Citizens of the United States and United Kingdom do not appear to approve of the idea of payment as motivation for changing health behaviors, according to study results published in the June 13, 2011 online edition of the Journal of Medical Ethics . The main objection, according to the analysis, is that this approach is unfair.

Financial incentives are increasingly being used to motivate people to remain drug-free, to stick with weight-loss plans, and to quit smoking, but evidence is limited and conflicting on the success of these programs.

British researchers performed a survey of nearly 188 residents of the U.S. and U.K. to gauge their thoughts on the topic.

Survey participants were informed that two types of financial incentives (weekly rewards or penalties) and two medical intervention types (weekly pills or injections) were equally effective in improving outcomes in the following contexts:

Weight loss.

Smoking cessation programs.

Treatment adherence in a drug addiction program.

Treatment adherence in a serious mental illness program.

Physiotherapy after surgery.

They were then asked to rate the acceptability and fairness of the four interventions. Across all five contexts, financial incentives were deemed less acceptable and less fair than medical interventions.

When comparing rewards to penalties, the researchers found that context played a role in preference. Both U.S. and U.K. participants preferred rewards over penalties for weight loss and treatment adherence for serious mental illness. Among U.S. participants, this “relative preference [was] moderated by perceived responsibility of the target group.” When members of the target group were less responsible for their health condition, participants more strongly supported funding for interventions.

Download Study Results

Physician’s Weekly wants to know…

What do you think form(s) the basis for such negative attitudes toward financial incentive programs to reach health goals?

Based on these survey results, would you encourage or discourage patients from participating in financial incentive programs?

Do you currently, or have you ever, worked with patients enrolled in a financial incentive program? If so, what were the experiences like for you and for your patient(s)?

What are your personal attitudes toward the use of financial incentives to reach health goals?