Evaluation of the effectiveness of behavioral economic incentive programs for goal achievement on healthy diet, weight control and physical activity: a systematic review and network meta-analysis

Suparee Boonmanunt, Oraluck Pattanaprateep, Boonsong Ongphiphadhanakul, Gareth McKay, John Attia, Ivo Vlaev, Ammarin Thakkinstian

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)
44 Downloads (Pure)

Abstract

Background: Healthy diet, weight control and physical activity to reduce obesity can be motivated by financial incentives (FI). Behavioral-economic approaches may improve the incentivization effectiveness. This study compares and ranks the effectiveness of standard and behavioral incentivization for healthy diet, weight control, and physical activity promotion.

Purpose: To investigate whether behavioral-economic insights improve incentivization effectiveness.

Methods: A systematic search of Medline and Scopus was performed from database inception to December 2020. Study characteristics, program designs, and risk ratio (RR) were extracted. A two-stage network meta-analysis pooled and ranked intervention effects.

Results: There were 35 eligible RCTs. For diet-weight control, standard FI, deposit contract (deposit), lottery-based incentive (lottery), and standard-FI + lottery increased goal achievement compared to no-FI but only deposit was statistically significant with pooled RRs and 95% confidence intervals (CI) of 1.21 (0.94, 1.56), 1.79 (1.04, 3.05), 1.45 (0.99, 2.13), and 1.73 (0.83, 3.63). For physical activity, standard-FI, deposit, and lottery significantly increased goal achievement compared to no-FI, with pooled RRs of 1.38 (1.13, 1.68), 1.63 (1.24, 2.14) and 1.43 (1.14, 1.80), respectively. In a follow-up period for physical activity, only deposit significantly increased goal achievement compared to no-FI, with pooled RRs of 1.39 (1.11, 1.73).

Conclusion: Deposit, followed by lottery, were best for motivating healthy diet, weight control and physical activity at program end. Post-intervention, deposit then standard-FI were best for motivating physical activity. Behavioral insights can improve incentivization effectiveness, although lottery-based approaches may offer only short-term benefit regarding physical activity. However, the imprecise intervention effects were major concerns.
Original languageEnglish
Pages (from-to)277-287
Number of pages11
JournalAnnals of Behavioral Medicine
Volume57
Issue number4
Early online date11 Nov 2022
DOIs
Publication statusPublished - 12 Apr 2023

Keywords

  • Psychiatry and Mental health
  • General Psychology

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