The use of incentives in the formation of healthy lifestyle habits following the school to work transition

Much national and international resource has been directed at the question “can you pay people to be healthy?” Via a cluster randomized control trial, we tested whether rewards (4 x £10 vouchers) could incentivize school-leavers to engage into a healthy behavior initiative. Participants were allocated to three groups: control, behavioral support, and behavioral support with reward. The number of participants attending an initial appointment was higher for those gaining a reward. Yet of the 171 participants receiving incentives only 74 actually attended their first intervention appointment, reducing to only 18 at follow-up. These data speak toillustrate the weak motivational role that engagement-contingent rewards (i.e., that have no competence affirmation to counteract negative effects of feeling controlled) play in even the short-term enactment of very specific behaviors. A follow-up trial with 54 school-leavers showed informational rewards to better support engagement via providing supports for the participants’ autonomy and competence. Implications are discussed.