Laypersons' Views of Material Incentives for Enhancing Colorectal Cancer Screening

Overview

Journal Health Expect

Publisher Wiley

Specialty Public Health

Date 2013 Jun 11

PMID 23745608

Citations 1

Authors

Lea Hagoel

Gad Rennert

Paula Feder-Bubis

Affiliations

Soon will be listed here.

Abstract

Background: Colorectal cancer (CRC) early detection improves health outcomes; screening programmes invest efforts in initiating invitations to target populations to be tested. Enhanced adherence is essential for reduction of morbidity and mortality. Participation rates in Israel are still relatively low.

Objective: To explore lay views regarding the concept of receiving material incentives in exchange for enhanced adherence to CRC screening.

Research Design: Qualitative study. Between November 2009 and February 2010 six focus group discussions were carried out in two urban, middle and low socio-economic status primary care clinics in a Northern city in Israel. Participants were eligible individuals for CRC screening, aged 50-68 (N = 24). Data analysis followed the principles of grounded theory, supported by qualitative software.

Results: Participants found administering incentives in exchange for CRC screening inappropriate on rational and moral grounds. They valued their relations with the medical team and the health system more than the potential gain expected. Individuals eligible for CRC screening perceived themselves as responsible for their health, admitting difficulties in realizing this responsibility. Incentives were reported unsuitable for solving reported screening difficulties and a potential harm to the doctor-patient relationship.

Conclusions: Focus group participants expressed an unconventional voice towards the use of material incentives. They pointed to the need for focused support of health behaviour change and valued their autonomy. While a proportion of the invitees in the target population see the importance of screening and appreciate the HMO's initiative to invite them for testing, they also expressed their need for support from the HMO in realizing the recommended health behaviour.

Citing Articles

Financial incentives for a healthy life style and disease prevention among older people: a systematic literature review.

Tambor M, Pavlova M, Golinowska S, Arsenijevic J, Groot W BMC Health Serv Res. 2016; 16 Suppl 5:426.

PMID: 27608973 PMC: 5016732. DOI: 10.1186/s12913-016-1517-0.

References

Heyman J, Ariely D . Effort for payment. A tale of two markets. Psychol Sci. 2004; 15(11):787-93. DOI: 10.1111/j.0956-7976.2004.00757.x. View

Glasziou P, Buchan H, Del Mar C, Doust J, Harris M, Knight R . When financial incentives do more good than harm: a checklist. BMJ. 2012; 345:e5047. DOI: 10.1136/bmj.e5047. View

Reisinger H, Brackett R, Buzza C, Paez M, Gourley R, Vander Weg M . "All the money in the world …" patient perspectives regarding the influence of financial incentives. Health Serv Res. 2011; 46(6pt1):1986-2004. PMC: 3393021. DOI: 10.1111/j.1475-6773.2011.01287.x. View

Flodgren G, Eccles M, Shepperd S, Scott A, Parmelli E, Beyer F . An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. Cochrane Database Syst Rev. 2011; (7):CD009255. PMC: 4204491. DOI: 10.1002/14651858.CD009255. View

Lott D, Jencius S . Effectiveness of very low-cost contingency management in a community adolescent treatment program. Drug Alcohol Depend. 2009; 102(1-3):162-5. DOI: 10.1016/j.drugalcdep.2009.01.010. View

Marteau T, Ashcroft R, Oliver A . Using financial incentives to achieve healthy behaviour. BMJ. 2009; 338:b1415. DOI: 10.1136/bmj.b1415. View

Mandel J, Bond J, Church T, Snover D, Bradley G, SCHUMAN L . Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993; 328(19):1365-71. DOI: 10.1056/NEJM199305133281901. View

Peterson N, Dwyer K, Mulvaney S, Dietrich M, Rothman R . The influence of health literacy on colorectal cancer screening knowledge, beliefs and behavior. J Natl Med Assoc. 2007; 99(10):1105-12. PMC: 2574401. View

Kane R, Johnson P, Town R, Butler M . A structured review of the effect of economic incentives on consumers' preventive behavior. Am J Prev Med. 2004; 27(4):327-52. DOI: 10.1016/j.amepre.2004.07.002. View

10.

Sutherland K, Christianson J, Leatherman S . Impact of targeted financial incentives on personal health behavior: a review of the literature. Med Care Res Rev. 2008; 65(6 Suppl):36S-78S. DOI: 10.1177/1077558708324235. View

11.

Jorgensen O, Kronborg O, Fenger C . A randomised study of screening for colorectal cancer using faecal occult blood testing: results after 13 years and seven biennial screening rounds. Gut. 2002; 50(1):29-32. PMC: 1773083. DOI: 10.1136/gut.50.1.29. View

12.

Ashcroft R . Personal financial incentives in health promotion: where do they fit in an ethic of autonomy?. Health Expect. 2011; 14(2):191-200. PMC: 3123700. DOI: 10.1111/j.1369-7625.2011.00664.x. View

13.

Kronborg O, Fenger C, Olsen J, Jorgensen O, Sondergaard O . Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet. 1996; 348(9040):1467-71. DOI: 10.1016/S0140-6736(96)03430-7. View

14.

Petry N, Alessi S, Carroll K, Hanson T, Mackinnon S, Rounsaville B . Contingency management treatments: Reinforcing abstinence versus adherence with goal-related activities. J Consult Clin Psychol. 2006; 74(3):592-601. DOI: 10.1037/0022-006X.74.3.592. View

15.

Petry N, Alessi S, Ledgerwood D, Sierra S . Psychometric properties of the contingency management competence scale. Drug Alcohol Depend. 2010; 109(1-3):167-74. PMC: 2875270. DOI: 10.1016/j.drugalcdep.2009.12.027. View

16.

Baron R, Rimer B, Breslow R, Coates R, Kerner J, Melillo S . Client-directed interventions to increase community demand for breast, cervical, and colorectal cancer screening a systematic review. Am J Prev Med. 2008; 35(1 Suppl):S34-55. DOI: 10.1016/j.amepre.2008.04.002. View

17.

GLUCKSBERG S . The influence of strength of drive on functional fixedness and perceptual recognition. J Exp Psychol. 1962; 63:36-41. DOI: 10.1037/h0044683. View

18.

Steinbrook R . Imposing personal responsibility for health. N Engl J Med. 2006; 355(8):753-6. DOI: 10.1056/NEJMp068141. View

19.

Jones R, Devers K, Kuzel A, Woolf S . Patient-reported barriers to colorectal cancer screening: a mixed-methods analysis. Am J Prev Med. 2010; 38(5):508-16. PMC: 2946825. DOI: 10.1016/j.amepre.2010.01.021. View

20.

Volpp K, Gurmankin Levy A, Asch D, Berlin J, Murphy J, Gomez A . A randomized controlled trial of financial incentives for smoking cessation. Cancer Epidemiol Biomarkers Prev. 2006; 15(1):12-8. DOI: 10.1158/1055-9965.EPI-05-0314. View