Promoting positive changes in physical activity through behavior economics

Student thesis: Doctoral ThesisDoctor of Philosophy


Physical inactivity is increasingly being recognised as a major problem in global health. The World Health Organisation estimates that 3.3 million people die around the world each year due to physical inactivity, making it the fourth leading underlying cause of mortality. Given that inactivity increases the risk for many of the costlier medical conditions such as type 2 diabetes, stroke, ischaemic heart disease, and depression, it is not surprising that physical inactivity via its health implications constitutes a substantial financial burden to society.

Whilst a range of tools are available to policy makers seeking to influence behaviour including legislation, price signals (taxes and subsidies) and information campaigns. The use of financial incentives has been suggested as a possible policy tool to promote desirable health behaviours and discourage unhealthy ones. The apparent enthusiasm for using incentives to influence health behaviours has come about as the full economic and social costs of unhealthy behaviours have become apparent and with the finding that health behaviours can be significantly affected by the structure of economic incentives that individuals face. One theoretical approach that has been used to explain the thinking behind using financial incentives to encourage behaviour change is that of behavioural economics (BE).

This thesis explores how key principles from behavioural economics’ could help public health practitioners design effective interventions both in relation to incentive designs and more widely. However, widespread concerns do exist and tend to centre on the potential coercive impact of using incentives and the ‘unfairness’ of rewarding people for doing things that are already in their own interest or the impacts of offering incentives could have on individuals long term motivations. Whilst some of those reservations are to note, the purpose of this thesis will not be to add further to this normative debate, but rather focus herein on positive ways in which to design incentives and to determine when they are considered appropriate. To date, no guidance has been provided to practitioners and policymakers regarding the level of incentives that trigger behaviour change among different groups (inactive individuals, overweight or obese, etc.). In addition, the cost-effectiveness of using financial incentives to encourage physical activity has been quite overlooked.
Date of AwardJul 2020
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorAlberto Longo (Supervisor) & George Hutchinson (Supervisor)


  • Physical activity
  • obesity
  • behavioural economics
  • behaviour change
  • financial incentives
  • contingent valuation

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