Incentive-based interventions: Historical context and new directions

There is growing recognition of the need for effective interventions to promote healthy behavior change. The use of incentives is one promising treatment wherein objectively verified measures of behavior change are reinforced, generally with monetary incentives, goods, or services. While the use of incentives began in the fields of obesity and substance use disorders (SUDs), most of its development has occurred within the latter. More than four decades of research in SUDs has resulted in a more unified view of drug use as a modifiable behavior that follows general behavioral principles. More recently the use of incentives has again gained interest in the area of obesity while also expanding into a variety of other areas, including medication adherence, physician performance, international efforts to combat health disparities, and family planning. With these expansions come new challenges, including new ethical considerations when using incentives in the health field.