title: The effectiveness of financial incentives for health behaviour change: systematic review and meta-analysis.
abstract: BACKGROUND
  Financial incentive interventions have been suggested as one method of promoting healthy behaviour change.
  
  
  OBJECTIVE
  To conduct a systematic review of the effectiveness of financial incentive interventions for encouraging healthy behaviour change; to explore whether effects vary according to the type of behaviour incentivised, post-intervention follow-up time, or incentive value.
  
  
  METHODS
  Searches were of relevant electronic databases, research registers, www.google.com, and the reference lists of previous reviews; and requests for information sent to relevant mailing lists.
  
  
  METHODS
  Controlled evaluations of the effectiveness of financial incentive interventions, compared to no intervention or usual care, to encourage healthy behaviour change, in non-clinical adult populations, living in high-income countries, were included.
  
  
  METHODS
  The Cochrane Risk of Bias tool was used to assess all included studies. Meta-analysis was used to explore the effect of financial incentive interventions within groups of similar behaviours and overall. Meta-regression was used to determine if effect varied according to post-intervention follow up time, or incentive value.
  
  
  RESULTS
  Seventeen papers reporting on 16 studies on smoking cessation (n = 10), attendance for vaccination or screening (n = 5), and physical activity (n = 1) were included. In meta-analyses, the average effect of incentive interventions was greater than control for short-term (≤ six months) smoking cessation (relative risk (95% confidence intervals): 2.48 (1.77 to 3.46); long-term (>six months) smoking cessation (1.50 (1.05 to 2.14)); attendance for vaccination or screening (1.92 (1.46 to 2.53)); and for all behaviours combined (1.62 (1.38 to 1.91)). There was not convincing evidence that effects were different between different groups of behaviours. Meta-regression found some, limited, evidence that effect sizes decreased as post-intervention follow-up period and incentive value increased. However, the latter effect may be confounded by the former.
  
  
  CONCLUSIONS
  The available evidence suggests that financial incentive interventions are more effective than usual care or no intervention for encouraging healthy behaviour change.
  
  
  BACKGROUND
  PROSPERO CRD42012002393.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
authors.forename: Emma L
authors.initials: EL
authors.lastname: Giles
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
authors.forename: Shannon
authors.initials: S
authors.lastname: Robalino
authors.affiliation: Newcastle Clinical Trials Unit, Institute of Health and Society, Newcastle University, The Medical School, Framlington Place, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
authors.forename: Elaine
authors.initials: E
authors.lastname: McColl
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
authors.forename: Falko F
authors.initials: FF
authors.lastname: Sniehotta
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Tyne and Wear, United Kingdom.
authors.forename: Jean
authors.initials: J
authors.lastname: Adams
mesh_terms: D016208:Databases, Factual; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D009042:Motivation; D009043:Motor Activity; D016017:Odds Ratio; D012042:Registries; D012306:Risk; D016540:Smoking Cessation