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PLoS One. 2014 Mar 11;9(3):e90347. doi: 10.1371/journal.pone.0090347. eCollection 2014.

The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis.

Author information

1
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
2
Newcastle Clinical Trials Unit, Institute of Health and Society, Newcastle University, The Medical School, Framlington Place, Newcastle upon Tyne, Tyne and Wear, United Kingdom.

Abstract

BACKGROUND:

Financial incentive interventions have been suggested as one method of promoting healthy behaviour change.

OBJECTIVES:

To conduct a systematic review of the effectiveness of financial incentive interventions for encouraging healthy behaviour change; to explore whether effects vary according to the type of behaviour incentivised, post-intervention follow-up time, or incentive value.

DATA SOURCES:

Searches were of relevant electronic databases, research registers, www.google.com, and the reference lists of previous reviews; and requests for information sent to relevant mailing lists.

ELIGIBILITY CRITERIA:

Controlled evaluations of the effectiveness of financial incentive interventions, compared to no intervention or usual care, to encourage healthy behaviour change, in non-clinical adult populations, living in high-income countries, were included.

STUDY APPRAISAL AND SYNTHESIS:

The Cochrane Risk of Bias tool was used to assess all included studies. Meta-analysis was used to explore the effect of financial incentive interventions within groups of similar behaviours and overall. Meta-regression was used to determine if effect varied according to post-intervention follow up time, or incentive value.

RESULTS:

Seventeen papers reporting on 16 studies on smoking cessation (n = 10), attendance for vaccination or screening (n = 5), and physical activity (n = 1) were included. In meta-analyses, the average effect of incentive interventions was greater than control for short-term (≤ six months) smoking cessation (relative risk (95% confidence intervals): 2.48 (1.77 to 3.46); long-term (>six months) smoking cessation (1.50 (1.05 to 2.14)); attendance for vaccination or screening (1.92 (1.46 to 2.53)); and for all behaviours combined (1.62 (1.38 to 1.91)). There was not convincing evidence that effects were different between different groups of behaviours. Meta-regression found some, limited, evidence that effect sizes decreased as post-intervention follow-up period and incentive value increased. However, the latter effect may be confounded by the former.

CONCLUSIONS:

The available evidence suggests that financial incentive interventions are more effective than usual care or no intervention for encouraging healthy behaviour change.

TRIAL REGISTRATION:

PROSPERO CRD42012002393.

PMID:
24618584
PMCID:
PMC3949711
DOI:
10.1371/journal.pone.0090347
[Indexed for MEDLINE]
Free PMC Article

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