The Trouble with Studying Financial Motivation

Oooh Baby

Childhood Obesity News has been looking at the pros and cons of bribing and/or rewarding kids for their weight loss efforts and/or successes. One thing to always keep in mind regarding bribery is that this is how a lot of families get in trouble in the first place — when parents use the promise of a sweet treat to barter for desired behavior.

Not only does this practice build dangerous mental and emotional links to high-calorie foods, but it may even render good behavior more difficult to achieve. A vast body of literature ties behavioral problems to the “sugar high.” But that’s a topic for another place and time.

A while back, concerned citizens of the United Kingdom expressed alarm because the National Institute for Health and Clinical Excellence had determined that there was some support for programs that paid people for smoking cessation, weight loss, and other health-enhancing efforts. Critics of the idea thought it a flat-out waste of public money.

Not long afterward, a group of four researchers announced a meta-study that would answer some questions about the efficacy of financial incentives, namely: whether effective financial reward would depend on the length of the intervention period and of the follow-up period; exactly what kind of incentive works best; and how these factors would vary according to the subjects’ socioeconomic position, gender, age, and other variables.

In the fall of 2013, the team published a paper “documenting the complexity of financial incentive interventions” when it came to behavioral change. They had looked into a number of different programs, past and present, and drawn some general inferences that were not so much conclusions as pointers to areas needing further exploration. Among the findings:

In practice, many financial incentive interventions designed to change health behaviours include a number of different incentive components…. Given the complexity of financial incentive interventions, the framework highlights the naivety of current research that tends to focus on simple questions of whether or not financial incentive interventions ‘work’ to successfully change healthy behaviours.

We do not believe that this complexity has been widely recognised previously and the framework helps both to highlight this and to provide a vocabulary to begin to explore it further.

In short, they don’t seem to have established much except how to ask better questions — which, after all, is no small matter.

Your responses and feedback are welcome!

Source: “Disgust over NHS bribes to lose weight and cut smoking,”, 09/27/10
Source: “Carrots, sticks and health behaviours: a framework for documenting the complexity of financial incentive interventions to change health behaviours,”, 10/21/13
Image by Emilio Labrador

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