The Impact of Financial Incentives on Attendance and Motivation for Bariatric Support Groups

ABSTRACT

Background: Attending bariatric support groups is associated with higher weight loss post-bariatric surgery;however, attendance can be low due to several important barriers (e.g., time, motivation, distance). Incentivizing participation in desired behaviors is one strategy that has been used widely in many areas (e.g., health behaviors, work performance) but has not been used specifically to increase attendance to bariatric support groups. Methods: A single-center, prospective, pilot study was performed from January 1, 2020 - March 1, 2020 (timeline shortened drastically due to COVID-19 pandemic). Participants who were > 1-year postoperative were eligible to receive a monetary incentive ($20 per support group meeting) for attending bariatric surgery support groups. They also were asked to complete the Treatment Self-Regulation Questionnaire (TSRQ) to assess motivation at each support group they attended. Results: Attendance pre-incentive (2019) to post-incentive (2020) increased significantly (RR = 9.1, 95% CI 4.8-19.2, p < .0001). Results from the TSRQ at baseline suggested higher intrinsic motivation (m = 4.75, sd = 1.09) than extrinsic motivation (m= 1.55, sd = 0.91), and there was no change in motivation level over time (p's > .05). Conclusions: This pilot study suggests the potential benefit of providing incentives to increase attendance to bariatric surgery support groups. It also suggests that motivation for many people participating in this study was intrinsic despite the provision of an extrinsic reward for attendance. Future research over a longer period may clarify what level and type of incentives provide the most benefit and how this impacts motivation over time.