The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis
Open accessAbstract
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.
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- Authors
- Giles, E. L., Robalino, S., McColl, E., Sniehotta, F. F., & Adams, J.
- Affiliations
- Newcastle University (GB)
- Corresponding author
- Giles, Emma L.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-03-11
- Volume
- 9
- Issue
- 3
- Pages
- e90347
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3949711
- OpenAlex
- W2001401696
- Cited by
- 470
- References
- 88
- Citations by year
- 2026: 19 · 2025: 32 · 2024: 25 · 2023: 32 · 2022: 44 · 2021: 46 · 2020: 90 · 2019: 41 · 2018: 46 · 2017: 29 · 2016: 31 · 2015: 30 · 2014: 5
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Teesside University Research Portal (Teesside University) (acceptedVersion, cc-by-nc-nd)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Newcastle University ePrints (Newcastle Univesity) (cc-by)
- Funders
- United Kingdom Clinical Research Collaboration
- Cancer Research UK
- National Institute for Health and Care Research (CDF-2011-04-001)
- British Heart Foundation
- Medical Research Council (MR/K02325X/1)
- Economic and Social Research Council
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- financial incentives, behavior change, smoking cessation, vaccine uptake, screening uptake, physical activity, incentive value, follow-up duration, non-clinical adults, health promotion
- MeSH terms
- Follow-Up Studies, Humans, Motivation, Motor Activity, Registries, Risk, Health Behavior, Odds Ratio, Databases, Factual, Smoking Cessation
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