To reward? ... or not to reward?: questioning the wisdom of using external reinforcement in health promotion programs.

Positive reinforcement through the use of rewards and incentives is generally accepted as an effective technique to change behavior and is regularly used to help raise children, teach students, and motivate workers. Ironically, research does not support the contention that rewards and incentives promote lasting behavior change. Nevertheless, many health promotion programs, from smoking cessation classes to exercise and weight loss competitions to worksite initiatives for lowering blood pressure and cholesterol have incorporated the use of rewards and incentives to help promote participation and health behavior change.