Elsevier

Preventive Medicine

Volume 75, June 2015, Pages 75-85
Preventive Medicine

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

https://doi.org/10.1016/j.ypmed.2015.03.001Get rights and content
Under a Creative Commons license
open access

Highlights

  • Sustained changes in health behaviours would reduce non-communicable disease burden.

  • Personal financial incentives can change habitual health-behaviours.

  • Personal financial incentives may help reduce health inequalities.

  • The impact of financial incentives is not sustained long after incentive removal.

  • The role of financial incentives in reducing disease burden is potentially limited.

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 18 months 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 > 6–12 months 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-related behavior
Systematic review
Meta-analysis
Health promotion

Cited by (0)

1

Present address: Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK.

2

Present address: School of Computing and Mathematics, Plymouth University, UK.