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 Team-Based Financial Incentives to Increase Physical Activity: A Randomized, Controlled Trial
ABSTRACT BACKGROUND More than half of adults in the United States do not attain the minimum recommended level of physical activity to achieve health benefits . The optimal design of financial incentives to promote physical activity is unknown . OBJECTIVE To compare the effectiveness of individual versus team-based financial incentives to increase physical activity . DESIGN R and omized , controlled trial comparing three interventions to control . PARTICIPANTS Three hundred and four adult employees from an organization in Philadelphia formed 76 four-member teams . INTERVENTIONS All participants received daily feedback on performance towards achieving a daily 7000 step goal during the intervention ( weeks 1– 13 ) and follow-up ( weeks 14– 26 ) periods . The control arm received no other intervention . In the three financial incentive arms , drawings were held in which one team was selected as the winner every other day during the 13-week intervention . A participant on a winning team was eligible as follows : $ 50 if he or she met the goal ( individual incentive ) , $ 50 only if all four team members met the goal ( team incentive ) , or $ 20 if he or she met the goal individually and $ 10 more for each of three teammates that also met the goal ( combined incentive).MAIN MEASURES Mean proportion of participant-days achieving the 7000 step goal during the intervention . KEY RESULTS Compared to the control group during the intervention period , the mean proportion achieving the 7000 step goal was significantly greater for the combined incentive ( 0.35 vs. 0.18 , difference : 0.17 , 95 % confidence interval [ CI ] : 0.07–0.28 , p < 0.001 ) but not for the individual incentive ( 0.25 vs 0.18 , difference : 0.08 , 95 % CI : -0.02–0.18 , p = 0.13 ) or the team incentive ( 0.17 vs 0.18 , difference : -0.003 , 95 % CI : -0.11–0.10 , p = 0.96 ) . The combined incentive arm participants also achieved the goal at significantly greater rates than the team incentive ( 0.35 vs. 0.17 , difference : 0.18 , 95 % CI : 0.08–0.28 , p < 0.001 ) , but not the individual incentive ( 0.35 vs. 0.25 , difference : 0.10 , 95 % CI : -0.001–0.19 , p = 0.05 ) . Only the combined incentive had greater mean daily steps than control ( difference : 1446 , 95 % CI : 448–2444 , p ≤ 0.005 ) . There were no significant differences between arms during the follow-up period ( weeks 14– 26 ) . CONCLUSIONS Financial incentives rewarded for a combination of individual and team performance were most effective for increasing physical activity . Trial Registration Clinical trials.gov identifier : NCT02001194
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 .