Try a new search

Format these results:

Searched for:

person:ladapj01

in-biosketch:yes

Total Results:

94


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

Ladapo, Joseph A; Orstad, Stephanie L; Wylie-Rosett, Judith; Tseng, Chi-Hong; Chung, Un Young Rebecca; Patel, Nikhil R; Shu, Suzanne B; Goldstein, Noah J; Wali, Soma; Jay, Melanie
BACKGROUND:The 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. METHODS:Cost-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. RESULTS:Mean 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). CONCLUSIONS:Goal-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.
PMID: 37919433
ISSN: 1476-5497
CID: 5623172

Goal-directed versus outcome-based financial incentives for smoking cessation among low-income, hospitalised patients: rationale and design of the Financial Incentives for Smoking Treatment II (FIESTA II) randomised controlled trial

Wali, Soma; Gaitonde, Anisha; Sherman, Scott; Min, Noelle; Pesantes, Andrea; Bidgoli, Ava; Shirley, Abraelle; Tseng, Chi-Hong; Ladapo, Joseph
INTRODUCTION:Smoking remains the leading preventable cause of death in the USA. Low utilisation of treatments for smoking cessation remains a major barrier for reducing smoking rates. Financial incentives represent an innovative approach to increasing use of therapies for smoking cessation. This paper will describe the rationale and design of the Financial Incentives for Smoking Treatment II (FIESTA II) study, a randomised controlled trial to evaluate the effectiveness and feasibility of goal-directed and outcome-based financial incentives to promote smoking cessation among hospitalised smokers. METHODS AND ANALYSIS:We are recruiting adult participants who smoked tobacco in the 30 days prior to initial interview and are contemplating quitting smoking. These participants will come from two hospitals in underserved communities in New York City and Los Angeles. They will be randomised into one of three arms. The first arm consists of goal-directed financial incentives plus enhanced usual care, which includes hospital-directed information about quitting smoking, nicotine replacement therapy and referral to a Quitline. The second arm involves outcome-based financial incentives plus enhanced usual care. The third arm consists of enhanced usual care alone. Multiple phone interviews with the participants will be completed after randomisation to assess smoking cessation. Participants will earn $20 for each follow-up interview completed and $30 for each smoking cessation test completed. Those who are randomised to the financial incentive groups can earn an additional $700. The participants in the outcome-based group will receive payments solely for exhibiting cessation, whereas the participants in the goal-based group are also eligible for receiving payments after meeting milestones such as speaking with a helpline coach. ETHICS:IRB#19-000 084. TRIAL REGISTRATION NUMBER:NCT03979885.
PMCID:10546144
PMID: 37775282
ISSN: 2044-6055
CID: 5631692

Effectiveness of Goal-Directed and Outcome-Based Financial Incentives for Weight Loss in Primary Care Patients With Obesity Living in Socioeconomically Disadvantaged Neighborhoods: A Randomized Clinical Trial

Ladapo, Joseph A; Orstad, Stephanie L; Wali, Soma; Wylie-Rosett, Judith; Tseng, Chi-Hong; Chung, Un Young Rebecca; Cuevas, Miguel A; Hernandez, Christina; Parraga, Susan; Ponce, Robert; Sweat, Victoria; Wittleder, Sandra; Wallach, Andrew B; Shu, Suzanne B; Goldstein, Noah J; Jay, Melanie
IMPORTANCE/UNASSIGNED:Financial incentives for weight management may increase use of evidence-based strategies while addressing obesity-related economic disparities in low-income populations. OBJECTIVE/UNASSIGNED:To examine the effects of 2 financial incentive strategies developed using behavioral economic theory when added to provision of weight management resources. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:Three-group, randomized clinical trial conducted from November 2017 to May 2021 at 3 hospital-based clinics in New York City, New York, and Los Angeles, California. A total of 1280 adults with obesity living in low-income neighborhoods were invited to participate, and 668 were enrolled. INTERVENTIONS/UNASSIGNED:Participants were randomly assigned to goal-directed incentives, outcome-based incentives, or a resources-only group. The resources-only group participants were given a 1-year commercial weight-loss program membership, self-monitoring tools (digital scale, food journal, and physical activity monitor), health education, and monthly one-on-one check-in visits. The goal-directed group included resources and linked financial incentives to evidence-based weight-loss behaviors. The outcome-based arm included resources and linked financial incentives to percentage of weight loss. Participants in the incentive groups could earn up to $750. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Proportion of patients achieving 5% or greater weight loss at 6 months. RESULTS/UNASSIGNED:The mean (SD) age of the 668 participants enrolled was 47.7 (12.4) years; 541 (81.0%) were women, 485 (72.6%) were Hispanic, and 99 (14.8%) were Black. The mean (SD) weight at enrollment was 98.96 (20.54) kg, and the mean body mass index (calculated as weight in kilograms divided by height in meters squared) was 37.95 (6.55). At 6 months, the adjusted proportion of patients who lost at least 5% of baseline weight was 22.1% in the resources-only group, 39.0% in the goal-directed group, and 49.1% in the outcome-based incentive group (difference, 10.08 percentage points [95% CI, 1.31-18.85] for outcome based vs goal directed; difference, 27.03 percentage points [95% CI, 18.20-35.86] and 16.95 percentage points [95% CI, 8.18-25.72] for outcome based or goal directed vs resources only, respectively). However, mean percentage of weight loss was similar in the incentive arms. Mean earned incentives was $440.44 in the goal-directed group and $303.56 in the outcome-based group, but incentives did not improve financial well-being. CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this randomized clinical trial, outcome-based and goal-directed financial incentives were similarly effective, and both strategies were more effective than providing resources only for clinically significant weight loss in low-income populations with obesity. Future studies should evaluate cost-effectiveness and long-term outcomes. TRIAL REGISTRATION/UNASSIGNED:ClinicalTrials.gov Identifier: NCT03157713.
PMID: 36469353
ISSN: 2168-6114
CID: 5378582

Effectiveness of Goal-Directed and Outcome-Based Financial Incentives for Weight Loss in Primary Care Patients With Obesity Living in Socioeconomically Disadvantaged Neighborhoods: A Randomized Clinical Trial (vol 183, pg 61, 2023) [Correction]

Ladapo, Joseph A.; Orstad, Stephanie L.; Wali, Soma; Wylie-Rosett, Judith; Tseng, Chi-Hong; Chung, Un Young Rebecca; Cuevas, Miguel A.; Hernandez, Christina; Parraga, Susan; Ponce, Robert; Sweat, Victoria; Wittleder, Sandra; Wallach, Andrew B.; Shu, Suzanne B.; Goldstein, Noah J.; Dapkins, Isaac; Jay, Melanie
ISI:000938839800002
ISSN: 2168-6106
CID: 5477662

The National Heart Lung and Blood Institute Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease Alliance

Kho, Abel; Daumit, Gail L; Truesdale, Kimberly P; Brown, Arleen; Kilbourne, Amy M; Ladapo, Joseph; Wali, Soma; Cicutto, Lisa; Matthews, Alicia K; Smith, Justin D; Davis, Paris D; Schoenthaler, Antoinette; Ogedegbe, Gbenga; Islam, Nadia; Mills, Katherine T; He, Jiang; Watson, Karriem S; Winn, Robert A; Stevens, June; Huebschmann, Amy G; Szefler, Stanley J
OBJECTIVE:To describe the NHLBI sponsored Disparities Elimination through Coordinated Interventions to Prevent and Control Heart and Lung Disease (DECIPHeR) Alliance to support late-stage implementation research aimed at reducing disparities in communities with high burdens of cardiovascular and/or pulmonary disease. STUDY SETTING/METHODS:NHBLI funded seven DECIPHeR studies and a Coordinating Center. Projects target high-risk diverse populations including racial and ethnic minorities, urban, rural and low-income communities, disadvantaged children, and persons with serious mental illness. Two projects address multiple cardiovascular risk factors, three focus on hypertension, one on tobacco use, and one on pediatric asthma. STUDY DESIGN/METHODS:The initial phase supports planning activities for sustainable uptake of evidence-based interventions in targeted communities. The second phase tests late-stage evidence-based implementation strategies. DATA COLLECTION/EXTRACTION METHODS/METHODS:not applicable. PRINCIPAL FINDINGS/RESULTS:We provide an overview of the DECIPHeR Alliance and individual study designs, populations and settings, implementation strategies, interventions and outcomes. We describe the Alliance's organizational structure, designed to promote cross-center partnership and collaboration. CONCLUSIONS:The DECIPHeR Alliance represents an ambitious national effort to develop sustainable implementation of interventions to achieve cardiovascular and pulmonary health equity.
PMID: 35383917
ISSN: 1475-6773
CID: 5204912

CAN ENGAGEMENT IN WEIGHT-LOSS BEHAVIORS HELP PRESERVE THE MENTAL HEALTH OF PATIENTS EXPERIENCING COVID-RELATED STRESS? [Meeting Abstract]

Gronda, Andres N.; Jay, Melanie; Adhiyaman, Akshitha; Wittleder, Sandra; Wali, Soma; Ladapo, Joseph A.; Orstad, Stephanie L.
ISI:000788118600131
ISSN: 0883-6612
CID: 5477642

IS HEALTH GOAL ADHERENCE HIGHER IF WEIGHT LOSS INTERVENTION PATIENTS ARE RANDOMIZED TO THEIR PREFERRED FINANCIAL INCENTIVE? [Meeting Abstract]

Adhiyaman, Akshitha; Orstad, Stephanie; Gronda, Andres N.; Jay, Melanie; Ladapo, Joseph; Wittleder, Sandra; Wali, Soma
ISI:000788118601417
ISSN: 0883-6612
CID: 5477652

Financial Incentives for Smoking Cessation in Hospitalized Patients: A Randomized Clinical Trial

Ladapo, Joseph A; Tseng, Chi-Hong; Sherman, Scott E
Background-Financial incentives for smoking cessation and use of evidence-based therapy may increase quit rates and reduce health and economic disparities. Methods-We randomized a low-income population of 182 hospitalized patients (mean age 58 years, 45% with high school education or less) to enhanced usual care, which included hospital-directed cessation care and Quitline referral, or enhanced usual care plus financial incentives. All patients received enhanced usual care, while participants randomized to the financial incentives group were also eligible to receive up to $550 for participation in Quitline counseling ($50), participation in a community-based cessation program ($50), use of pharmacotherapy ($50), and biochemically-confirmed smoking cessation at 2 months ($150) and 6 months ($250). Primary outcome was biochemically-confirmed smoking cessation at 6 months after hospital discharge. Results-Total mean payment was $84 (SD=$133) in the incentive group. The 6-month rate of biochemically-confirmed smoking cessation was 19.6% in the incentive group and 8.9% in the enhanced usual care group (odds ratio, 2.56; 95% CI, 0.84 to 7.83, P=0.10). Participants in the incentive group had higher rates of nicotine replacement therapy use (57.3% versus 31.3%, P=0.002). Financial incentives did not improve subjective social status but did increase financial stress. Conclusions-Rates of bioconfirmed smoking cessation were higher among hospitalized patients randomized to financial incentives compared to usual care alone, but the difference was not significant. Considering the frequency of low payouts and the importance of assistance for successful quitting, future studies should explore the effectiveness of financial incentives sufficiently large to overcome barriers to evidence-based therapy.
PMID: 31982494
ISSN: 1555-7162
CID: 4293762

ImPlementation REsearCh to DEvelop Interventions for People Living with HIV (the PRECluDE consortium): Combatting chronic disease comorbidities in HIV populations through implementation research

Gamble-George, Joyonna Carrie; Longenecker, Christopher T; Webel, Allison R; Au, David H; Brown, Arleen F; Bosworth, Hayden; Crothers, Kristina; Cunningham, William E; Fiscella, Kevin A; Hamilton, Alison B; Helfrich, Christian D; Ladapo, Joseph A; Luque, Amneris; Tobin, Jonathan N; Wyatt, Gail E
Antiretroviral therapy (ART) prevented premature mortality and improved the quality of life among people living with the human immunodeficiency virus (PLWH), such that now more than half of PLWH in the United States are 50 years of age and older. Increased longevity among PLWH has resulted in a significant rise in chronic, comorbid diseases. However, the implementation of guideline-based interventions for preventing, treating, and managing such age-related, chronic conditions among the HIV population is lacking. The PRECluDE consortium supported by the Center for Translation Research and Implementation Science at the National Heart, Lung, and Blood Institute catalyzes implementation research on proven-effective interventions for co-occurring heart, lung, blood, and sleep diseases and conditions among PLWH. These collaborative research studies use novel implementation frameworks with HIV, mental health, cardiovascular, and pulmonary care to advance comprehensive HIV and chronic disease healthcare in a variety of settings and among diverse populations.
PMID: 32199901
ISSN: 1873-1740
CID: 4421982

Competitiveness and Consistency Preferences Associated With Self-Monitoring in Patients With Obesity [Meeting Abstract]

Orstad, Stephanie; Jay, Melanie; Gerchow, Lauren; Wittleder, Sandra; Shu, Suzanne; Wali, Soma; Ladapo, Joseph
ISI:000585142900201
ISSN: 1930-7381
CID: 5477592