Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Pyathai, Bangkok 10400, Thailand.
Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Pyathai, Bangkok 10400, Thailand.
Ann Behav Med. 2023 Apr 12;57(4):277-287. doi: 10.1093/abm/kaac066.
Healthy diet, weight control and physical activity to reduce obesity can be motivated by financial incentives (FI). Behavioral-economic approaches may improve the incentivization effectiveness. This study compares and ranks the effectiveness of standard and behavioral incentivization for healthy diet, weight control, and physical activity promotion.
To investigate whether behavioral-economic insights improve incentivization effectiveness.
A systematic search of Medline and Scopus was performed from database inception to December 2020. Study characteristics, program designs, and risk ratio (RR) were extracted. A two-stage network meta-analysis pooled and ranked intervention effects.
There were 35 eligible RCTs. For diet-weight control, standard FI, deposit contract (deposit), lottery-based incentive (lottery), and standard-FI + lottery increased goal achievement compared to no-FI but only deposit was statistically significant with pooled RRs and 95% confidence intervals (CI) of 1.21 (0.94, 1.56), 1.79 (1.04, 3.05), 1.45 (0.99, 2.13), and 1.73 (0.83, 3.63). For physical activity, standard-FI, deposit, and lottery significantly increased goal achievement compared to no-FI, with pooled RRs of 1.38 (1.13, 1.68), 1.63 (1.24, 2.14) and 1.43 (1.14, 1.80), respectively. In a follow-up period for physical activity, only deposit significantly increased goal achievement compared to no-FI, with pooled RRs of 1.39 (1.11, 1.73).
Deposit, followed by lottery, were best for motivating healthy diet, weight control and physical activity at program end. Post-intervention, deposit then standard-FI were best for motivating physical activity. Behavioral insights can improve incentivization effectiveness, although lottery-based approaches may offer only short-term benefit regarding physical activity. However, the imprecise intervention effects were major concerns.
健康饮食、控制体重和体育活动以减少肥胖可以通过经济激励（FI）来实现。行为经济学方法可以提高激励的有效性。本研究比较并排名了标准激励和行为经济学激励在促进健康饮食、控制体重和体育活动方面的有效性。
研究行为经济学的见解是否能提高激励的有效性。
系统地检索了 Medline 和 Scopus 数据库，检索时间从数据库建立到 2020 年 12 月。提取研究特征、方案设计和风险比（RR）。采用两阶段网络荟萃分析汇总和排名干预效果。
共有 35 项符合条件的 RCT 纳入研究。在饮食-体重控制方面，标准 FI、存款合同（存款）、基于彩票的激励（彩票）和标准 FI+彩票比无 FI 更能提高目标的达成，但只有存款在统计学上有显著差异，合并 RR 及其 95%置信区间（CI）为 1.21（0.94，1.56）、1.79（1.04，3.05）、1.45（0.99，2.13）和 1.73（0.83，3.63）。在体育活动方面，标准 FI、存款和彩票与无 FI 相比，显著提高了目标的达成，合并 RR 分别为 1.38（1.13，1.68）、1.63（1.24，2.14）和 1.43（1.14，1.80）。在体育活动的随访期间，只有存款与无 FI 相比，显著提高了目标的达成，合并 RR 为 1.39（1.11，1.73）。
在项目结束时，存款，其次是彩票，是激励健康饮食、控制体重和体育活动的最佳方式。在干预后，存款然后是标准 FI 是激励体育活动的最佳方式。行为洞察力可以提高激励的有效性，尽管基于彩票的方法可能对体育活动只提供短期效益。然而，干预效果的不精确是主要关注点。
