Our framework should help research ers and policy-makers identify the most effective incentive configurations for helping individuals adopt healthy behaviours
Financial incentive interventions are increasingly used as a method of encouraging healthy behaviours , from attending for vaccinations to taking part in regular physical activity .
There is a growing body of research on the effectiveness of financial incentive interventions for health behaviours .
Wide variations in the nature of these interventions make it difficult to draw firm conclusions about what makes an effective incentive , for whom and under what circumstances .
Whilst there has been some recognition of the theoretical complexity of financial incentive interventions for health behaviours , there is no framework that categorises these interventions .
This limits the research community 's ability to clearly establish which components of financial incentives interventions are more and less effective , and how these components might interact to enable behavioural change .
We propose a framework for describing health-promoting financial incentive interventions .
Patients as Mercenaries?: The Ethics of Using Financial Incentives in the War on Unhealthy Behaviors
Consider the following paradox : few people would balk if research ers offered smokers $ 1,000 to participate in a year-long r and omized trial of a smoking cessation intervention , yet many would find it distasteful for a large employer to pay its smoking employees an extra $ 1,000 if they remained smoke-free for one year . Such discrepant judgments are underst and able from the perspective of classical economics . Research participants merit compensation for the risks and opportunity costs they endure in the service of public health , whereas individuals should need no reward for promoting their own well being . However , contrary to traditional theories of rationality , people frequently fail to make health-promoting choices , particularly when such choices require short-term sacrifices to foster long-term goals .1,2 Thus , corporate and government health plan leaders are increasingly applying extrinsic motivations such as financial incentives and other programs to augment health – particularly cardiovascular health – while hopefully increasing productivity and restraining costs.3 , 4 Early evidence suggests that financial incentives can effectively promote the cardioprotective behaviors of smoking cessation,5 , 6 weight loss,7 , 8 and cholesterol reduction.9  Incentives are also currently being studied as a means of promoting warfarin adherence.10 Although the results of these early studies are promising , further research is needed to determine which incentive structures and amounts are optimal , assess the ability of incentives to produce sustained behavior changes , and evaluate the cost-effectiveness of implementing incentive programs  . Ethical dimensions of the incentives themselves are also in need of further analysis . For example , some have charged that financial incentive programs are coercive , inequitable , and inconsistent with shared social values.11 Others have even suggested that implementing incentive programs serves to punish patients for their illnesses.12 In this essay , we outline the rationale for incentive programs to promote cardiovascular health , identify the ethical arguments that have been used to challenge such programs , and assess the merits of these arguments
Our framework should help research ers and policy-makers identify the most effective incentive configurations for helping individuals adopt healthy behaviours
Financial incentive interventions are increasingly used as a method of encouraging healthy behaviours , from attending for vaccinations to taking part in regular physical activity .
There is a growing body of research on the effectiveness of financial incentive interventions for health behaviours .
Wide variations in the nature of these interventions make it difficult to draw firm conclusions about what makes an effective incentive , for whom and under what circumstances .
Whilst there has been some recognition of the theoretical complexity of financial incentive interventions for health behaviours , there is no framework that categorises these interventions .
This limits the research community 's ability to clearly establish which components of financial incentives interventions are more and less effective , and how these components might interact to enable behavioural change .
We propose a framework for describing health-promoting financial incentive interventions .