Evidence map›Paper›PMID 37919433›Full record

Trial reportInternational journal of obesity (2005)2024

Cost-effectiveness of goal-directed and outcome-based financial incentives for weight loss in low-income populations: the FIReWoRk randomized clinical trial.

Joseph A Ladapo, Stephanie L Orstad, Judith Wylie-Rosett, Chi-Hong Tseng, Un Young Rebecca Chung, Nikhil R Patel, Suzanne B Shu, Noah J Goldstein, Soma Wali, Melanie Jay

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in International journal of obesity (2005), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.5field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 1 country.

Joseph A LadapoDepartment of Medicine, University of Florida College of Medicine, Gainesville, FL, USA. Joseph.Ladapo@medicine.ufl.edu.ORCID 0000-0002-8518-4800
Stephanie L OrstadDivision of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA.
Judith Wylie-RosettDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Chi-Hong TsengDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Un Young Rebecca ChungDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Nikhil R PatelDivision of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA.ORCID 0000-0001-6683-3329
Suzanne B ShuCornell Dyson School of Applied Economics and Management, Ithaca, NY, USA.
Noah J GoldsteinAnderson School of Management at UCLA, Los Angeles, CA, USA.
Soma WaliDepartment of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA.
Melanie JayDivision of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA.
New York University · USUniversity of California, Los Angeles · USAlbert Einstein College of Medicine · USAnderson University - South Carolina · USCornell University · USOlive View-UCLA Medical Center · USUniversity of Florida · USVA NY Harbor Healthcare System · US

Funding

Project-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5M
Financial incentive strategies for weight loss in obese patients living in socioeconomically disadvantaged neighborhoodsR01MD011544 · NIMHD · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JAY, MELANIE, WALI, SOMA · 2016 to 2020
$3.5M
NCATS NIH HHS UL1 TR001445NIMHD NIH HHS R01 MD011544
6 · The paper itself

Abstract

backgroundThe Financial Incentives for Weight Reduction (FIReWoRk) clinical trial showed that financial incentive weight-loss strategies designed using behavioral economics were more effective than provision of weight-management resources only. We now evaluate cost-effectiveness.

methodsCost-effectiveness analysis of a multisite randomized trial enrolling 668 participants with obesity living in low-income neighborhoods. Participants were randomized to (1) goal-directed incentives (targeting behavioral goals), (2) outcome-based incentives (targeting weight-loss), and (3) resources only, which were provided to all participants and included a 1-year commercial weight-loss program membership, wearable activity monitor, food journal, and digital scale. We assessed program costs, time costs, quality of life, weight, and incremental cost-effectiveness in dollars-per-kilogram lost.

resultsMean program costs at 12 months, based on weight loss program attendance, physical activity participation, food diary use, self-monitoring of weight, and incentive payments was $1271 in the goal-directed group, $1194 in the outcome-based group, and $834 in the resources-only group (difference, $437 [95% CI, 398 to 462] and $360 [95% CI, 341-363] for goal-directed or outcome-based vs resources-only, respectively; difference, $77 [95% CI, 58-130] for goal-directed vs outcome-based group). Quality of life did not differ significantly between the groups, but weight loss was substantially greater in the incentive groups (difference, 2.34 kg [95% CI, 0.53-4.14] and 1.79 kg [95% CI, -0.14 to 3.72] for goal-directed or outcome-based vs resources only, respectively; difference, 0.54 kg [95% CI, -1.29 to 2.38] for goal-directed vs outcome-based). Cost-effectiveness of incentive strategies based on program costs was $189/kg lost in the goal-directed group (95% CI, $124/kg to $383/kg) and $186/kg lost in the outcome-based group (95% CI, $113/kg to $530/kg).

conclusionsGoal-directed and outcome-based financial incentives were cost-effective strategies for helping low-income individuals with obesity lose weight. Their incremental cost per kilogram lost were comparable to other weight loss interventions.

Indexed as

MotivationWeight Reduction ProgramsCost-Benefit AnalysisCost-Effectiveness AnalysisGoalsHumansObesityQuality of Life

Identifiers

PMID37919433
PMCPMC13643863
OpenAlexW4388289258

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.