a Institute of Psychological Sciences , University of Leeds , Leeds LS29JT , UK.
b Manchester Centre for Health Psychology, School of Psychological Sciences , University of Manchester , Manchester M13 9PL , UK.
Health Psychol Rev. 2015;9(4):434-51. doi: 10.1080/17437199.2015.1030685. Epub 2015 Jul 14.
Financial incentives to improve health have received increasing attention, but are subject to ethical concerns. Monetary Contingency Contracts (MCCs), which require individuals to deposit money that is refunded contingent on reaching a goal, are a potential alternative strategy. This review evaluates systematically the evidence for weight loss-related MCCs. Randomised controlled trials testing the effect of weight loss-related MCCs were identified in online databases. Random-effects meta-analyses were used to calculate overall effect sizes for weight loss and participant retention. The association between MCC characteristics and weight loss/participant retention effects was calculated using meta-regression. There was a significant small-to-medium effect of MCCs on weight loss during treatment when one outlier study was removed. Group refunds, deposit not paid as lump sum, participants setting their own deposit size and additional behaviour change techniques were associated with greater weight loss during treatment. Post-treatment, there was no significant effect of MCCs on weight loss. There was a significant small-to-medium effect of MCCs on participant retention during treatment. Researcher-set deposits paid as one lump sum, refunds delivered on an all-or-nothing basis and refunds contingent on attendance at classes were associated with greater retention during treatment. Post-treatment, there was no significant effect of MCCs on participant retention. The results support the use of MCCs to promote weight loss and participant retention up to the point that the incentive is removed and identifies the conditions under which MCCs work best.
经济激励措施在改善健康方面受到了越来越多的关注，但也引发了一些伦理问题。金钱约束合同（MCCs）是一种潜在的替代策略，要求个人存入一定金额，只有达到目标才能获得退款。本综述系统评估了与体重减轻相关的 MCC 的证据。在在线数据库中确定了测试与体重减轻相关的 MCC 效果的随机对照试验。使用随机效应荟萃分析计算体重减轻和参与者保留的总体效应大小。使用元回归计算 MCC 特征与体重减轻/参与者保留效果之间的关联。当排除一项异常值研究时，MCC 对治疗期间体重减轻的影响具有显著的中小效应。团体退款、不一次性支付定金、参与者自行设定定金金额和额外的行为改变技术与治疗期间体重减轻更多有关。治疗后，MCC 对体重减轻没有显著影响。MCC 对治疗期间的参与者保留有显著的中小效应。研究人员设定的定金一次性支付、退款以全有或全无的方式支付以及退款取决于参加课程与治疗期间的更高保留率有关。治疗后，MCC 对参与者保留没有显著影响。结果支持使用 MCC 来促进体重减轻和参与者保留，直到激励措施被取消，并确定了 MCC 效果最好的条件。
