The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis
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{"title"=>"The effectiveness of financial incentives for health behaviour change: Systematic review and meta-analysis", "type"=>"generic", "authors"=>[{"first_name"=>"Emma L.", "last_name"=>"Giles", "scopus_author_id"=>"55651052000"}, {"first_name"=>"Shannon", "last_name"=>"Robalino", "scopus_author_id"=>"55650755000"}, {"first_name"=>"Elaine", "last_name"=>"McColl", "scopus_author_id"=>"7003798747"}, {"first_name"=>"Falko F.", "last_name"=>"Sniehotta", "scopus_author_id"=>"8550046900"}, {"first_name"=>"Jean", "last_name"=>"Adams", "scopus_author_id"=>"7404784266"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84897550170", "pmid"=>"24618584", "pui"=>"372764225", "isbn"=>"1932-6203", "scopus"=>"2-s2.0-84897550170", "doi"=>"10.1371/journal.pone.0090347", "issn"=>"19326203"}, "id"=>"9b5ad046-6131-315d-bea8-9966c05bd7c9", "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. 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.", "link"=>"http://www.mendeley.com/research/effectiveness-financial-incentives-health-behaviour-change-systematic-review-metaanalysis-2", "reader_count"=>156, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>4, "Researcher"=>30, "Student > Doctoral Student"=>16, "Student > Ph. D. Student"=>28, "Student > Postgraduate"=>8, "Student > Master"=>36, "Other"=>10, "Student > Bachelor"=>15, "Lecturer"=>3, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>4, "Researcher"=>30, "Student > Doctoral Student"=>16, "Student > Ph. D. Student"=>28, "Student > Postgraduate"=>8, "Student > Master"=>36, "Other"=>10, "Student > Bachelor"=>15, "Lecturer"=>3, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>12, "Agricultural and Biological Sciences"=>5, "Business, Management and Accounting"=>6, "Computer Science"=>6, "Decision Sciences"=>1, "Economics, Econometrics and Finance"=>17, "Engineering"=>2, "Nursing and Health Professions"=>9, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>45, "Neuroscience"=>1, "Sports and Recreations"=>1, "Psychology"=>25, "Social Sciences"=>24}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>45}, "Social Sciences"=>{"Social Sciences"=>24}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>25}, "Unspecified"=>{"Unspecified"=>12}, "Engineering"=>{"Engineering"=>2}, "Neuroscience"=>{"Neuroscience"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>17}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>5}, "Computer Science"=>{"Computer Science"=>6}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>6}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>9}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}}, "reader_count_by_country"=>{"Romania"=>1, "United States"=>3, "United Kingdom"=>4, "South Africa"=>1, "Australia"=>1, "Indonesia"=>1}, "group_count"=>12}

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  • {"files"=>["https://ndownloader.figshare.com/files/1415483"], "description"=>"<p>Flow diagram of study selection and exclusion.</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "diagram"], "article_id"=>958293, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g001", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_of_study_selection_and_exclusion_/958293", "title"=>"Flow diagram of study selection and exclusion.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415506"], "description"=>"<p>Meta-regression of follow-up point on relative risk, all behaviours (latest follow-up point).</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "follow-up", "behaviours"], "article_id"=>958310, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g015", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_of_follow_up_point_on_relative_risk_all_behaviours_latest_follow_up_point_/958310", "title"=>"Meta-regression of follow-up point on relative risk, all behaviours (latest follow-up point).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415502"], "description"=>"<p>Meta-regression of incentive value on relative risk, attendance at vaccination & screening.</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "vaccination"], "article_id"=>958306, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g012", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_of_incentive_value_on_relative_risk_attendance_at_vaccination_amp_screening_/958306", "title"=>"Meta-regression of incentive value on relative risk, attendance at vaccination & screening.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415490"], "description"=>"<p>Meta-regression of follow-up period on relative risk, smoking cessation (follow-up >six months).</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "follow-up", "smoking", "cessation"], "article_id"=>958300, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g007", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_of_follow_up_period_on_relative_risk_smoking_cessation_follow_up_gt_six_months_/958300", "title"=>"Meta-regression of follow-up period on relative risk, smoking cessation (follow-up >six months).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415510", "https://ndownloader.figshare.com/files/1415511", "https://ndownloader.figshare.com/files/1415512", "https://ndownloader.figshare.com/files/1415513", "https://ndownloader.figshare.com/files/1415514"], "description"=>"<div><p>Background</p><p>Financial incentive interventions have been suggested as one method of promoting healthy behaviour change.</p><p>Objectives</p><p>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.</p><p>Data Sources</p><p>Searches were of relevant electronic databases, research registers, <a href=\"http://www.google.com\" target=\"_blank\">www.google.com</a>, and the reference lists of previous reviews; and requests for information sent to relevant mailing lists.</p><p>Eligibility Criteria</p><p>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.</p><p>Study Appraisal and Synthesis</p><p>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.</p><p>Results</p><p>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.</p><p>Conclusions</p><p>The available evidence suggests that financial incentive interventions are more effective than usual care or no intervention for encouraging healthy behaviour change.</p><p>Trial Registration</p><p>PROSPERO <a href=\"http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42012002393#.Uv7D-7RFA7A\" target=\"_blank\">CRD42012002393</a></p></div>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "incentives", "behaviour", "systematic"], "article_id"=>958314, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0090347.s001", "https://dx.doi.org/10.1371/journal.pone.0090347.s002", "https://dx.doi.org/10.1371/journal.pone.0090347.s003", "https://dx.doi.org/10.1371/journal.pone.0090347.s004", "https://dx.doi.org/10.1371/journal.pone.0090347.s005"], "stats"=>{"downloads"=>4, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Effectiveness_of_Financial_Incentives_for_Health_Behaviour_Change_Systematic_Review_and_Meta_Analysis_/958314", "title"=>"The Effectiveness of Financial Incentives for Health Behaviour Change: Systematic Review and Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415485"], "description"=>"<p>Meta-analysis of financial incentives for smoking cessation (follow-up ≤six months).</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "incentives", "smoking", "cessation"], "article_id"=>958295, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g003", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_financial_incentives_for_smoking_cessation_follow_up_8804_six_months_/958295", "title"=>"Meta-analysis of financial incentives for smoking cessation (follow-up ≤six months).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415486"], "description"=>"<p>Meta-regression of follow-up period on relative risk, smoking cessation (follow-up </p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "follow-up", "smoking", "cessation"], "article_id"=>958296, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g004", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_regression_of_follow_up_period_on_relative_risk_smoking_cessation_follow_up_lt_six_months_/958296", "title"=>"Meta-regression of follow-up period on relative risk, smoking cessation (follow-up", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415505"], "description"=>"<p>Meta-analysis of financial incentives for all behaviours (latest follow-up point).</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "incentives", "behaviours", "follow-up"], "article_id"=>958309, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g014", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_financial_incentives_for_all_behaviours_latest_follow_up_point_/958309", "title"=>"Meta-analysis of financial incentives for all behaviours (latest follow-up point).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415484"], "description"=>"<p>Risk of bias in included studies.</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "included"], "article_id"=>958294, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g002", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_of_bias_in_included_studies_/958294", "title"=>"Risk of bias in included studies.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415504"], "description"=>"<p>Contour enhanced funnel plot, attendance at vaccination and screening.</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "enhanced", "funnel", "vaccination"], "article_id"=>958308, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g013", "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Contour_enhanced_funnel_plot_attendance_at_vaccination_and_screening_/958308", "title"=>"Contour enhanced funnel plot, attendance at vaccination and screening.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415501"], "description"=>"<p>Meta-analysis of financial incentives for attendance at vaccination and screening.</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "incentives", "vaccination"], "article_id"=>958305, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g011", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Meta_analysis_of_financial_incentives_for_attendance_at_vaccination_and_screening_/958305", "title"=>"Meta-analysis of financial incentives for attendance at vaccination and screening.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/1415499"], "description"=>"<p>Contour enhanced funnel plot, smoking cessation (follow-up ≤six months).</p>", "links"=>[], "tags"=>["Clinical research design", "meta-analyses", "Systematic reviews", "Non-clinical medicine", "Health care policy", "Comparative effectiveness research", "Public health", "alcohol", "Behavioral and social aspects of health", "Health screening", "immunizations", "preventive medicine", "tobacco control", "psychology", "Cognitive psychology", "motivation", "enhanced", "funnel", "smoking", "cessation"], "article_id"=>958303, "categories"=>["Medicine", "Sociology"], "users"=>["Emma L. Giles", "Shannon Robalino", "Elaine McColl", "Falko F. Sniehotta", "Jean Adams"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0090347.g009", "stats"=>{"downloads"=>2, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Contour_enhanced_funnel_plot_smoking_cessation_follow_up_8804_six_months_/958303", "title"=>"Contour enhanced funnel plot, smoking cessation (follow-up ≤six months).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-03-11 03:25:26"}

PMC Usage Stats | Further Information

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