The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis

Emma Giles, Shannon Robalino, Elaine McColl, Falko Sniehotta, Jean M. Adams

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    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. Metaregression 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 postintervention 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.
    Original languageEnglish
    JournalPLoS ONE
    Volume9
    Issue number3
    DOIs
    Publication statusPublished - 11 Mar 2014

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