TY - JOUR
T1 - Financial incentives for promoting colorectal cancer screening
T2 - A randomized, comparative effectiveness trial
AU - Gupta, Samir
AU - Miller, Stacie
AU - Koch, Mark
AU - Berry, Emily
AU - Anderson, Paula
AU - Pruitt, Sandi L.
AU - Borton, Eric
AU - Hughes, Amy E.
AU - Carter, Elizabeth
AU - Hernandez, Sylvia
AU - Pozos, Helen
AU - Halm, Ethan A.
AU - Gneezy, Ayelet
AU - Lieberman, Alicea J.
AU - Sugg Skinner, Celette
AU - Argenbright, Keith
AU - Balasubramanian, Bijal
N1 - Publisher Copyright:
© 2016 by the American College of Gastroenterology.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - OBJECTIVES:Offering financial incentives to promote or "nudge" participation in cancer screening programs, particularly among vulnerable populations who traditionally have lower rates of screening, has been suggested as a strategy to enhance screening uptake. However, effectiveness of such practices has not been established. Our aim was to determine whether offering small financial incentives would increase colorectal cancer (CRC) screening completion in a low-income, uninsured population.METHODS:We conducted a randomized, comparative effectiveness trial among primary care patients, aged 50-64 years, not up-to-date with CRC screening served by a large, safety net health system in Fort Worth, Texas. Patients were randomly assigned to mailed fecal immunochemical test (FIT) outreach (n=6,565), outreach plus a $5 incentive (n=1,000), or outreach plus a $10 incentive (n=1,000). Outreach included reminder phone calls and navigation to promote diagnostic colonoscopy completion for patients with abnormal FIT. Primary outcome was FIT completion within 1 year, assessed using an intent-to-screen analysis.RESULTS:FIT completion was 36.9% with vs. 36.2% without any financial incentive (P=0.60) and was also not statistically different for the $10 incentive (34.6%, P=0.32 vs. no incentive) or $5 incentive (39.2%, P=0.07 vs. no incentive) groups. Results did not differ substantially when stratified by age, sex, race/ethnicity, or neighborhood poverty rate. Median time to FIT return also did not differ across groups.CONCLUSIONS:Financial incentives, in the amount of $5 or $10 offered in exchange for responding to mailed invitation to complete FIT, do not impact CRC screening completion.
AB - OBJECTIVES:Offering financial incentives to promote or "nudge" participation in cancer screening programs, particularly among vulnerable populations who traditionally have lower rates of screening, has been suggested as a strategy to enhance screening uptake. However, effectiveness of such practices has not been established. Our aim was to determine whether offering small financial incentives would increase colorectal cancer (CRC) screening completion in a low-income, uninsured population.METHODS:We conducted a randomized, comparative effectiveness trial among primary care patients, aged 50-64 years, not up-to-date with CRC screening served by a large, safety net health system in Fort Worth, Texas. Patients were randomly assigned to mailed fecal immunochemical test (FIT) outreach (n=6,565), outreach plus a $5 incentive (n=1,000), or outreach plus a $10 incentive (n=1,000). Outreach included reminder phone calls and navigation to promote diagnostic colonoscopy completion for patients with abnormal FIT. Primary outcome was FIT completion within 1 year, assessed using an intent-to-screen analysis.RESULTS:FIT completion was 36.9% with vs. 36.2% without any financial incentive (P=0.60) and was also not statistically different for the $10 incentive (34.6%, P=0.32 vs. no incentive) or $5 incentive (39.2%, P=0.07 vs. no incentive) groups. Results did not differ substantially when stratified by age, sex, race/ethnicity, or neighborhood poverty rate. Median time to FIT return also did not differ across groups.CONCLUSIONS:Financial incentives, in the amount of $5 or $10 offered in exchange for responding to mailed invitation to complete FIT, do not impact CRC screening completion.
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U2 - 10.1038/ajg.2016.286
DO - 10.1038/ajg.2016.286
M3 - Article
C2 - 27481306
AN - SCOPUS:84980357075
SN - 0002-9270
VL - 111
SP - 1630
EP - 1636
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 11
ER -