CAN MONEY MOTIVATE FIREFIGHTERS TO EXERCISE?
BY AMBER ROUND, B.S., AND DICK GREEN, Ed.D.
Motivation can broadly be defined as actively seeking out, approaching, or having an attraction to certain situations and the amount of effort put forth by an individual.1 There are two sources of motivation, intrinsic and extrinsic. Those who are intrinsically motivated strive inwardly for competence to master a task. They typically enjoy competition, action, and excitement and focus on fun and learning skills. Extrinsically motivated individuals receive positive and negative reinforcement from others to increase motivation, enhance learning, and increase desire to participate. (1)
Behavior can be influenced and modified using various strategies of motivation. Some strategies may include environmental cues or prompts, social support, goal setting, written agreements/contracts, and reinforcements such as feedback and self-offered and externally offered rewards. Such strategies are implemented by companies to encourage greater work attendance, increase client load, increase employee output, improve performance, or increase involvement.2,3
One strategy of interest is the use of monetary incentives. The effects of money as an award have been the subject of many studies involving companies and their employees over the years. The FACTS survey found that 46 percent of eligible employees receiving monetary awards for their performance exceeded the company goals. The values of rewards offered, cash and noncash, ranged from $1 to $6,000. One appliance distributor found the incentive program helped emphasize teamwork and meeting quotas. The company also discovered that morale and business were down when the incentive program was not used. A nursing home offering from $25 to $500 value awards felt the incentives “turned the company around, reduced staff turnover, and increased sales from $6 million to $8 million.” (3, page 46) Incentive awards of $15 to $1,000 in value have resulted in “improved efficiency of production personnel U and reduced lost-time accidents over 48 percent” for one chemical manufacturer. (3, page 46)
Turner reported eight companies that felt money is the only method of motivation whether through commission, bonus, or a combination of methods. According to Turner, the co-owner of The Barn Nursery & Landscape Center, the commission and salary combination had been the most effective, resulting in increased sales and improved quality.4
Exercise is another behavior that can be influenced through motivational techniques.5,6 The role of motivation in exercise is to drive the individual toward initiating and maintaining participation in exercise. Robison and Rogers listed lack of motivation as one of the most common characteristics of those who lack adherence to exercise.7
Various forms of intrinsic and extrinsic motivation are used in promoting exercise adherence. Intrinsic motivation may include participation because of self-motivation, desire to master a task, love of sport/exercise, and pride. Extrinsic motivators include T-shirts, trophies, gift certificates, travel opportunities, lottery (drawings/prizes), and money.
MONEY AS AN INCENTIVE
An increase in exercise adherence and participation was demonstrated in several studies where money was used as the incentive. Epstein et al found greater exercise attendance when lottery was used as the incentive.8 Robison reported an overall exercise adherence of 97 percent when money was the incentive as opposed to 19 percent adherence by the control group.9 Garofalo presented the Wellchallynge program in which the grand prize was a four-day Caribbean cruise for two. Of the 638 participants, 81.5 percent completed at least 10 weeks of the 12-week program, 99.1 percent felt they would continue to exercise, 93.5 percent said they would participate again the next year, and 62.4 percent reported that the incentives motivated them. Prior to Wellchallynge, 63 percent of employees exercised approximately two times a week. With the implementation of the program, 75.7 percent of employees exercised at least three times per week.10
Despite the findings that support money as a motivator, several studies have also found that monetary incentives are unsuccessful motivators. Turner found monetary incentives unnecessary and harmful and believed intrinsic motivation to be the best. (4) Leibman and Weinstein suggest money should not be the focus of the employee; the focus should be on improved customer service and higher quality products.11 Frederick, Morrison, and Manning suggest extrinsic motivation may actually have a negative influence and cause pressure, anxiety, and lack of enjoyment, ultimately leading to quitting exercise entirely.12
Studies examining the effects of monetary rewards for weight loss also suggest that money is not an effective motivator. Jeffery et al found that monetary rewards had no effect on weight loss whether used alone or with another form of motivation. (6) Wing et al found no significant increase in exercise adherence when money or lottery tickets were the reward. The focus of this study was to determine whether a monetary incentive would be effective in motivating professional firefighters to participate in a fitness program.13
Twenty-six professional male firefighters with mean age of 33.3 years +/16.7 and weight 195.9 pounds +/14.3 from a small northwest county fire district were presented with the opportunity to participate in the study. Two firefighters opted not to participate, and three firefighters dropped from the program after six months. Eighteen of the 26 eligible firefighters completed all testing sessions. Prior to testing, all participating firefighters signed an informed consent, and approval for testing was obtained from the Gonzaga University Human Subjects Committee.
A voluntary fitness testing program was initiated for the fire district. Firefighters had the potential to earn up to $1,200/year to improve and/or maintain their fitness level. In most cases, the firefighters had the option to use an allotted time during their shift. Various strength and aerobic machines were available at each work site; however, no form of exercise prescription or monitoring of exercise progress was implemented. Each firefighter could receive a maximum of $100/month for averaging above the 80th percentile of established norms for various fitness tests. Those scoring at least at the 50th percentile received $50/month. Regardless of their score, all firefighters received $50/month for the first six months.
Fitness tests included measures of cardiovascular endurance, body composition, flexibility, and muscular endurance and strength. Tests were performed quarterly. Each participant scheduled an appointment for testing with a qualified fitness coordinator at a local physical therapy clinic. At the start of each testing session, the participant`s age, height, weight, resting heart rate, and blood pressure were recorded. Bioelectrical impedance was conducted using the Biodynamics Model 310 to measure body composition. Maximal oxygen consumption (VO2max) was predicted using submaximal data from the Modified Bruce Protocol for the treadmill.
Muscular endurance was tested with the performance of push-ups and curl-ups; the maximum number completed were recorded. A correct push-up was defined as starting in the up position, lowering to a point where the chest touched the technician`s fist, and then pushing back up until the elbows were straight. The subjects performed as many as they could without stopping. Curl-ups were performed lying on the back, knees bent, and feet flat on the floor. Participants curled up with palms of the hands flat on the floor until fingers touched a tape strip placed seven inches from the participant`s fingertips. Participants attempted as many curl-ups as possible without pausing.
The sit-and-reach test was used to measure hamstring flexibility. Subjects sat on the floor with shoes off and feet flat against the resting apparatus, shoulder width apart, with legs fully extended. Participants extended arms forward along the measuring scale as far as possible without flexing the knees. The best of three attempts was recorded. Grip strength was measured in pounds on both right and left hands using the Jamar Grip Dynamometer. Upper arm was vertical, and forearm was positioned between 90 and 180 degrees, alternating hands between trials. An average of three trials for each hand was recorded. Static lift tests for the arms and torso were performed using a prototype machine for Joint Specific Strength Test (JSST). To measure arm strength, participants stood upright with the handle adjusted to a height at which the elbows were flexed to 90 degrees. Forearms were supinated. Participants were instructed to lift straight upward against a fixed resistance and hold for five seconds. The average of three trials was recorded. The static lift was again used to measure torso strength. Participants were in a partial squat position (depending on their body mechanics), and the bar was set at the level of the participants` knees in standing (roughly 50 cm from the floor). The participants were instructed to grasp the handle with their hands in between their knees and lift upward against a fixed resistance, holding for five seconds. The average of three trials was recorded.
Initial testing revealed a relatively sedentary, overly fat (19.5 percent +/15.5 percent fat, mean +/1SD) group of younger men. Significant differences (p<.001) occurred in diastolic blood pressure (78.1 vs. 72.2), RHR (71.0 vs. 65.8, p<.002), curl-ups (35.1 vs. 49.5, p<.001), and flexibility (17.7 vs. 19.5, p<.001). There were no significant differences in any measures of strength (static arm lift, hand grip, leg/torso), body composition, body weight, or submaximal VO2. Statistical significance was determined using the simple t-test, with p<.05 as the desired level of significance.
The results of the first year of this study did not support the hypothesis that money serves as a motivator to exercise, contradictory to the work of Epstein and Garofalo. The present study focused on money as an incentive and did not examine other possible motivators. The monetary incentive may not have been of sufficient amount for this specific population to provide substantial results. Along with the monetary incentive, Epstein (8), Garofalo (10), and Robison (9) incorporated structured fitness programs in which participants exercised in teams/groups at specified times. Participants were given specific exercise programs to follow and oftentimes were required to submit a record of exercise. Incorporating these aspects in the continuation of this study could help strengthen the findings.
MONEY NOT EFFECTIVE
Based on the result, it appears that monetary incentive is not effective in bringing about change for this specific population, whose fitness level is fundamental to their work. These data suggest that even the potential of earning $1,200 per year was not sufficient incentive for this group to participate in regular activity to a degree where typical fitness components were improved. It may be necessary to look at increasing the amount of money offered or other forms of incentives.
Several factors may have influenced the firefighters` motivation to exercise. The location of the clinic where the testing was conducted was inconvenient for many participants. The program did not require participants to keep a record of exercise outside of the testing, and no personal trainer was assigned or exercise program designed for the participants.
Some of the firefighters may have concern for job security. If programs such as this one continue, they may fear that higher standards of fitness, which they may be unable or unwilling to attain, will become the norm. This is an issue before many departments and union representatives today as they attempt to determine whether fitness can be a prerequisite for employment.
Changes that have been proposed for year two include personalized training programs, greater emphasis on educating groups on the benefits of exercise, making testing sessions more convenient, and attempting to develop a collaborative effort with the local university Exercise Science Department. Increasing the monetary incentive has also been discussed. Our hope is that next year we can show much improved data. n
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13. Wing, R.R. and others, “Effects of a personal trainer and financial incentives on exercise adherence in overweight women in a behavioral weight loss program,” Obesity Research, 1996; 4:5, 457-462.
(Top left) Hand-grip dynamometer. (Photos by Dick Green.) (Top right) Continuous push-up. (Bottom left) In the electrical impedence method of determining the level of body fat, electrodes are attached to the wrist and ankle, low-voltage current passes through bodily tissue, and the amount of resistance encountered is assessed. (Bottom right) Modified sit-and-reach.
n AMBER ROUND, B.S., is a recent graduate from the Exercise Science program of Gonzaga University, Spokane, Washington.
n DICK GREEN, Ed.D., is assistant professor at Gonzaga University Exercise Science Department, a volunteer firefighter, and an EMT.