Abstract
Improving participation in preventive activities will require finding methods to encourage
consumers to engage in and remain in such efforts. This review assesses the effects
of economic incentives on consumers' preventive health behaviors. A study was classified
as complex preventive health if a sustained behavior change was required of the consumer;
if it could be accomplished directly (e.g., immunizations), it was considered simple.
A systematic literature review identified 111 randomized controlled trials of which
47 (published between 1966 and 2002) met the criteria for review. The economic incentives
worked 73% of the time (74% for simple, and 72% for complex). Rates varied by the
goal of the incentive. Incentives that increased ability to purchase the preventive
service worked better than more diffuse incentives, but the type matters less than
the nature of the incentive. Economic incentives are effective in the short run for
simple preventive care, and distinct, well-defined behavioral goals. Small incentives
can produce finite changes, but it is not clear what size of incentive is needed to
yield a major sustained effect.
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© 2004 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
