Search

We welcome the commentaries by Hagger et al. and Stephens and consider their observations to be timely and constructive. Hagger et al. raise concerns regarding the sustainability of behaviour change once incentives have been removed and their influence on intrinsic motivation.We concur that questions regarding both of these issues remain but argue that, in the case of sustainability, there is some evidence to support long-term behaviour change, given particular conditions. Given that the question of maintenance is applicable to any health intervention, we propose that the role of incentives may be better matched with motivating initial behaviour change, and researchers should explore other mechanisms for sustaining behaviour change and intrinsic motivation, over a longer period of time.Stephens highlights the complexity of health behaviours and warns of the dangers associated with taking an individualised approach to health promotion.We support the need for both downstream and upstream approaches to reducing health inequalities and contend that financial incentives still have a potential role to play in encouraging health behaviour change. [ABSTRACT FROM AUTHOR]

Background: The use of financial incentives or pay-for-performance programs for health care providers has triggered emerging interest in the use of financial incentives for encouraging health behaviour change. Purpose: This paper aims to identify key conditions under which the use of financial incentives for improvements in public health outcomes is most likely to be effective and appropriate. Methods: We review recent systematic reviews on their effectiveness in changing health behaviour and identify existing moral concerns concerning personal financial incentives. Results: Current evidence indicates that incentives can be effective in driving health behaviour change under certain provisos, while a number of misgivings continue to be deliberated on. We outline a number of key principles for consideration in decisions about the potential use of incentives in leading to public health improvements. Conclusion: These key principles can assist policy makers in making decisions on the use of financial incentives directed at achieving improvements in public health. [ABSTRACT FROM AUTHOR]