Human nature is such that we very rarely do things that don’t provide a payback in some form or other. This payback may be financial, psychological or even spiritual, but with few exceptions this is the way of the world that we live in.

I've recently been doing a fair amount of work with American companies and it is clear that the US has taken the "what's in it for me" culture to a new level. Many US employers provide incentives to their employees to engage in workplace health promotion initiatives.

A decade or so ago these incentives used to be things like a cap or a t-shirt, however now they are "cold hard dollars". Complete an annual health risk assessment questionnaire? That'll be $100 thank-you very much.

Enrol in a weight management or smoking cessation programme - $50, and a further $50 on completion. This may seem staggering to us with a state funded healthcare system here in the UK, but with the majority of healthcare insurance costs still being borne by employers in America they are desperate to try any means they can to stop the costs escalating. But would this approach work here?

A couple of years ago I remember the NHS getting some rather bad press for piloting a scheme that paid obese people to lose weight, despite the fact that a significant proportion of those targeted did actually manage to meet weight loss targets. So does the incentives model have a future here in the UK? I guess the main question that needs to be asked is whether the changes that are being incented are sustainable? Looking at the research literature it is very clear that incentives, whether in the form of direct cash rewards or lottery style approaches, do work in getting more people engaged in a particular endeavour, as well as delivering better short- to medium-term outcomes.

Examples include weight loss, smoking cessation and medication adherence. The downside, however, is that once the incentives are removed behaviour tends to regress back to that at the start of the programme. A number of organisations offer incentives for high attendance rates at work. Possibly one of the most infamous schemes was that of the Royal Mail offering cars to employees who had exemplary absence records. So maybe we should be thinking about the whole area of offering incentives for individuals to adopt healthier lifestyles? After all, the evidence linking health to productivity and performance is extremely good.