Supplementary File E (Data Extraction Table).xlsx

Purpose: To update the evidence on the effects of financial incentives (FI) on physical activity (PA) in adults. Design: Systematic review and meta-analysis. Data sources: Medline, EMBASE, PsychINFO, Scopus, Web of Science, CINAHL, EconLit, SPORTDiscus, and Cochrane. Methods: ‘Vote counting' and random-effects meta-analyses assessed short- (<6 months) and long-term (>6 months) FI effects, as well as impact during follow-up (incentive withdrawal). Meta-regressions examined moderator effects. Eligibility criteria for selecting studies: Randomised controlled trials (RCTs) and pilot RCTs published between June 1, 2018 and March 31, 2024 examining FI-for-PA interventions. Results: Twenty-nine studies (n=21 RCT, n=8 pilot RCTs; median FI size=$1.19 USD/day) involving 9604 participants were included (60.8% female, mean age=42.7 years). 17 of 21 studies reported positive short-term effects. 5 of 5 and 3 of 8 studies, respectively, reported positive long-term and follow-up effects. Among the 15 studies included in daily step count meta-analyses (most commonly reported PA outcome), FI had a moderate effect during short-term interventions (standardized mean difference [SMD] [95% CI]=0.52 [0.25-0.78], p<0.001) and a small effect in follow-up (SMD [95% CI]=0.20 [0.01-0.40], p=0.04). Too few long-term studies reported daily step count to conduct pooled analyses (n=1). Meta-regressions suggest study length, incentive size, wearable device-use, and goal setting moderate FI effects (p<0.05). Conclusion: Twenty-nine studies were identified over a 6-year span. Short-term FI interventions increase PA. The impact on daily step count is clinically significant (>1000 steps/day). Key contextual factors moderate effects. Evidence is limited regarding long-term and follow-up effects.