used their card at least once, earning a mean of 374 pts. 121 earned sufficient to collect a reward and 76 redeemed points for vouchers but only 48 exchanged the vouchers for rewards. The most popular reward was not that of highest monetary value: two cinema tickets (300 pts, £10).
Conclusions
The value that participants place on a reward might be more important than its monetary value. Some might appreciate receiving the voucher, without spending it. In choosing incentives to boost trial participation, it may help to allow people to choose from a variety of rewards, rather than reimbursing in money.
Resumo:
Objective: To assess the effect of provision of free glasses on academic performance in rural Chinese children with myopia. Design: Cluster randomized, investigator masked, controlled trial.Setting 252 primary schools in two prefectures in western China, 2012-13. Participants: 3177 of 19 934 children in fourth and fifth grades (mean age 10.5 years) with visual acuity <6/12 in either eye without glasses correctable to >6/12 with glasses. 3052 (96.0%) completed the study.Interventions Children were randomized by school (84 schools per arm) to one of three interventions at the beginning of the school year: prescription for glasses only (control group), vouchers for free glasses at a local facility, or free glasses provided in class. Main outcome measures: Spectacle wear at endline examination and end of year score on a specially designed mathematics test, adjusted for baseline score and expressed in standard deviations. Results: Among 3177 eligible children, 1036 (32.6%) were randomized to control, 988 (31.1%) to vouchers, and 1153 (36.3%) to free glasses in class. All eligible children would benefit from glasses, but only 15% wore them at baseline. At closeout glasses wear was 41% (observed) and 68% (self reported) in the free glasses group, and 26% (observed) and 37% (self reported) in the controls. Effect on test score was 0.11 SD (95% confidence interval 0.01 to 0.21) when the free glasses group was compared with the control group. The adjusted effect of providing free glasses (0.10, 0.002 to 0.19) was greater than parental education (0.03, −0.04 to 0.09) or family wealth (0.01, −0.06 to 0.08). This difference between groups was significant, but was smaller than the prespecified 0.20 SD difference that the study was powered to detect. Conclusions: The provision of free glasses to Chinese children with myopia improves children’s performance on mathematics testing to a statistically significant degree, despite imperfect compliance, although the observed difference between groups was smaller than the study was originally designed to detect. Myopia is common and rarely corrected in this setting. Trial Registration: Current Controlled Trials ISRCTN03252665.
Resumo:
Background
Increasing physical activity in the workplace can provide employee physical and mental health benefits, and employer economic benefits through reduced absenteeism and increased productivity. The workplace is an opportune setting to encourage habitual activity. However, there is limited evidence on effective behaviour change interventions that lead to maintained physical activity. This study aims to address this gap and help build the necessary evidence base for effective, and cost-effective, workplace interventions
Methods/design
This cluster randomised control trial will recruit 776 office-based employees from public sector organisations in Belfast and Lisburn city centres, Northern Ireland. Participants will be randomly allocated by cluster to either the Intervention Group or Control Group (waiting list control). The 6-month intervention consists of rewards (retail vouchers, based on similar principles to high street loyalty cards), feedback and other evidence-based behaviour change techniques. Sensors situated in the vicinity of participating workplaces will promote and monitor minutes of physical activity undertaken by participants. Both groups will complete all outcome measures. The primary outcome is steps per day recorded using a pedometer (Yamax Digiwalker CW-701) for 7 consecutive days at baseline, 6, 12 and 18 months. Secondary outcomes include health, mental wellbeing, quality of life, work absenteeism and presenteeism, and use of healthcare resources. Process measures will assess intervention “dose”, website usage, and intervention fidelity. An economic evaluation will be conducted from the National Health Service, employer and retailer perspective using both a cost-utility and cost-effectiveness framework. The inclusion of a discrete choice experiment will further generate values for a cost-benefit analysis. Participant focus groups will explore who the intervention worked for and why, and interviews with retailers will elucidate their views on the sustainability of a public health focused loyalty card scheme.
Discussion
The study is designed to maximise the potential for roll-out in similar settings, by engaging the public sector and business community in designing and delivering the intervention. We have developed a sustainable business model using a ‘points’ based loyalty platform, whereby local businesses ‘sponsor’ the incentive (retail vouchers) in return for increased footfall to their business.
