Unique digital images as incentives in clinical trials: a digital shift toward meaningful participation

Journal article

Incentivization in clinical trial participation can be challenging, with many studies failing to meet recruitment or retention goals despite traditional compensation strategies. Digital health evolves, and with it, new approaches can emerge to engage participants meaningfully. We propose unique digital images as a novel, symbolic incentive for clinical trials. Digital images combine qualities such as personalization, ownership, and digital visibility, which may drive engagement more effectively than monetary rewards alone. In our illustrative study, participants complete artificial intelligence–personalized digital therapeutics training using CURATE.DTx, generating individualized learning trajectories. These are transformed into digital artworks and minted as nonfungible tokens given as a reward upon trial completion. This concept integrates gamification, personalization, and blockchain technology to support both intrinsic and extrinsic motivation. We explore the implications for decentralized health care, long-term behavior change, and participant recognition in the context of preventive medicine and longevity science. Our aim is to encourage research into the use of digital incentives to transform the trial participant experience and promote sustained engagement in health interventions.

Authors: Tadeo, X; Seres, G; Wang, P; Sapanel, Y; Remus, A

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: JMIR Publications
• Journal: Journal of Medical Internet Research
• Volume: 28
• Article number: e88022
• Publication date: 2026-06-08
• Acceptance date: 2026-04-20
• DOI: 10.2196/88022
• EISSN: 1438-8871
• Language: English
• Keywords: AI; decentralized health care; behavior change; participant incentives; digital health; clinical trial engagement; NFT; artificial intelligence; nonfungible tokens