The clinical utility of delay discounting and demand as therapeutic targets for improving health behaviors: A systematic review protocol (Preprint)

BACKGROUND Our health is shaped significantly by health-related behaviors as diverse as tobacco and other substance use, diet, physical activity, sleep, sexual activities, treatment and care-seeking, and adherence to treatment regimens. Historically, health behavior change models have focused on social and cognitive factors, however, behavior change interventions derived from these models are less than optimally effective. Behavioral economic constructs, such as delay discounting and behavioral economic demand, currently unaccounted for in traditional health behavior change models, are relatively new targets for health behavior change. The application of these constructs in health behavior research represents the novel approach of examining underlying processes generalizable to a wide variety of unhealthy behaviors; however, the clinical utility of these constructs has yet to be explicated. OBJECTIVE This systematic review aims to offer a rigorous, comprehensive, replicable synthesis of the available published scientific literature that examines concomitant changes in delay discounting and/or demand and targeted health behaviors as a consequence of an intervention or treatment. Our objective is to provide evidence, insights, and recommendations that will advance the science in this domain. METHODS The development of this systematic review protocol followed the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. This protocol has been registered on PROSPERO International Prospective Register of Systematic Reviews (CRD420261284218). RESULTS Preliminary searches and reviews were conducted in 2024 and 2025. Formal study selection and data extraction are expected to be complete in February 2026. Data synthesis is expected to be complete in May 2026. CONCLUSIONS This systematic review will identify key aspects of intervention type, health behaviors, delay discounting and demand measures, and analyses useful in identifying knowledge gaps, informing future research, and advancing science in this domain. We expect that these findings will contribute valuable insights for understanding the clinical utility of delay discounting and demand as therapeutic targets for improving health behaviors.