The Role of Self-Rewards in Behaviour Change.

  • Emma Brown

Student thesis: Phd


Objectives: Smoking is still regarded as the leading cause of premature morbidity and mortality, making the current smoking prevalence rates a public health concern. Approaches have been established in the UK to target the smoking prevalence rates such as the development of UK stop smoking programmes. However, it has been suggested that some of these programmes do not achieve the most optimal levels of successful four-week quit outcomes, which has resulted in a plateau of smoking prevalence rates over the last ten years. Use of externally administered rewards has appeared to be an effective means of increasing the smoking quit outcomes within UK stop smoking programmes, though the costs associated means that this technique has only been used on a small sample of smokers. Therefore, this PhD aimed to assess the role and effectiveness of self-administered rewards (i.e., self-rewards) as an inexpensive alternative to externally administered rewards to increase the smoking quit outcomes within UK stop smoking programmes. Three separate studies were conducted to identify the role of self-rewards towards behaviour, and to investigate the possible role and effectiveness of self-rewards for smokers attending a UK stop smoking programme. Methods: A systematic review and meta-analysis (N = 10 studies) was conducted to identify the use and overall effectiveness of self-rewards in behaviour change. Two randomised controlled trials (N = 90, & N = 159 participants respectively) were conducted to investigate the role and effectiveness of self-rewards towards smoking cessation within UK community based stop smoking programmes. Results: Findings from the systematic review and meta-analysis reported that self-rewards appear to be an ineffective behaviour change technique when used in isolation, though the lack of available studies in this review hindered any further moderation analyses. A key finding from the narrative synthesis was that participants often fail to administer the self-reward contingent on progress towards, or achievement of the pre-specified goal. This suggests that self-rewards may require an additional prompt to encourage the successful administration of the self-reward when the behaviour is achieved in the future. Two randomised controlled trials utilising implementation intention prompts (self-generated plan specifying "when", "where" and "how" they would self-reward; experimenter-provided "if-then" stem, respectively) to encourage self-reward administration, found that self-rewards augmented the smoking quit outcomes within UK stop smoking programmes at 3-month follow-up. The first randomised controlled trial (self-generated implementation intentions and self-rewards) found that both the weekly self-rewarding and monthly self-rewarding conditions were not significant predictors of smoking quit status, using the active control as the comparison condition (asked to form a plan to quit smoking only). The second randomised controlled trial (experimenter-provided implementation intention stem, and a list of experimenter-provided self-rewards) found a statistically significant increase in smoking quit outcomes within UK stop smoking programmes for both weekly, and monthly self-rewarding groups compared to the active control condition. Further analyses from the second randomised controlled trial found that the mechanism of successfully administering a self-reward was required to produce successful smoking quit outcomes, as opposed to merely intending to use a self-reward as directed at baseline. Conclusions: The available evidence on the role and effectiveness of self-rewards is lacking, though it is possible to successfully encourage the administration of self-rewards using implementation intentions to produce increases in smoking quit outcomes at 3-month follow-up. Future research is required to add to this evidence in order to ascertain if self-rewards are effective for other populations, behaviours and contexts.
Date of Award1 Aug 2017
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorChristopher Arden Armitage (Supervisor) & Debbie Smith (Supervisor)

Cite this