Financial incentives for physical activity in adults: systematic review and meta-analysis

Abstract

ObjectiveThe use of financial incentives to promote physical activity (PA) has grown in popularity due in part to technological advances that make it easier to track and reward PA. The purpose of this study was to update the evidence on the effects of incentives on PA in adults.Data sourcesMedline, PubMed, Embase, PsychINFO, CCTR, CINAHL and COCH.Eligibility criteriaRandomised controlled trials (RCT) published between 2012 and May 2018 examining the impact of incentives on PA.DesignA simple count of studies with positive and null effects (‘vote counting’) was conducted. Random-effects meta-analyses were also undertaken for studies reporting steps per day for intervention and post-intervention periods.Results23 studies involving 6074 participants were included (64.42% female, mean age = 41.20 years). 20 out of 22 studies reported positive intervention effects and four out of 18 reported post-intervention (after incentives withdrawn) benefits. Among the 12 of 23 studies included in the meta-analysis, incentives were associated with increased mean daily step counts during the intervention period (pooled mean difference (MD), 607.1; 95% CI: 422.1 to 792.1). Among the nine of 12 studies with post-intervention daily step count data incentives were associated with increased mean daily step counts (pooled MD, 513.8; 95% CI:312.7 to 714.9).ConclusionDemonstrating rising interest in financial incentives, 23 RCTs were identified. Modest incentives ($1.40 US/day) increased PA for interventions of short and long durations and after incentives were removed, though post-intervention ‘vote counting’ and pooled results did not align. Nonetheless, and contrary to what has been previously reported, these findings suggest a short-term incentive ‘dose’ may promote sustained PA.

Commercial app use linked with sustained physical activity in two Canadian provinces: a 12-month quasi-experimental study

“…Our findings are comparable to those of a recent metaanalysis of RCTs testing PA incentives delivered using smartphone/wearable technology (n = 12). In this study Mitchell et al (2019) concluded that incentives increased mean daily step counts for short and long duration interventions by 607 steps [44]. Sub-group meta-analyses suggested physically inactive adults are especially sensitive to incentive intervention and that PA increases do not necessarily wane for longer interventions, consistent with what was found here.…”

Leveraging Family Dynamics to Increase the Effectiveness of Incentives for Physical Activity: The FIT-FAM Randomized Controlled Trial

“…Consistent with these predictions, studies indicate that economic incentives can effectively increase physical activity in both children and adults [9][10][11][12][13][14].…”

Leveraging Family Dynamics to Increase the Effectiveness of Incentives for Physical Activity: The FIT-FAM Randomized Controlled Trial

“…Given that financial incentives are commonly used to motivate both children and adults to increase PA [7,8], identifying optimal strategies for leveraging incentives is needed. Linking children's financial incentives to both their own and their parents' behavior represents a novel strategy not previously studied.…”

“…One component includes the use of financial rewards (termed "incentives") in the National Steps Challenge™, a program that is run by the Health Promotion Board and open to all residents [6]. Although this program has not been independently evaluated, financial incentives to increase PA have demonstrated effectiveness both in adults and children [7,8].…”