Nudging for health: do we need financial incentives?

Incentive theory, or the "pull theory" of motivation, suggests that external rewards primarily drive behavior. Individuals are motivated to engage in activities when they anticipate a desirable outcome. This is why people often work hard for promotions or study intensively to achieve high grades. These incentives can be tangible, physical rewards such as money or promotions, or intangible, non-physical rewards like praise and social recognition.
The theory differentiates between intrinsic and...

The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...

Researchers have tested many persuasion strategies, including the foot-in-the door and the door-in-the-face techniques, in a variety of contexts. Ultimately, the principles are effective in selling products and changing people’s attitude, ideas, and behaviors (Cialdini & Goldstein, 2004).

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...

Adopting a healthier lifestyle often requires overcoming significant challenges, but leveraging psychological, social, and cultural resources can facilitate meaningful change. Effective self-change hinges on understanding and applying key tools such as motivation and goal setting, which help sustain efforts toward long-term health benefits.
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...