Our primary conclusion is that there is a lack of compelling evidence that incentives of any form represent a compelling NCD reduction strategy .
The rising epidemic of non-communicable diseases ( NCDs ) poses substantial health and economic challenges to both individuals and society .
Application of incentive-based strategies based on traditional and behavioural economic theory has emerged as a potential strategy to address rising rates of NCDs .
Yet , whether or not incentives truly represent a promising strategy for addressing NCDs has not been systematic ally addressed nor is it clear whether certain behavioural economic strategies outperform others or simply offering a cash-based incentive for meeting a goal .
In this systematic review we aim to determine whether there is an evidence base for any of these strategies .
A Trial of Financial and Social Incentives to Increase Older Adults' Walking.
INTRODUCTION Despite evidence that regular physical activity confers health benefits , physical activity rates among older adults remain low . Both personal and social goals may enhance older adults ' motivation to become active . This study tested the effects of financial incentives , donations to charity , and the combined effects of both interventions on older adults ' uptake and retention of increased levels of walking . STUDY DESIGN RCT comparing three interventions to control . Data collection occurred from 2012 to 2013 . Analyses were conducted in 2013 - 2016 . PARTICIPANTS Ninety-four adults aged ≥65 years from Philadelphia-area retirement communities . INTERVENTION All participants received digital pedometers , walking goals of a 50 % increase in daily steps , and weekly feedback on goal attainment . Participants were r and omized to one of four groups : ( 1 ) Control : received weekly feedback only ; ( 2 ) Financial Incentives : received payment of $ 20 each week walking goals were met ; ( 3 ) Social Goals : received donation of $ 20 to a charity of choice each week walking goals were met ; and ( 4 ) Combined : received $ 20 each week walking goals were met that could be received by participant , donated to a charity of choice , or divided between the participant and charity . MAIN OUTCOME MEASURES Mean proportion of days walking goals were met during the 16-week intervention and 4-week follow-up period . RESULTS After adjusting for baseline walking , the proportion of days step goals were met during the 16-week intervention period was higher in all intervention groups versus controls ( relative risk , 3.71 ; 95 % CI=1.37 , 10.01 ) . During the 4-week follow up period , the proportion of days step goals were met did not differ in intervention groups compared to control ( relative risk , 2.91 ; 95 % CI=0.62 , 13.64 ) . CONCLUSIONS Incentive schemes that use donations to a charity of choice , personal financial incentives , or a combination of the two can each increase older adults ' initial uptake of increased levels of walking . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT01643538
Our primary conclusion is that there is a lack of compelling evidence that incentives of any form represent a compelling NCD reduction strategy .
The rising epidemic of non-communicable diseases ( NCDs ) poses substantial health and economic challenges to both individuals and society .
Application of incentive-based strategies based on traditional and behavioural economic theory has emerged as a potential strategy to address rising rates of NCDs .
Yet , whether or not incentives truly represent a promising strategy for addressing NCDs has not been systematic ally addressed nor is it clear whether certain behavioural economic strategies outperform others or simply offering a cash-based incentive for meeting a goal .
In this systematic review we aim to determine whether there is an evidence base for any of these strategies .