TY - JOUR
T1 - Financial incentives to promote colorectal cancer screening
T2 - A longitudinal randomized control trial
AU - Lieberman, Alicea
AU - Gneezy, Ayelet
AU - Berry, Emily
AU - Miller, Stacie
AU - Koch, Mark
AU - Ahn, Chul
AU - Balasubramanian, Bijal A.
AU - Argenbright, Keith E.
AU - Gupta, Samir
N1 - Publisher Copyright:
© 2019 American Association for Cancer Research.
PY - 2019
Y1 - 2019
N2 - Background: Financial incentives may improve health behaviors. We tested the impact of offering financial incentives for mailed fecal immunochemical test (FIT) completion annually for 3 years. Methods: Patients, ages 50 to 64 years, not up-to-date with screening were randomized to receive either a mailed FIT outreach (n ¼ 6,565), outreach plus $5 (n ¼ 1,000), or $10 (n ¼ 1,000) incentive for completion. Patients who completed the test were reinvited using the same incentive the following year, for 3 years. In year 4, patients who returned the kit in all preceding 3 years were reinvited without incentives. Primary outcome was FIT completion among patients offered any incentive versus outreach alone each year. Secondary outcomes were FIT completion for groups offered $5 versus outreach alone, $10 versus outreach alone, and $5 versus $10. Results: Year 1 FIT completion was 36.9% with incentives versus 36.2% outreach alone (P ¼ 0.59) and was not statistically different for $10 (34.6%; P ¼ 0.31) or $5 (39.2%; P ¼ 0.070) versus outreach alone. Year 2 completion was 61.6% with incentives versus 60.8% outreach alone (P ¼ 0.75) and not statistically different for $10 or $5 versus outreach alone. Year 3 completion was 79.4% with incentives versus 74.8% outreach alone (P ¼ 0.080), and was higher for $10 (82.4%) versus outreach alone (P ¼ 0.033), but not for $5 versus outreach alone. Completion was similar across conditions in year 4 (no incentives). Conclusions: Offering small incentives did not increase FIT completion relative to standard outreach. Impact: This was the first longitudinal study testing the impact of repeated financial incentives, and their withdrawal, on FIT completion.
AB - Background: Financial incentives may improve health behaviors. We tested the impact of offering financial incentives for mailed fecal immunochemical test (FIT) completion annually for 3 years. Methods: Patients, ages 50 to 64 years, not up-to-date with screening were randomized to receive either a mailed FIT outreach (n ¼ 6,565), outreach plus $5 (n ¼ 1,000), or $10 (n ¼ 1,000) incentive for completion. Patients who completed the test were reinvited using the same incentive the following year, for 3 years. In year 4, patients who returned the kit in all preceding 3 years were reinvited without incentives. Primary outcome was FIT completion among patients offered any incentive versus outreach alone each year. Secondary outcomes were FIT completion for groups offered $5 versus outreach alone, $10 versus outreach alone, and $5 versus $10. Results: Year 1 FIT completion was 36.9% with incentives versus 36.2% outreach alone (P ¼ 0.59) and was not statistically different for $10 (34.6%; P ¼ 0.31) or $5 (39.2%; P ¼ 0.070) versus outreach alone. Year 2 completion was 61.6% with incentives versus 60.8% outreach alone (P ¼ 0.75) and not statistically different for $10 or $5 versus outreach alone. Year 3 completion was 79.4% with incentives versus 74.8% outreach alone (P ¼ 0.080), and was higher for $10 (82.4%) versus outreach alone (P ¼ 0.033), but not for $5 versus outreach alone. Completion was similar across conditions in year 4 (no incentives). Conclusions: Offering small incentives did not increase FIT completion relative to standard outreach. Impact: This was the first longitudinal study testing the impact of repeated financial incentives, and their withdrawal, on FIT completion.
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U2 - 10.1158/1055-9965.EPI-19-0039
DO - 10.1158/1055-9965.EPI-19-0039
M3 - Article
C2 - 31387970
AN - SCOPUS:85074379397
SN - 1055-9965
VL - 28
SP - 1902
EP - 1908
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 11
ER -