Nudge or not: can incentives change health behaviours?

The approach of "nudging" people toward healthier behaviours is currently in vogue, and user financial incentives (UFIs) are one possible nudge tool. Interesting debates arise as to the criteria UFIs must meet to qualify as a nudge. The more pressing issue, however, is to determine how UFIs can be structured and implemented to motivate and sustain health behaviour change. To date, Canadian public health strategies to promote physical activity and balanced nutrition focus mainly on information provision, with some product regulation measures and indirect financial incentives. Governments cannot afford direct UFI programs to incent all 60% of overweight and obese Canadians to reduce their body mass, but governments could consider UFIs targeted to specific risk groups where a shorter-term intervention could have long-term payoffs.