Effect of Behavioral Economic Incentives for Colorectal Cancer Screening in a Randomized Trial.
Colon Cancer
Money
Payment
Prevention
Journal
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
ISSN: 1542-7714
Titre abrégé: Clin Gastroenterol Hepatol
Pays: United States
ID NLM: 101160775
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
14
10
2019
revised:
15
06
2020
accepted:
21
06
2020
pubmed:
6
7
2020
medline:
10
9
2021
entrez:
6
7
2020
Statut:
ppublish
Résumé
Financial incentives might increase participation in prevention such as screening colonoscopy. We studied whether incentives informed by behavioral economics increase participation in risk assessment for colorectal cancer (CRC) and completion of colonoscopy for eligible adults. Employees of a large academic health system (50-64 y old; n = 1977) were randomly assigned to groups that underwent risk assessment for CRC screening and direct access colonoscopy scheduling (control), or risk assessment, direct access colonoscopy scheduling, a $10 loss-framed incentive to complete risk assessment, and a $25 unconditional incentive for colonoscopy completion (incentive). The primary outcome was the percentage of participants who completed screening colonoscopy within 3 months of initial outreach. Secondary outcomes included the percentage of participants who scheduled colonoscopy and the percentage who completed the risk assessment. At 3 months, risk assessment was completed by 19.5% of participants in the control group (95% CI, 17.0-21.9%) and 31.9% of participants in the incentive group (95% CI, 29.0-34.8%) (P < .001). At 3 months, 0.7% of controls had completed a colonoscopy (95% CI, .2%-1.2%) compared with 1.2% of subjects in the incentive group (95% CI, .5%-1.9%) (P = .25). In a randomized trial of participants who underwent risk assessment for CRC with vs without financial incentive, the financial incentive increased CRC risk assessment completion but did not result in a greater completion of screening colonoscopy. Clinicaltrials.gov no: NCT03068052.
Sections du résumé
BACKGROUND & AIMS
Financial incentives might increase participation in prevention such as screening colonoscopy. We studied whether incentives informed by behavioral economics increase participation in risk assessment for colorectal cancer (CRC) and completion of colonoscopy for eligible adults.
METHODS
Employees of a large academic health system (50-64 y old; n = 1977) were randomly assigned to groups that underwent risk assessment for CRC screening and direct access colonoscopy scheduling (control), or risk assessment, direct access colonoscopy scheduling, a $10 loss-framed incentive to complete risk assessment, and a $25 unconditional incentive for colonoscopy completion (incentive). The primary outcome was the percentage of participants who completed screening colonoscopy within 3 months of initial outreach. Secondary outcomes included the percentage of participants who scheduled colonoscopy and the percentage who completed the risk assessment.
RESULTS
At 3 months, risk assessment was completed by 19.5% of participants in the control group (95% CI, 17.0-21.9%) and 31.9% of participants in the incentive group (95% CI, 29.0-34.8%) (P < .001). At 3 months, 0.7% of controls had completed a colonoscopy (95% CI, .2%-1.2%) compared with 1.2% of subjects in the incentive group (95% CI, .5%-1.9%) (P = .25).
CONCLUSIONS
In a randomized trial of participants who underwent risk assessment for CRC with vs without financial incentive, the financial incentive increased CRC risk assessment completion but did not result in a greater completion of screening colonoscopy. Clinicaltrials.gov no: NCT03068052.
Identifiants
pubmed: 32623005
pii: S1542-3565(20)30910-1
doi: 10.1016/j.cgh.2020.06.047
pmc: PMC7775888
mid: NIHMS1610252
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03068052']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1635-1641.e1Subventions
Organisme : NCI NIH HHS
ID : K08 CA234326
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001878
Pays : United States
Informations de copyright
Copyright © 2021 AGA Institute. All rights reserved.
Références
J Natl Cancer Inst. 2015 Dec 06;108(5):
pubmed: 26640244
JAMA Netw Open. 2019 Mar 1;2(3):e191156
pubmed: 30901053
Am J Health Promot. 2012 Jan-Feb;26(3):184-8
pubmed: 22208418
N Engl J Med. 2013 Sep 19;369(12):1095-105
pubmed: 24047059
Prev Med Rep. 2019 Jun 21;15:100924
pubmed: 31333996
Addict Behav. 2013 Apr;38(4):2084-8
pubmed: 23403276
Ann N Y Acad Sci. 2019 Aug;1449(1):46-55
pubmed: 31111509
MMWR Morb Mortal Wkly Rep. 2017 Mar 03;66(8):201-206
pubmed: 28253225
Science. 2008 Mar 21;319(5870):1687-8
pubmed: 18356530
Am J Prev Med. 2020 Apr;58(4):596-603
pubmed: 32008799
Gastroenterology. 2017 Nov;153(5):1227-1229.e2
pubmed: 28734830
Gut. 2018 Feb;67(2):291-298
pubmed: 27733426
CA Cancer J Clin. 2018 Jan;68(1):7-30
pubmed: 29313949
Am J Health Promot. 2009 May-Jun;23(5):343-52
pubmed: 19445438
Ann Intern Med. 2016 Mar 15;164(6):385-94
pubmed: 26881417
Am J Manag Care. 2015 Jul;21(7):511-7
pubmed: 26247741
Health Serv Res. 2011 Oct;46(5):1663-74
pubmed: 21492159
N Engl J Med. 2017 Oct 12;377(15):1412-1414
pubmed: 29020586
Health Psychol. 1995 Mar;14(2):178-84
pubmed: 7789354