The ABCs of incentive-based treatment in health care: a behavior analytic framework to inform research and practice

Abstract

Steven E Meredith,1 Brantley P Jarvis,2 Bethany R Raiff,3 Alana M Rojewski,2 Allison Kurti,2 Rachel N Cassidy,2 Philip Erb,2 Jolene R Sy,4 Jesse Dallery2 1Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Department of Psychology, University of Florida, Gainesville, FL, USA; 3Department of Psychology, Rowan University, Glassboro, NJ, USA; 4Saint Louis University School of Social Work, St Louis, MO, USA Abstract: Behavior plays an important role in health promotion. Exercise, smoking cessation, medication adherence, and other healthy behavior can help prevent, or even treat, some diseases. Consequently, interventions that promote healthy behavior have become increasingly common in health care settings. Many of these interventions award incentives contingent upon preventive health-related behavior. Incentive-based interventions vary considerably along several dimensions, including who is targeted in the intervention, which behavior is targeted, and what type of incentive is used. More research on the quantitative and qualitative features of many of these variables is still needed to inform treatment. However, extensive literature on basic and applied behavior analytic research is currently available to help guide the study and practice of incentive-based treatment in health care. In this integrated review, we discuss how behavior analytic research and theory can help treatment providers design and implement incentive-based interventions that promote healthy behavior. Keywords: incentives, contingency management, conditional cash transfer, pay-for-performance, wellness