Financial incentives an incentive to healthier choices, reveals largest study of its kind

12 March 2014

A team at Newcastle University looked at 16 previous research results, involving over 30,000 participants, who were tasked with quitting smoking or taking up other healthy behaviour, such as physical activity or attending vaccination or screening sessions.

Such a broad look at what effect incentives can have has never been carried out before. Financial incentives ranged from small amounts of cash or supermarket vouchers to larger amounts of cash.

In the paper, published in the journal PLOS ONE, the team found that even small incentives, of as little as 3 could make people up to 50 per cent more likely to change their behaviour, when compared with usual care or no intervention.

In fact the study, organised by Fuse, The Centre for Translational Research in Public Health and funded by the National Institute of Health Research, found that larger incentives were no more likely than smaller incentives to be effective.

Financial penalties for not succeeding in the task were also found to work. With these studies participants had to hand over a set amount of money and would then get that back as they fulfilled the requirements of the healthy behaviour.

At the moment it is not clear if the effect works long term, after the rewards have stopped, or what the ideal amount of incentive is. It is also not clear whether there is a higher impact in certain socio-economic groups. More work needs to be done to calculate whether any implementation of the technique as a policy would save the NHS money in the long run.

Smoking and obesity combined are estimated to cost the NHS 9.4bn every year, with millions of people struggling to give up smoking or lose weight.

Staying healthy for longer
Newcastle University Research Associate, Dr Emma Giles, lead author of the study, says,  ''This was an interesting finding and we were surprised at just how strong the effect was.  People who took part in these reward or penalty schemes were much more likely to adopt healthy behaviours, and if they continued they would have more chance of remaining healthy for longer.

''Many studies used vouchers for supermarkets or similar things rather than actual cash. This might be a more acceptable way of implementing this.''

Senior lecturer in public health at Newcastle University and member of Fuse, Dr Jean Adams, said: ''We were surprised how few studies we found which had looked at the impact financial incentives can have. At this stage we don't know the right level that incentives should be at, so it is not clear if this sort of scheme would save the NHS and country money. We try all kinds of techniques to try to help people to quit smoking or otherwise live healthy lives, so why not try this? It is about nudging people to healthier behaviours. There is a chance this could save the tax payer money in the long run.''

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