University of Vermont

College of Medicine

Higgins’ Pioneering Health and Incentives Research Theme of Special Journal Supplement

Stephen Higgins, Ph.D.
Stephen Higgins, Ph.D., UVM professor of psychiatry and psychology (Photo: UVM Med Photo)

Behavior choices – like cigarette smoking, food selection and exercise – can significantly impact health, yet experts continue to wrestle with the challenge of getting individuals to make changes. For more than 20 years, Stephen Higgins, Ph.D., University of Vermont professor of psychiatry and psychology, has led pioneering research providing compelling scientific evidence that modest financial incentives can be effective at promoting healthy behavior. 

The vice chair of the Neuroscience, Behavior and Health Initiative and editor of the textbook Contingency Management in Substance Abuse Treatment (The Guilford Press, 2007), Higgins and Stacey Sigmon, Ph.D., associate professor of psychiatry, recently served as co-editors and contributors for a special supplement to the journal Preventive Medicine, titled “Incentives and Health” (Volume 55, Supplement, Pages S1-S124, November 1, 2012).

Using financial incentives for promoting health – a model developed by Higgins – is founded on the use of small monetary rewards in exchange for healthy behavior compliance. This low-cost approach has been successfully applied to reinforce a variety of healthy behaviors in studies and public health initiatives around the world.

Below, Higgins provides an overview of the special issue of Preventive Medicine:
“The overarching scientific rationale for this strategy is discussed in the Introduction, along with two articles exploring the neurobiological rationales. Additional papers address fundamental issues undermining health in industrialized countries, including cigarette smoking, illicit drug abuse, weight management, and medication management. There is also an article discussing efforts to incentivize physicians to provide more effective care to patients suffering from chronic diseases who are impacted by lifestyle. Other articles address challenges in developing and middle-income countries, including basic questions around infant inoculations, contraception, and other challenges to improving health in those settings. Some of the ethical and public perception issues that can arise with incentive strategies are examined as well. Important to underscore is that support for this special issue was generously provided by the U.S. Navy as military health is impacted by many of these same issues. They commissioned an examination of the scientific evidence on this strategy for improving health generally rather than specific to the military per se.  Specific questions about applying this strategy to the U.S. military are examined in two articles.  Overall, this special issue provides a thorough and comprehensive examining and an emerging, evidence-based strategy for improving health that all of us are likely to contact in our professional or personal lives as experts wrestle with ways to improve health and curb spiraling health care costs.”

In addition to Higgins and Sigmon, UVM contributors to the special supplement include Philip Ades, M.D., professor of medicine; Ira Bernstein, M.D., professor and chair of obstetrics, gynecology and reproductive sciences; Diann Gaalema, Ph.D., assistant professor of psychiatry; Hugh Garavan, Ph.D., associate professor of psychiatry; Sarah Heil, Ph.D., associate professor of psychiatry; Evan Hermann, predoctoral fellow in psychiatry; Tara M. Higgins, first-year medical student; Mollie Patrick, predoctoral fellow in psychiatry; Laura Solomon, Ph.D., professor of family medicine and psychology emerita; and Karen Weierstall, research project assistant in psychiatry.