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Viewpoint
May 28, 2014

Commitment DevicesUsing Initiatives to Change Behavior

Author Affiliations
  • 1Harvard Kennedy School, Harvard University, Boston, Massachusetts
  • 2The Wharton School, Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia
  • 3Philadelphia VA Medical Center, The Perelman School of Medicine and The Wharton School, Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia
JAMA. 2014;311(20):2065-2066. doi:10.1001/jama.2014.3485

Unhealthy behaviors are responsible for a large proportion of health care costs and poor health outcomes.1 Surveys of large employers regularly identify unhealthy behaviors as the most important challenge to affordable benefits coverage. For this reason, employers increasingly leverage incentives to encourage changes in employees’ health-related behaviors. According to one survey, 81% of large employers provide incentives for healthy behavior change.2 In this Viewpoint, we discuss the potential and limitations of an approach that behavioral science research has shown can be used to influence health behaviors but that is distinct from incentives: the use of commitment devices (Table).3

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