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A growing body of evidence has shown that incorporating behavioral economicsprinciples into the design of financial incentive programs helps improve theircost-effectiveness, promote individuals' short-term engagement, and increasecompliance in health behavior interventions. Yet, their effects on long-termengagement have not been fully examined. In study designs where repeatedadministration of incentives is required to ensure the regularity of behaviors,the effectiveness of subsequent incentives may decrease as a result of the lawof diminishing marginal utility. In this paper, we introduce random-lossincentive -- a new financial incentive based on loss aversion andunpredictability principles -- to address the problem of individuals' growinginsensitivity to repeated interventions over time. We evaluate the newincentive design by conducting a randomized controlled trial to measure theinfluences of random losses on participants' dietary self-tracking andself-reporting compliance using a mobile web application called Eat & Tell. Theresults show that random losses are significantly more effective than fixedlosses in encouraging long-term engagement.

Eat & Tell: A Randomized Trial of Random-Loss Incentive to Increase Dietary Self-Tracking Compliance