Impact of financial incentives on behavior change program participation and risk reduction in worksite health promotion.

PURPOSE To examine the impact of financial incentives on behavior change program registration, completion, and risk improvement rates. DESIGN Retrospective cohort study conducted to observe the relationship between financial incentives and behavior change program registration, completion, and risk improvement rates. SETTING Large public- or private-sector employers. SUBJECTS Twenty-four organizations (n = 511,060 eligible employees) that offered comprehensive worksite health promotion (WHP) programs. INTERVENTION Financial incentives offered for completion of a behavior change program as part of a WHP program. MEASURES Behavior change program registration and completion data were obtained from standard reports. Company-level risk change was calculated from the average per-person number of risks on baseline and follow-up health risk assessments. Incentive design was determined from questionnaires completed by WHP program managers. ANALYSIS Average registration rates, program completion rates, and risk improvement rates were compared using t-tests for companies that did versus did not offer incentives. Comparisons were also made between companies with incentives of less than $100 and those with incentives of $100 or more. Correlations between incentive value and outcome variables were assessed using Pearson correlations. RESULTS Companies that offered incentives had significantly higher health coaching completion rates than companies not offering an incentive (82.9% vs. 76.4%, respectively, p = .017) but there was no significant association with registration (p = .384) or risk improvement rates (p = .242). Incentive values were not significantly associated with risk improvement rates (p = .240). CONCLUSION Offering incentives for completing behavior change programs may increase completion rates, but increased health improvement does not necessarily follow.