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Dissemination Centre

What are financial incentives and what do we already know?

"Financial incentives seem to show promise for short term behaviour changes such as quitting smoking during pregnancy. An important next step in this research will be determining if, how and when the incentives are given can improve their impact whilst maintaining cost effectiveness. Smaller, more frequent incentives linked to habitual behaviours such as physical activity are particularly interesting given recent improvements in real time tracking technology."

Hugo Harper, Principal Advisor, Behavioural Insights Team


Financial incentives are rewards (which may be cash or alternatives such as store vouchers, or entries into prize draws) that are given to people as a reward for changing a particular behaviour. Economic motivations shape a wide range of everyday behaviours, but many uncertainties remain about the effectiveness and acceptability of offering financial incentives to people in order to change their health-related behaviours.

Research into the effectiveness of financial incentives has yielded mixed results. Although they appear to be effective in changing some health behaviours in some circumstances, results are often inconsistent and may last for only a short time – often only as long as the incentive is in place. Incentives can vary widely in design and approach, so it is sometimes complex to identify which elements are likely to be effective for which groups. Important factors include not only the behaviour in question, but the value and timeliness of the financial incentive and how it is awarded, the patient and their circumstances and beliefs, and the social and professional context in which the incentive is used. Additionally, research suggests that consideration should be given to the risk of unintended consequences, and the acceptability of financial incentives to the public and healthcare professionals.

Research and systematic reviews have partially unpicked some important features of financial incentives and how and why they might work. Recent NIHR research has added to this understanding.


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