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

Research output: Contribution to journalArticleResearchpeer-review

24 Downloads (Pure)

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

Fingerprint

economic incentives
Health Behavior
systematic review
behavior change
meta-analysis
Meta-Analysis
Motivation
Screening
Health
group behavior
Smoking Cessation
vaccination
screening
relative risk
economic valuation
physical activity
Vaccination
electronics
confidence interval
health behavior

Bibliographical note

This is an open-access article distributed under the terms of the Creative Commons Attribution License.

Cite this

Giles, Emma ; Robalino, Shannon ; McColl, Elaine ; Sniehotta, Falko ; Adams, Jean M. / The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis. In: PLoS ONE. 2014 ; Vol. 9, No. 3.
@article{f078d66ca0444192b82714cd19f803ed,
title = "The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis",
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-interventionfollow-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-incomecountries, 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.",
author = "Emma Giles and Shannon Robalino and Elaine McColl and Falko Sniehotta and Adams, {Jean M.}",
note = "This is an open-access article distributed under the terms of the Creative Commons Attribution License.",
year = "2014",
month = "3",
day = "11",
doi = "10.1371/journal.pone.0090347",
language = "English",
volume = "9",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "3",

}

The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis. / Giles, Emma; Robalino, Shannon; McColl, Elaine; Sniehotta, Falko; Adams, Jean M.

In: PLoS ONE, Vol. 9, No. 3, 11.03.2014.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis

AU - Giles, Emma

AU - Robalino, Shannon

AU - McColl, Elaine

AU - Sniehotta, Falko

AU - Adams, Jean M.

N1 - This is an open-access article distributed under the terms of the Creative Commons Attribution License.

PY - 2014/3/11

Y1 - 2014/3/11

N2 - 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-interventionfollow-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-incomecountries, 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.

AB - 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-interventionfollow-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-incomecountries, 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.

U2 - 10.1371/journal.pone.0090347

DO - 10.1371/journal.pone.0090347

M3 - Article

VL - 9

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 3

ER -