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Incentive-Based Interventions: Historical Context and New Directions

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Social Neuroscience and Public Health

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Abstract

There is growing recognition of the need for effective interventions to promote healthy behavior change. The use of incentives is one promising treatment wherein objectively verified measures of behavior change are reinforced, generally with monetary incentives, goods, or services. While the use of incentives began in the fields of obesity and substance use disorders (SUDs), most of its development has occurred within the latter. More than four decades of research in SUDs has resulted in a more unified view of drug use as a modifiable behavior that follows general behavioral principles. More recently the use of incentives has again gained interest in the area of obesity while also expanding into a variety of other areas, including medication adherence, physician performance, international efforts to combat health disparities, and family planning. With these expansions come new challenges, including new ethical considerations when using incentives in the health field.

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Authors and Affiliations

  1. Department of Psychiatry, University of Vermont, UHC Campus, OH3, MS482, 1 South Prospect Street, Burlington, VT 05401, USA

    Diann E. Gaalema

  2. Departments of Psychiatry and Psychology, University of Vermont, UHC Campus, Room 1415, 1 South Prospect Street, Burlington, VT 05401, USA

    Alexa A. Lopez

  3. Departments of Psychiatry and Psychology, University of Vermont, UHC Campus, Rm 3100B 3rd Floor, Old Hall, 1 South Prospect Street, Burlington, VT 05401, USA

    Stephen T. Higgins

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  1. Diann E. Gaalema
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  2. Alexa A. Lopez
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  3. Stephen T. Higgins
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Correspondence to Diann E. Gaalema .

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  1. , Department of Applied Health Sciences, University of Waterloo, University Avenue West 200, Waterloo, N2L 3G1, Ontario, Canada

    Peter A. Hall

Highlights

Highlights

  • This chapter provides a detailed overview of research on the use of monetary incentives to produce health-related behavior change; these interventions leverage the same reward processes that underpin vulnerability to substance abuse, overeating, and other unhealthy behavior patterns to increase healthier choices.

  • Incentives have been examined across a range of health problems, including SUDs, physical inactivity/weight loss, and medication adherence.

  • These programs have been investigated in studies ranging from initial proof of concept investigations examining drug use as a modifiable behavior to large-scale community interventions such as Conditional Cash Transfers, used to combat chronic poverty in low and middle income countries.

  • Unhealthy personal behaviors account for approximately 40 % of premature deaths in the United States each year, opening the door for potential wide-scale implementations of incentive-based interventions to improve U.S. population health.

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Gaalema, D.E., Lopez, A.A., Higgins, S.T. (2013). Incentive-Based Interventions: Historical Context and New Directions. In: Hall, P. (eds) Social Neuroscience and Public Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6852-3_9

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