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 .
Applying economic incentives to increase effectiveness of an outpatient weight loss program (TRIO) - A randomized controlled trial.
The prevalence of overweight and obesity has more than doubled in the past three decades , leading to rising rates of non-communicable diseases . This study tests whether adding a payment/rewards ( term reward ) program to an existing evidence -based weight loss program can increase weight loss and weight loss maintenance . We conducted a parallel-group r and omized controlled trial from October 2012 to October 2015 with 161 overweight or obese individuals r and omized to either control or reward arm in a 1:2 ratio . Control and reward arm participants received a four month weight loss program at the LIFE ( Lifestyle Improvement and Fitness Enhancement ) Centre at Singapore General Hospital . Those in the reward arm paid a fee of S$165.00 ( 1 US$ = 1.35S$ ) to access a program that provided rewards of up to S$660 for meeting weight loss and physical activity goals . Participants could choose to receive rewards as guaranteed cash payments or a lottery ticket with a 1 in 10 chance of winning but with the same expected value . The primary outcome was weight loss at months 4 , 8 , and 12 . 161 participants were r and omized to control ( n = 54 ) or reward ( n = 107 ) arms .  Average weight loss was more than twice as great in the reward arm compared to the control arm at month 4 when the program concluded ( 3.4 kg vs 1.4 kg , p < 0.01 ) , month 8 when rewards concluded ( 3.3 kg vs 1.8 kg , p < 0.05 ) , and at month 12 ( 2.3 kg vs 0.8 kg , p < 0.05 ) . These results reveal that a payment/rewards program can be used to improve weight loss and weight loss maintenance when combined with an evidence -based weight loss program . Future efforts should attempt to replicate this approach and identify how to cost effectively exp and these programs to maximize their reach . This study is registered at www . clinical trials.gov ( Identifier : NCT01533454 )
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 .