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Prev Med. 2015 Jun;75:75-85. doi: 10.1016/j.ypmed.2015.03.001. Epub 2015 Apr 2.

Personal financial incentives for changing habitual health-related behaviors: A systematic review and meta-analysis.

Author information

1
Health Psychology Section, King's College London, London, UK. Electronic address: em578@medschl.cam.ac.uk.
2
Institute of Pharmaceutical Science, King's College London, London, UK. Electronic address: me@fvogt.net.
3
Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK. Electronic address: ids29@medschl.cam.ac.uk.
4
MRC Clinical Trials Unit Hub for Trials Methodology Research, MRC Clinical Trials Unit, London, UK. Electronic address: yinghui.wei@plymouth.ac.uk.
5
School of Social and Community Medicine, University of Bristol, Bristol UK; Centre for Reviews and Dissemination, University of York, York, UK. Electronic address: Julian.higgins@bristol.ac.uk.
6
Health Psychology Section, King's College London, London, UK; Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK. Electronic address: tm388@medschl.cam.ac.uk.

Abstract

OBJECTIVES:

Uncertainty remains about whether personal financial incentives could achieve sustained changes in health-related behaviors that would reduce the fast-growing global non-communicable disease burden. This review aims to estimate whether: i. financial incentives achieve sustained changes in smoking, eating, alcohol consumption and physical activity; ii. effectiveness is modified by (a) the target behavior, (b) incentive value and attainment certainty, (c) recipients' deprivation level.

METHODS:

Multiple sources were searched for trials offering adults financial incentives and assessing outcomes relating to pre-specified behaviors at a minimum of six months from baseline. Analyses included random-effects meta-analyses and meta-regressions grouped by timed endpoints.

RESULTS:

Of 24,265 unique identified articles, 34 were included in the analysis. Financial incentives increased behavior-change, with effects sustained until 18months from baseline (OR: 1.53, 95% CI 1.05-2.23) and three months post-incentive removal (OR: 2.11, 95% CI 1.21-3.67). High deprivation increased incentive effects (OR: 2.17; 95% CI 1.22-3.85), but only at >6-12months from baseline. Other assessed variables did not independently modify effects at any time-point.

CONCLUSIONS:

Personal financial incentives can change habitual health-related behaviors and help reduce health inequalities. However, their role in reducing disease burden is potentially limited given current evidence that effects dissipate beyond three months post-incentive removal.

KEYWORDS:

Financial incentives; Health promotion; Health-related behavior; Meta-analysis; Systematic review

PMID:
25843244
PMCID:
PMC4728181
DOI:
10.1016/j.ypmed.2015.03.001
[Indexed for MEDLINE]
Free PMC Article

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