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 Trial of Incentives for Smoking Treatment in Medicaid Members.
INTRODUCTION Low-income population s are especially likely to smoke and have difficulty quitting . This study evaluated a monetary incentive intended to increase smoking treatment engagement and abstinence among Medicaid recipients who smoke . STUDY DESIGN Two-group r and omized clinical trial of Incentive ( n=948 ) and Control interventions ( n=952 ) for smoking . SETTING / PARTICIPANTS Medicaid recipients recruited from primary care patients ( n=920 ) and callers to the Wisconsin Tobacco Quit Line ( n=980 ) . INTERVENTION Participants were offered five quitline cessation calls and were encouraged to obtain cessation medication ( covered by Medicaid ) . All participants received payment for completing a baseline assessment and a 6-month smoking test . Only Incentive condition participants received compensation for taking counseling calls ( $ 30 per call ) and for biochemically verified abstinence at the 6-month visit ( $ 40 ) . MAIN OUTCOME MEASURES Seven-day point-prevalence smoking abstinence 6-months post study entry and cost/quit . RESULTS Incentive condition participants had significantly higher biochemically determined 7-day point-prevalence smoking abstinence rates 6 months after study induction than did Controls ( 21.6 % vs 13.8 % , respectively , p<0.0001 ) . A positive treatment effect of incentives was present across other abstinence indices , but the size of effects and levels of abstinence varied considerably across indices . Incentive condition participants were also significantly more likely than non-incentivized Control participants to accept Wisconsin Tobacco Quit Line treatment calls and their acceptance of calls mediated their attainment of higher abstinence rates at 6-month follow-up . The cost/quit/participant averaged $ 4,268.26 for the Control participants and $ 3,601.37 for the Incentive participants . CONCLUSIONS This study shows that fairly moderate levels of incentive payments for treatment engagement and abstinence ( a total possible payment of $ 190 ) increased very low-income smokers ' engagement and success in smoking cessation treatment . CLINICAL REGISTRATION This study is registered at www . clinical trials.gov : NCT02713594
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 .