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 .
Individual- Versus Group-Based Financial Incentives for Weight Loss
BACKGROUND Data on the effectiveness of employer-sponsored financial incentives for employee weight loss are limited . OBJECTIVE To test the effectiveness of 2 financial incentive design s for promoting weight loss among obese employees . DESIGN R and omized , controlled trial . ( Clinical Trials.gov : NCT01208350 ) SETTING Children 's Hospital of Philadelphia . PARTICIPANTS 105 employees with a body mass index between 30 and 40 kg/m2 . INTERVENTION 24 weeks of monthly weigh-ins ( control group ; n = 35 ) ; individual incentive , design ed as $ 100 per person per month for meeting or exceeding weight-loss goals ( n = 35 ) ; and group incentive , design ed as $ 500 per month split among participants within groups of 5 who met or exceeded weight-loss goals ( n = 35 ) . MEASUREMENTS Weight loss after 24 weeks ( primary outcome ) and 36 weeks and changes in behavioral mediators of weight loss ( secondary outcomes ) . RESULTS Group-incentive participants lost more weight than control participants ( mean between-group difference , 4.4 kg [ 95 % CI , 2.0 to 6.7 kg ] ; P < 0.001 ) and individual-incentive participants ( mean between-group difference , 3.2 kg [ CI , 0.9 to 5.5 kg ] ; P = 0.008 ) . Twelve weeks after incentives ended and after adjustment for 3-group comparisons , group-incentive participants maintained greater weight loss than control group participants ( mean between-group difference , 2.9 kg [ CI , 0.5 to 5.3 kg ] ; P = 0.016 ) but not greater than individual-incentive participants ( mean between-group difference , 2.7 kg [ CI , 0.4 to 5.0 kg ] ; P = 0.024 ) . LIMITATION Single employer and short follow-up . CONCLUSION A group-based financial incentive was more effective than an individual incentive and monthly weigh-ins at promoting weight loss among obese employees at 24 weeks . PRIMARY FUNDING SOURCE National Institute on Aging
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 .