Designing financial incentives for health behaviour change: a mixed-methods case study of weight loss in men with obesity

Marjon van der Pol* (Corresponding Author), Matthew Mcdonald, Hannah Elizabeth Collacott, Stephan Dombrowski, Fiona Harris, Frank Kee, Alison Avenell, Cindy Gray, Rebecca Skinner, Pat Hoddinott

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Aim: Designing financial incentives for health behaviour change requires choices across several domains, including value (the size of the incentive), frequency of incentives, and direction (gain or loss). However, the rationale underlying complex incentive design is infrequently reported. Transparent reporting is important if we want to understand and improve the incentive development process. This paper describes a mixed methods approach for designing financial incentives for health behaviour change which involves stakeholders throughout the design process.
Subject and methods: The mixed methods approach focuses on incentives for weight loss for men with obesity living in areas with high levels of disadvantage. The approach involves: (a) using an existing framework to identify all domains of a financial incentive scheme for which choices need to be made, deciding what criteria are relevant (such as effectiveness, acceptability and uptake) and making choices on each domain on the basis of the criteria; (b) conducting a survey of target population preferences to inform choices for domains and to design the incentive scheme; and (c) making final decisions at a stakeholder consensus workshop.
Results: The approach was implemented and an incentive scheme for weight loss for men living with obesity was developed. Qualitative interview data from men receiving the incentives in a feasibility trial endorses our approach.
Conclusion: This paper demonstrates that a mixed methods approach with stakeholder involvement can be used to design financial incentives for health behaviour change such as weight loss. Trial registration number: NCT03040518. Date: 2 February 2017.
Original languageEnglish
Pages (from-to)65-77
Number of pages13
JournalJournal of Public Health
Issue number1
Early online date12 Dec 2022
Publication statusPublished - Jan 2024

Bibliographical note

We would like to thank Nicolas Krucien for advice on the DCE design and analysis. This project was funded by the National Institute for Health Research [Public Health Research] (project number 14/185/09). The Chief Scientist Office of the Scottish Government Health and Social Care Directorates funds HERU and NMAHP-RU. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of Public Health Research, NIHR, NHS, the Department of Health or CSO. The Health Informatics Centre, University of Dundee provided the automated software for intervention delivery. We would like to thank all the men, Game of Stones research team and stakeholders who gave generously of their time.

Data Availability Statement

Data are available on reasonable request. Access to data can be arranged through the coprincipal investigators of the study: Professor Pat Hoddinott (University of Stirling, and Dr. Stephan Dombrowski (University of New Brunswick, to discuss data sharing, data requirements and conficts of interest, in line with any EU and other regulations, including ethics approvals.

The online version contains supplementary material available at


  • Financial incentives
  • Health behaviour
  • Intervention design
  • Preferences
  • Stakeholder involvement


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