Promoting Healthy Childhood Behaviors With Financial Incentives: A Narrative Review of Key Considerations and Design Features for Future Research
Section snippets
Potential Effects on Intrinsic Motivation
One of the primary critiques of financial incentives to promote health behaviors relates to the potential effects on intrinsic motivation. The motivational crowding theory suggests that providing external rewards to incentivize behavior can potentially decrease intrinsic motivation by “crowding out” existing intrinsic motivation or preventing it from developing.10 While there is no clear consensus on how and when incentives may crowd out intrinsic motivation, several researchers have
Framing: Gain and Loss-Framed Incentives
Behavioral economists have built on the foundational work on positive and negative reinforcement8,9,34,35 by exploring the differential framing of financial incentives. Individuals tend to overly weight the impacts of losses compared to gains. Implementing loss-framed incentives for health behaviors has been effective in increasing physical activity and smoking cessation rates in adult populations,36,37 but there is less evidence in children.
Two randomized clinical trials seeking to improve
Future Research
While the use of financial incentives to promote childhood health behaviors is not new, knowledge of what approaches are most effective at what developmental stage remains poorly understood. The quantity of experimental studies in children is limited and distributed across a range of behaviors, yet several early observations are emerging. While there is robust evidence for loss-framing in adults, it is not clear that this approach is effective in children. Also, evidence from several primary
Acknowledgments
Financial statement: This work was supported by the National Institutes of Health award grant no. K23HL136842 to C.C.K and K08CA226390 to B.P.J.
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Cited by (2)
The authors have no conflict of interest to disclose.
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These authors contributed equally.