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Rewarding people to live healthier lives is acceptable if it works, study reveals

4 December 2012

A UK study reveals that the public find it acceptable to reward people for changing their health-related behaviour, such as smoking or weight loss, as long as it works. In the past, such incentives have provoked negative public reactions.

Researchers at the Centre for the Study of Incentives in Health at King's College London surveyed over 600 people about their views on using incentives to encourage people to stop smoking or lose weight. Their findings reveal that people are willing to trade off their dislike of incentive treatments against the effectiveness of the programme - in other words, people are prepared to 'pay them if it works'.

However, people's willingness to accept the use of incentives did vary with the type of incentive offered. Offering vouchers that could be spent on healthy groceries was more acceptable than offering cash or luxury items. And overall, the use of incentives was more acceptable for encouraging people to lose weight than to stop smoking. This could be a reflection of people's moral view of the two behaviours, suggest the researchers.

The study, supported by a Strategic Award in Biomedical Ethics from the Wellcome Trust, is the first to examine how acceptability of incentives varies with effectiveness and the first to compare the acceptability of different incentive types.

The public's dislike of incentive schemes may reflect their concerns about fairness and equity. The results of this study clearly show that people are willing to put such concerns to one side in order to maximise health benefits and find the most cost-effective solution for everybody. The researchers suggest that incentive-based treatments that are found to be effective need to be clearly communicated to the public in order to improve the acceptability of their use.

Image credit: Anthea Sieveking/Wellcome Images

Reference

Promberger M et al. “Pay them if it works”: discrete choice experiments on the acceptability of financial incentives to change health related behaviour. Social Science and Medicine 2012;75:2509-14.

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