Behavioral Strategies

Behavioral strategies for obesity and prevention control focus on teaching behavioral management skills and structuring the social environment to provide support for people trying to initiate or maintain weight change. Strategies often include individual or group behavioral counseling and will often involve coworkers, family members, and other intermediaries who are part of an individual's social environment. Behavioral methods may involve modeling or demonstration, participatory skill development, individual benchmarking (i.e., goal-setting and achievement), providing feedback, providing incentives or disincentives, or providing materials necessary to enhance the desired behavior (e.g., pedometer, food journals).

Promising Practice: Behavioral Practices With Incentives

Behavioral practices teach behavioral management skills, modeling or demonstration, participatory skill development, and individual benchmarking (i.e., goal-setting and achievement), and provide feedback and building social support for behavioral patterns. Such practices are complemented by in-kind or financial incentives, typically given for participation and completion of the program.

Evidence of Effectiveness

We identified 17 studies that evaluated the effectiveness of the use of behavioral practices with incentives.^{29, 86-102} Fourteen studies^{29, 85-90, 92-96, 98, 99} measured weight, with a median effect size of −6.24 lbs.

Promising Practice: Behavioral Practices Without Incentives

These programs teach participants specific behavioral skills that enable them to incorporate physical activity and improve their nutrition through modeling or demonstration, participatory skill development, individual benchmarking (i.e., goal-setting and achievement), feedback, and building social support for behavioral patterns. These programs did not offer incentives. The typical behavioral practice consisted of one-on-one or group consultations with personalized goals or plan of action to improve employees' nutrition, increase their physical activity, or help them lose weight..

Evidence of Effectiveness

We identified 47 studies that evaluated the effectiveness of the use of behavioral practices without incentives.^{59, 103-148} Thirty-four studies^{59, 103, 104, 106-109, 111, 114-117, 120, 122, 123, 125, 127-130, 132-136, 138, 139, 142-148} measured weight, with a median effect size of –5.81 lbs. Seven studies^{118, 121, 124, 126, 131, 137, 141} reported a BMI change with a median effect size of –0.24 kg/m².

Promising Practice: Weight-Loss Competitions and Incentives

Competitions and incentives consist of rewards for weight loss and behavioral change to increase physical activity or improve nutrition. The rewards can be in-kind, financial, or the honor or pride of winning. The incentives can vary in size and by type and can be used for screening, enrollment, compliance (i.e., staying in the program), completion of the program, and maintenance of the changes after completion of the program.
*These practices do not include teaching behavioral management skills, modeling or demonstration, or participatory skill development.

Evidence of Effectiveness

We identified 16 studies that evaluated the effectiveness of the use of competitions and incentives.^149-164 Twelve studies^{149-156, 160-163} measured weight, with a median effect size of –6.51 lbs. Two studies^{157, 164} measured percent body fat with skinfold measurements and reported a median effect size of –1.58%.

Additional Resources

Partnership for Prevention's Investing in Health: Proven Health Promotion Practices for Workplaces* (PDF-1.7Mb)
This resource will help workplaces of all sizes choose effective health promotion practices at work. See Physical Activity and Nutrition. p.15.

Also in This Section

• Environmental and Policy Strategies
• Health Educational Strategies
• Additional Strategies

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