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煮熟的鸭子嘴硬:需要考虑机制和人际背景来阐明个人财务激励对健康行为的影响。

The goose is (half) cooked: a consideration of the mechanisms and interpersonal context is needed to elucidate the effects of personal financial incentives on health behaviour.

机构信息

Curtin University, Perth, WA, Australia,

出版信息

Int J Behav Med. 2014 Feb;21(1):197-201. doi: 10.1007/s12529-013-9317-y.

Abstract

While we agree that personal financial incentives (PFIs) may have some utility in public health interventions to motivate people in the uptake and persistence of health behaviour, we disagree with some of the sentiments outlined by Lynagh et al. (Int J Behav Med 20:114-120, 2012). Specifically, we feel that the article gives a much stronger impression that PFIs will likely lead to long-term behaviour change once the incentive has been removed than is warranted by current research. This claim has not received strong empirical support nor is it grounded in psychological theory on the role of incentives and motivation. We also feel that the presentation of some of the tenets of self-determination theory by the authors is misleading. Based on self-determination theory, we propose that PFIs, without sufficient consideration of the mechanisms by which external incentives affect motivation and the interpersonal context in which they are presented, are unlikely to lead to persistence in health behaviour once the incentive is removed. We argue that interventions that adopt PFIs as a strategy to promote health-behaviour change should incorporate strategies in the interpersonal context to minimise the undermining effect of the incentives on intrinsic motivation. Interventions should present incentives as informational regarding individuals' competence rather than as purely contingent on behavioural engagement and emphasise self-determined reasons for pursuing the behaviour.

摘要

虽然我们同意个人经济激励(PFIs)在促进人们采取和坚持健康行为的公共卫生干预措施中可能具有一定的作用,但我们不同意 Lynagh 等人(Int J Behav Med 20:114-120, 2012)提出的一些观点。具体来说,我们认为,这篇文章给人的印象是,一旦激励措施取消,PFIs 很可能会导致长期的行为改变,而这超出了当前研究的支持程度。这一说法并没有得到强有力的实证支持,也没有基于激励和动机的心理理论。我们还认为,作者对自我决定理论的一些原则的表述具有误导性。基于自我决定理论,我们认为,PFIs 如果没有充分考虑外部激励因素影响动机的机制,以及它们呈现的人际环境,那么一旦激励措施取消,就不太可能导致健康行为的持续。我们认为,采用 PFIs 作为促进健康行为改变策略的干预措施,应该在人际环境中纳入策略,以最大程度地减少激励因素对内在动机的破坏效应。干预措施应该将激励作为有关个人能力的信息呈现,而不是纯粹取决于行为参与,并强调追求行为的自我决定原因。

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