Financial incentives can help motivate people to make lifestyle changes

Mantzari E, Vogt F, Schemilt I, et al. Personal financial incentives for changing habitual health-related behaviors: A systematic review and meta-analysis Prev Med. 2015;75:75-85.

Review question

Do financial incentives help motivate people to adopt healthy lifestyle behaviours?

Background

Smoking, poor diet, excessive alcohol consumption, and physical inactivity can lead to serious and preventable health issues such as cardiovascular disease, type 2 diabetes, cancer and respiratory disease. Financial incentives can help motivate people to change health-related behaviours for the better. More research is needed to learn how best to use financial incentives to encourage long-term behaviour changes, particularly after the incentive is removed.

How the review was done

The researchers did a systematic review and meta-analysis of 34 randomized controlled trials, which included over 10,500 adult participants. The included studies were of moderate quality.

Key features of studies included in this review:

• People were offered financial incentives (vouchers, cash or lottery) to change behaviours such as smoking (19 studies), healthier eating and/or physical activity (15 studies)
• Incentives were offered for 3 weeks to 18 months (depending on the study)
• Behaviour changes were compared to control groups offered the same treatment without financial incentives
• Most studies (30 of 34) offered incentives along with other options to change behaviours, such as counselling, self-help books and professional advice

What the researchers found

Financial incentives led to behaviour changes for up to 18 months. However, these benefits weakened over time and lasted less than 3 months after the incentives were removed. These results were consistent regardless of the target health behaviour, or the value or type of incentive offered.  Incentives to quit smoking had the longest impact on behaviour change (up to 3 months after incentive was removed). Incentives were more effective when offered to people who were more financially deprived.

Financial incentives may be a useful way to encourage people to make initial health behaviour changes, but are unlikely to lead to new habits and healthier lifestyles in the long-term.  It is not known whether financial incentives work better than other strategies to promote healthier lifestyles, but incentives may be useful if used in combination with other approaches that promote long-term behaviour change and prevent relapses. 

Conclusion

Personal financial incentives can lead to short-term changes in health-related behaviors (smoking, healthier eating and physical activity). However, the effects did not last after the incentives were removed and this approach is unlikely to lead to long-term changes in health behaviours.