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 randomized study of reinforcing ambulatory exercise in older adults.
Many older adults do not meet physical activity recommendations and suffer from health-related complications . Reinforcement interventions can have pronounced effects on promoting behavior change ; this study evaluated the efficacy of a reinforcement intervention to enhance walking in older adults . Forty-five sedentary adults with mild to moderate hypertension were r and omized to 12-week interventions consisting of pedometers and guidelines to walk 10,000 steps/day or that same intervention with chances to win $ 1-$100 prizes for meeting recommendations . Patients walked an average of about 4,000 steps/day at baseline . Throughout the intervention , participants in the reinforcement intervention  met walking goals on 82.5 % ± 25.8 % of days versus 55.3 % ± 37.1 % of days in the control condition , p < .01 . Even though steps walked increased significantly in both groups relative to baseline , participants in the reinforcement condition walked an average of about 2,000 more steps/day than participants in the control condition , p < .02 . Beneficial effects of the reinforcement condition relative to the control condition persisted at a 24-week follow-up evaluation , p < .02 , although steps/day were lower than during the intervention period in both groups . Participants in the reinforcement intervention also evidence d greater reductions in blood pressure and weight over time and improvements in fitness indices , ps < .05 . This reinforcement-based intervention substantially increased walking and improved clinical parameters , suggesting that larger-scale evaluations of reinforcement-based interventions for enhancing active lifestyles in older adults are warranted . Ultimately , economic analyses may reveal reinforcement interventions to be cost-effective , especially in high-risk population s of older adults
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 .