The Financial Incentives for Weight Reduction (FIReWoRk) trial assessed the comparative effectiveness of financial incentives on the attainment of weight loss goals among adult patients (aged 18 to 70 years old) with obesity from neighborhoods with low socioeconomic status in New York City and Los Angeles. Eligible patients were identified at 3 primary care locations: NYC Health+Hospitals – Bellevue, Sunset Park Family Health Center at NYU Langone Hospital – Brooklyn, and OliveView UCLA Medical Center.

A total of 668 participants were consented and randomly assigned into one of three study arms: intervention with outcome-based financial incentives, intervention with goal-directed financial incentives, and intervention with behavior-change resources only. Participants who were randomized into programs with financial incentives and met requisite goals or outcomes received payments during the first 6 months of follow-up. Biometric and survey data were collected at multiple intervals: baseline, after 30 days, and at 2, 3, 4, 5, 6, 9 and 12 months for a total follow-up period of 12 months.

Study measures include:

• Height and weight
• Waist circumference
• Blood pressure
• Lipids and Hemoglobin A1c (HbA1c)
• Sociodemographics and financial well-being
• Chronic health conditions
• Quality of life
• Diet and dietary changes
• Alcohol and tobacco use
• Physical activity (via survey and Fitbit monitoring)
• Self-efficacy
• Outcome expectations
• Intrinsic motivation
• Attendance of a weight loss program
• Hospitalizations and emergency room visits
• Adverse events