'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study

Currie, Marian J.; Schmidt, Matthias; Davis, B. K.; Baynes, Anne M; O'Keefe, Elissa J; Bavinton, T.; McNiven, Michelle; Martin, Sarah; Bowden, Francis J.

doi:10.1071/sh08091

Cited by 35 publications

(58 citation statements)

References 18 publications

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“…the use of Internet independent of geographic area [28], financial incentives [29], a focus on self-identity [30], and/or the use of social media in combination with role models (people who disclose that they have tested) to overcome low susceptibility and lack of supportive social norms [31]. …”

Section: Discussionmentioning

confidence: 99%

Non-participation in chlamydia screening in the Netherlands: determinants associated with young people’s intention to participate in chlamydia screening

et al. 2013

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BackgroundIn the Netherlands, a national chlamydia screening program started in 2008, but the participation was low and the screening was not cost-effective. This study aimed to explore unconscious and conscious associations with chlamydia screening (16-29 year-olds). In addition, we examined whether information presented in chlamydia screening invitation letters had an effect on the evaluation of these determinants compared to a no-letter group.MethodsAn Internet survey was conducted that included self-report measures of attitude, susceptibility, severity, unrealistic optimism, subjective, moral, and descriptive norm, perceived behavioral control, outcome expectations, barriers, intention, and a response time measure to assess unconscious associations of chlamydia screening with annoyance, threat and reassurance.ResultsOn the unconscious level, participants (N = 713) who received no information letter associated testing for chlamydia with annoyance and threat, but also with reassurance (all p’s < .001). On the self-report measures, participants showed a low intention towards chlamydia screening (M = 1.42, range 1–5). Subjective norm, moral norm, perceived susceptibility and attitude were the most important predictors of the intention to screen (R2 = .56). Participants who rated their susceptibility as high also reported more risky behaviors (p < .001).In the groups that received a letter (N = 735), a weaker unconscious association of chlamydia screening with annoyance was found compared with the no-letter group (p < .001), but no differences were found in reassurance or threat. Furthermore, the letters caused a higher intention (p < .001), but intention remained low (M = 1.74). On a conscious level, giving information caused a more positive attitude, higher susceptibility, a higher subjective and moral norm, and more positive outcome expectations (all p’s < .001).ConclusionSubjective norm, moral norm, susceptibility, and attitude towards chlamydia might be crucial targets to increase chlamydia screening behavior among sexually active young people. This study shows that informational invitation letters increase the intention and the intention-predicting variables. More evidence is needed on whether screening behavior can be increased by the use of an alternative information letter adapted to the specific unconscious and conscious determinants revealed in this study, or that we need other, more interactive behavior change methods.

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Section: Discussionmentioning

confidence: 99%

Non-participation in chlamydia screening in the Netherlands: determinants associated with young people’s intention to participate in chlamydia screening

et al. 2013

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“…This increased return rate suggests that the participants’ cash reward was a major contributor to the success of our study. As with other chlamydia screening studies we have undertaken,5 the cash reward appears to have encouraged men to be screened (male to female ratio: 1.7 : 1), although the positivity rate appeared higher among women than men, p=0.04, the 95% confidence limits overlapped (5.3%; 95% CI 2.4% to 8.0% vs 1.4%; 95% CI 0.5% to 3.1%).…”

Section: Discussionmentioning

confidence: 60%

“…Previously explored screening venues include tertiary campuses,5 drug treatment/correctional facilities,6 schools7 and pharmacies 8–10. Community pharmacies have many attributes that make them a logical place to offer chlamydia screening—conveniently located, open long hours, supervised by regulated primary healthcare providers, and no appointments are needed.…”

Section: Introductionmentioning

confidence: 99%

“…As studies have shown screening participation rates can be increased if either health professionals or those screened, are compensated for their time and effort,5 14 we conducted a cross-sectional study in community pharmacies in the Australian Capital Territory (ACT) which measured the effect of a cash incentive, offered to both the providers and the consumers of chlamydia screening.…”

Section: Introductionmentioning

confidence: 99%

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Community pharmacy and cash reward: a winning combination for chlamydia screening?

et al. 2012

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“…[28][29][30] Other studies described incentive programmes, but did not provide a test of the impact of the incentive. 26,31 Of the relevant articles, four considered screening for chlamydia, 25,[32][33][34] three investigated breast or cervical screening, [35][36][37] five investigated tuberculosis (TB) screening or returning to collect test results, [38][39][40][41][42] two investigated work wellness programmes or private health-care plans providing preventative health-care screening, 27,43 and single papers describing incentives in diabetic retinopathy screening, 44 and glycated haemoglobin (HbA 1c ) plus cholesterol screening in patients with diabetes. 45 Three of the four studies investigating chlamydia screening observed a positive impact of incentives, 25,32,34 with evidence that vouchers were more effective than prize draws.…”

Section: Systematic Review Of Literature On Incentives In Screeningmentioning

confidence: 99%

Incentives in Diabetic Eye Assessment by Screening (IDEAS) trial: a three-armed randomised controlled trial of financial incentives

Judah

Darzi

Vlaev

et al. 2017

Health Serv Deliv Res

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Background: The UK national diabetic eye screening (DES) programme invites diabetic patients aged > 12 years annually. Simple and cost-effective methods are needed to increase screening uptake. This trial tests the impact on uptake of two financial incentive schemes, based on behavioural economic principles. Objectives: To test whether or not financial incentives encourage screening attendance. Secondarily to understand if the type of financial incentive scheme used affects screening uptake or attracts patients with a different sociodemographic status to regular attenders. If financial incentives were found to improve attendance, then a final objective was to test cost-effectiveness. Design: Three-armed randomised controlled trial. Setting: DES clinic within St Mary ’ s Hospital, London, covering patients from the areas of Kensington, Chelsea and Westminster. Participants: Patients aged ≥ 16 years, who had not attended their DES appointment for ≥ 2 years. Interventions: (1) Fixed incentive – invitation letter and £10 for attending screening; (2) probabilistic (lottery) incentive – invitation letter and 1% chance of winning £1000 for attending screening; and (3) control – invitation letter only. Main outcome measures: The primary outcome was screening attendance. Rates for control versus fixed and lottery incentive groups were compared using relative risk (RR) and risk difference with corresponding 95% confidence intervals (CIs). Results: A total of 1274 patients were eligible and randomised; 223 patients became ineligible before invite and 1051 participants were invited (control, n = 435; fixed group, n = 312; lottery group, n = 304). Thirty-four (7.8%, 95% CI 5.29% to 10.34%) control, 17 (5.5%, 95% CI 2.93% to 7.97%) fixed group and 10 (3.3%, 95% CI 1.28% to 5.29%) lottery group participants attended. Participants offered incentives were 44% less likely to attend screening than controls (RR 0.56, 95% CI 0.34 to 0.92). Examining incentive groups separately, the lottery group were 58% less likely to attend screening than controls (RR 0.42, 95% CI 0.18 to 0.98). No significant differences were found between fixed incentive and control groups (RR 0.70, 95% CI 0.35 to 1.39) or between fixed and lottery incentive groups (RR 1.66, 95% CI 0.65 to 4.21). Subgroup analyses showed no significant associations between attendance and sociodemographic factors, including gender (female vs. male, RR 1.25, 95% CI 0.77 to 2.03), age ( ≤ 65 years vs. > 65 years, RR 1.26, 95% CI 0.77 to 2.08), deprivation [0 – 20 Index of Multiple Deprivation (IMD) decile vs. 30 – 100 IMD decile, RR 1.12, 95% CI 0.69 to 1.83], years registered [mean difference (MD) – 0.13, 95% CI – 0.69 to 0.43], and distance from screening location (MD – 0.18, 95% CI – 0.65 to 0.29). Limitations: Despite verification, some address details may have been outdated, and high ethnic diversity may have resulted in language barriers for participants. Conclusions: Those receiving incentives were not more likely to attend a DES than those receiving a usual invitation letter...

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'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study

Cited by 35 publications

References 18 publications

Non-participation in chlamydia screening in the Netherlands: determinants associated with young people’s intention to participate in chlamydia screening

Non-participation in chlamydia screening in the Netherlands: determinants associated with young people’s intention to participate in chlamydia screening

Community pharmacy and cash reward: a winning combination for chlamydia screening?

Incentives in Diabetic Eye Assessment by Screening (IDEAS) trial: a three-armed randomised controlled trial of financial incentives

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