Financial incentives for healthy living in cardiac patients from the perspective of healthcare professionals: an interview study
ABSTRACT
Background:
A promising new approach to support lifestyle change in cardiovascular disease (CVD) patients is the use of financial incentives. Although financial incentives have proven to be effective, their implementation remains controversial and ethical objections have been raised. It is unknown whether healthcare professionals involved in CVD care find it acceptable to provide financial incentives to CVD patients as support for lifestyle change.
Objective:
This study investigated healthcare professionals’ perspectives on using financial incentives to support healthy living in CVD patients. More specifically, we aimed to (1) provide insight into attitudes towards using financial incentives and (2) provide insight into obstacles and facilitators of implementing financial incentives in current CVD care.
Methods:
16 semi-structured in-depth face-to-face interviews were conducted with Dutch healthcare professionals involved in supporting CVD patients with lifestyle change. Discussed topics were: (1) attitudes towards an incentive system, (2) obstacles for using an incentive system and (3) possible solutions to facilitate the use of an incentive system.
Results:
Healthcare professionals perceived an incentive system for healthy living in CVD patients as possibly effective and showed generally high acceptance. However, there were concerns related to (1) focusing too much on extrinsic aspects of lifestyle change, (2) disengagement when rewards are insignificant, (3) paternalization and threatening autonomy and (4) low digital literacy in the target group. According to healthcare professionals, solutions to mitigate these concerns were: (1) emphasize intrinsic aspects of healthy living while giving extrinsic rewards, (2) integrate social aspects to increase engagement, (3) support autonomy by allowing freedom of choice in rewards and (4) aim for target group that can work with the necessary technology.
Conclusions:
The current study mapped perspectives of Dutch healthcare professionals and shows that attitudes are predominantly positive, provided that contextual factors, design and target group are accurately considered. Follow-up research needs to validate these insights among CVD patients.
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Copyright
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