Are Financial Incentives for Lifestyle Behavior Change Informed or Inspired by Behavioral Economics? A Mapping Review

Am J Health Promot. 2019 Jan;33(1):131-141. doi: 10.1177/0890117118770837. Epub 2018 Apr 26.

Abstract

Objective: To identify the behavioral economics (BE) conceptual underpinnings of lifestyle financial incentive (FI) interventions.

Data source: A mapping review of peer-reviewed literature was conducted by searching electronic databases.

Study inclusion and exclusion criteria: Inclusion criteria were real-world FI interventions explicitly mentioning BE, targeting individuals, or populations with lifestyle-related behavioral outcomes. Exclusion criteria were hypothetical studies, health professional focus, clinically oriented interventions.

Data extraction: Study characteristics were tabulated according to purpose, categorization of BE concepts and FI types, design, outcome measures, study quality, and findings.

Data synthesis and analysis: Financial incentives were categorized according to type and payment structure. Behavioral economics concepts explicitly used in the intervention design were grouped based on common patterns of thinking. The interplay between FI types, BE concepts, and outcome was assessed.

Results: Seventeen studies were identified from 1452 unique records. Analysis showed 76.5% (n = 13) of studies explicitly incorporated BE concepts. Six studies provided clear theoretical justification for the inclusion of BE. No pattern in the type of FI and BE concepts used was apparent.

Conclusions: Not all FI interventions claiming BE inclusion did so. For interventions that explicitly included BE, the degree to which this was portrayed and woven into the design varied. This review identified BE concepts common to FI interventions, a first step in providing emergent and pragmatic information to public health and health promotion program planners.

Keywords: behavioral economics; chronic disease; financial incentives; health behavior change; lifestyle interventions.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Economics, Behavioral*
  • Health Promotion / methods*
  • Humans
  • Motivation*
  • Reward
  • Risk Reduction Behavior*