The effects of tangible and intangible incentives on health behaviour

Duration: April 2015 - November 2015
Publication: LBI-HTA Projektbericht No. 83: https://eprints.aihta.at/1078/

Language: German

Background:

According to the health determinants model, our health conditions strongly depend on structural frameworks in society as well as on our individual health behaviour patterns.

Basically, health determinants represent factors that profoundly coin our health status. Apart from individual factors (e.g. age, genetic factors), health determinants describe socio-economic aspects and environmental frameworks as well as the individual’s health behaviour patterns and life-styles. Hence, health sciences distinguish between two basic approaches to influence health (and the development of diseases) in populations. Structural prevention intends to influence health by changing people’s living conditions (e.g. labour conditions, family related issues, leisure time options or environmental issues). The aim is to create low-risk living and working environments (e.g. via health promotion at the workplace, ban on smoking at restaurants, bars, public spaces etc.). By contrast, behavioural prevention attempts to influence on individual health behaviour patterns. This may include health (promotion) information, economic sanctions or monetary incentives etc., in order to motivate the individual to avoid health risks and to live a healthy life (e.g. physical activities, healthy food etc.).

Consequently, the project attempts to answer the following research questions:

• Which incentive concepts do exist to influence positively citizens’ health behaviour?
• Which incentives focusing on lifestyle changes on micro / meso and macro level have been analysed concerning their effectiveness and which other effects have been observed?

Aim of project:

The project aim is defined under the premise of a health care system that is based on solidarity. Against this backdrop, the project focuses on incentives per se respectively on (country specific) concepts of incentive systems pursuing the support of positive health behaviour (lifestyle changes). In this context, potential repercussions of incentives for specific subpopulations (e.g. social disadvantaged groups) shall be considered.

The first part of the project will provide an overview of concepts dealing with tangible and intangible incentives (incl. healthy living conditions as well as healthy life-styles). The second project part will describe concrete examples of influencing factors (to be further defined), the available evidence of (in)effective measures and their implications for the increase or decrease of health inequalities.

Methods:

Scoping with the contracting authority

Part 1: Literature overview based on selective literature search (hand search, expert inputs etc.)

Measures including potential incentives shall be categorized according to the following table:

The target groups of the identified incentives and possible indicators that were used in the context of the interventions shall also be presented.

Part 2: (depending on the thematic issues to be further defined)

• Systematic literature search (in several databases)
• Selective literature search (e.g. project databases)
• Literature selection
• Data extraction / presentation of results
• (methodological specification to be further defined)

Time schedule/milestones:

April - May 2015: scoping, project protocol

May - June 2015: literature search and summary of the identified incentives

July 2015: choice of the thematic issues for part II in consultation with the Main Association of Austrian Social Security Institutions

July - October 2015: systematic literature search, literature selection, data extraction, drafting of report

November 2015: internal and external review, publication