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

Posted on 11/12/2012
Older person smoking

A UK study led by King’s College London’s Institute of Psychiatry 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 (CSI Health) at King's Institute of Psychiatry 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.

Dr Marianne Promberger, from King’s and lead author of the study, says: "Most participants in our study were willing to accept incentives provided they were effective. A substantial minority of people however did not accept incentives even when they were described as being four times as effective as standard treatment. Vocal opposition to incentives may come from a minority of people and we are currently further investigating what underlies their judgment."

Professor Theresa Marteau, co-author of the study and Director of CSI Health at King’s, says: “This study focused on whether incentives for health behaviours are acceptable to the general public. The effectiveness levels we used were hypothetical, and better evidence on the effectiveness of such interventions needs to be established, especially long-term.”

The study, supported by 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.

Paper 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 doi: 10.1016/j.socscimed.2012.09.033

For further information, please contact Seil Collins, Press Officer, King's College London, Institute of Psychiatry. Email: seil.collins@kcl.ac.uk or tel: 0207 848 5377

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