Currently submitted to: Journal of Medical Internet Research
Date Submitted: Apr 5, 2026
Open Peer Review Period: Apr 6, 2026 - Jun 1, 2026
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Incentivisation in Communities of Practice for Chronic Conditions: Systematic Review
ABSTRACT
Background:
Incentivisation is increasingly used to maintain engagement and support behaviour change within communities of practice (CoPs), yet its effectiveness across chronic disease contexts remains uncertain.
Objective:
To examine how incentives are integrated into CoPs and related peer-support models, and to assess their impact on participant activation, engagement, and health-related outcomes.
Methods:
PubMed/MEDLINE, Embase, Scopus, and CENTRAL were searched from inception to June 2025 using predefined terms relating to CoPs, incentivisation, and patient-centred outcomes. Peer-reviewed empirical studies involving incentivised CoPs or analogous peer-support interventions for adults with chronic conditions were eligible. Four reviewers independently screened studies, extracted data, and assessed risk of bias in line with PRISMA 2020 guidance. Heterogeneity in design and outcomes required narrative synthesis.
Results:
From 667 records, four randomised controlled trials met inclusion criteria. Financial incentives produced the greatest short-term gains in physical activity, while non-financial approaches such as gamification, points, badges, and structured peer support yielded modest improvements in step count, treatment adherence, or diet quality. No consistent effects were observed for patient activation, self-efficacy, mental health, or quality of life. Engagement moderated effectiveness, although attrition was common.
Conclusions:
Incentivisation can enhance short-term behavioural outcomes within CoPs, but evidence for sustained psychosocial benefit is limited. Larger, longer-term studies are needed to clarify which incentive strategies deliver durable improvements in engagement and self-management. Clinical Trial: This review was registered on PROSPERO, an international prospective register of systematic review (January 2026, reference CRD420251244276).
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