In the last decade, there has been a robust increase in research using financial incentives to promote healthy behaviors as behavioral economics and new monitoring technologies have been applied to health behaviors. Most studies of financial incentives on health behaviors have focused on adults, yet many unhealthy adult behaviors have roots in childhood and adolescence. The use of financial incentives is an attractive but controversial strategy in childhood. In this review, we first propose 5 general considerations in designing and applying incentive interventions to children. These include: 1) the potential impact of incentives on intrinsic motivation, 2) ethical concerns about incentives promoting undue influence, 3) the importance of child neurodevelopmental stage, 4) how incentive interventions may influence health disparities, and 5) how to finance effective programs. We then highlight empirical findings from randomized trials investigating key design features of financial incentive interventions, including framing (loss vs gain), timing (immediate vs delayed), and magnitude (incentive size) effects on a range of childhood behaviors from healthy eating to adherence to glycemic control in type 1 diabetes. Though the current research base on these subjects in children is limited, we found no evidence suggesting that loss-framed incentives perform better than gain-framed incentives in children and isolated studies from healthy food choice experiments support the use of immediate, small incentives versus delayed, larger incentives. Future research on childhood incentives should compare the effectiveness of gain versus loss-framing and focus on which intervention characteristics lead to sustained behavior change and habit formation.

在过去十年中，随着行为经济学和新的监测技术被应用于健康行为，使用经济激励来促进健康行为的研究有了强劲增长。大多数关于健康行为的经济激励研究都集中在成年人身上，但许多不健康的成年人行为都源于童年和青春期。在儿童时期，使用经济激励是一种有吸引力但有争议的策略。在这篇综述中，我们首先提出了 5 个设计和应用儿童激励干预的一般考虑因素。其中包括：1) 激励措施对内在动机的潜在影响，2) 对促进不当影响的激励措施的伦理担忧，3) 儿童神经发育阶段的重要性，4) 激励措施如何影响健康差异，5) 如何资助有效的项目。然后，我们重点介绍了随机试验的实证结果，该试验调查了财务激励干预的主要设计特征，包括框架（损失与收益）、时间（立即与延迟）和幅度（激励规模）对从健康饮食到依从性的一系列儿童行为的影响1 型糖尿病的血糖控制。尽管目前对儿童这些主题的研究基础有限，但我们没有发现任何证据表明损失框架激励措施比收益框架激励措施在儿童中表现更好，而且来自健康食物选择实验的孤立研究支持使用即时的、小的激励措施而不是延迟的，更大的激励。