Feasibility and Acceptability of an Incentive-Based Intervention for Health Behaviour Change Among Rural Residents in...

Encouraging healthy behaviours among rural residents in China is crucial to promote health and well-being. Although financial incentives are known to be effective in promoting single healthy behaviours, their efficacy in simultaneously encouraging multiple healthy behaviours remains unclear. This study aimed to test the feasibility and acceptability of an incentive-based intervention to encourage multiple healthy behaviours.

'Health Bank', a digital platform established by the Changxing County Center for Disease Control and Prevention, was employed financial incentives to engage villagers in promoting healthy behaviours. The intervention, conducted from January to October 2022, was followed by a mixed-methods evaluation in November 2022 to assess its feasibility and acceptability as the primary outcomes. Feasibility was assessed based on quantitative data from self-administered questionnaires and routine data, while acceptability was assessed by conducting semi-structured interviews.

Routine data indicated that 1164 out of 3137 (37.1%) villagers participated in 'Health Bank', with the majority completing the required three daily healthy behaviours, despite their low participation rates in other behaviours. Among the 140 surveyed villagers, 68 respondents were not willing to participate in 'Health Bank', with only 19% refraining due to a lack of interest or need. The qualitative results suggested that financial incentives were a compelling factor for most participants, though challenges remained regarding the programme's elderly-friendliness, gift redemption process and the range of activities covered.

Although the incentive-based behaviour change intervention exhibited promising feasibility and acceptability, participant feedback necessitates further modifications. To comprehensively assess the efficacy of this intervention, larger-scale, randomised controlled trials were encouraged.

A team-based approach was taken for developing the incentive-based intervention model for this study. This included experienced staff from local Centers for Disease Control and Prevention, as well as community workers and community residents.