Behavioral Economics, Incentives, and Preventive Health Behavior: Evidence from Three Randomized Field Experiments
Encouraging preventive health behavior is a key component of policies to improve public health and mitigate rising health care costs, yet compliance with recommendations is often low. This panel includes three studies, all employing RCTs, that investigate how behavioral economics might be applied to increase compliance. The papers provide evidence on the effectiveness, and appropriate design, of interventions to promote and sustain positive health behavior change. The first paper investigates decision-making underlying low compliance with flu vaccination, conducting an online messaging campaign at six colleges (n=9,356). The authors find attention to information is high, but take-up is still low, partly due to lack of follow-through on intentions. Three interventions are tested. A financial incentive significantly increased take-up. Two low-cost nudges did not, although the peer endorsement nudge increased exposure to information, especially if aligned with social networks. The second paper studies the optimal structure of incentives in programs that encourage wellness. Models of habit formation and time preference suggest that alternatives to constant incentives might be more effective. One incentive scheme studied uses declining incentives, and the second uses incentives offered periodically. The authors contrast the effects of these incentive structures on exercise and health, relative to an incentive that is constant over time. The third paper examines whether incentives “crowd out” pre-existing intrinsic motivation. The study measures intrinsic motivation when financial incentives are structured as cash rewards or deposit contracts. Participants were found to be highly motivated at baseline, and incentives did not crowd out intrinsic motivation over time.