PublicationsSystematic reviewsIncentives - systematic review
A systematic review of the evidence for incentive schemes to encourage positive health and other social behaviours in young people

What do we want to know?

There is considerable and growing, interest in the possibility that providing direct incentives of one kind or another can encourage healthy behaviours. This systematic review brings together the relevant research literature to examine the impact of single or dual component incentives schemes in encouraging positive health and other social behaviours in young people aged 11-19. It also examines ongoing incentive-based schemes in more detail.

Who wants to know?

Policy-makers, practitioners, researchers, young people.

What did we find? 

  • Overall incentive schemes do not offer a simple route to ensuring general positive behaviour changes in young people. However, they may be useful in particular settings and for particular groups.
  • There is evidence that non-financial incentives are effective in encouraging teenage mothers to attend an early post-natal health clinic.
  • We found no evidence that simple incentive schemes are effective in improving either young peoples levels of effort applied to educational tests or attendance levels in school.
  • Incentives are effective in reducing smoking behaviours in the context of school-based competitions. These findings were based on a small number of non-UK studies, and should be interpreted with caution. 
  • Simple incentives schemes may be more effective where a simple or single action is required, rather than a sustained positive health behaviour change.

What are the implications?

  • Incentive schemes to promote the uptake of simple or single event preventive health behaviours in young people should be designed and piloted. These schemes could include immunisation or health screening programmes, and accessing pre- and post-natal health services.
  • Classroom-based incentive schemes which aim to delay the onset of or reduce levels of smoking should be piloted and evaluated in well-designed randomised controlled trials.
  • Future incentive schemes should access, and take into account, the views of young people on important areas of behaviour change, and what types of incentive-based interventions might be acceptable to them. This is an essential first step in designing and implementing acceptable and effective interventions.
  • Future evaluation research in this area should prioritise the use of randomised controlled trials. All evaluations should be accompanied by well-designed process evaluations.
  • Those conducting publicly funded incentive schemes should be encouraged to conduct reliable evaluations of the interventions that they implement with young people.

How did we get these results?

The results of sixteen trials and seven process evaluations were synthesised to yield the best evidence currently available about the role of incentive schemes in promoting young people's well-being.

This report should be cited as: Kavanagh J, Trouton A, Oakley A, Powell C (2006) A systematic review of the evidence for incentive schemes to encourage positive health and other social behaviours in young people. London: EPPI Centre, Social Science Research Unit, Institute of Education, University of London.

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