Evidence map›Paper›PMID 35037172›Full record

ArticleJournal of general internal medicine2022

Exploring Why Financial Incentives Fail to Affect At-home Colorectal Cancer Screening: a Mixed Methods Study.

Alicia B W Clifton, Shivan J Mehta, Jocelyn V Wainwright, Shannon N Ogden, Chelsea A Saia, Katharine A Rendle

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alicia B W CliftonPenn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Shivan J MehtaDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jocelyn V WainwrightDepartment of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, 51 N 39th St., PPMC Mutch Building, Floor 7, Philadelphia, PA, 19104, USA.
Shannon N OgdenDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
Chelsea A SaiaDepartment of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, 51 N 39th St., PPMC Mutch Building, Floor 7, Philadelphia, PA, 19104, USA.
Katharine A RendlePenn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. katharine.rendle@pennmedicine.upenn.edu.ORCID http://orcid.org/0000-0002-7761-8728

Funding

Integrated Care for Addiction, HIV and HCV Research and Education (ICAHRE)T32DA041898 · NIDA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Rachel Sayko Adams, Michael D Stein · 2017 to 2026
$3.8M
Behavioral Economics and Population-based Colorectal Cancer ScreeningK08CA234326 · NCI · UNIVERSITY OF PENNSYLVANIA · PI MEHTA, SHIVAN JATIN · 2018 to 2022
$1.3M
NCI NIH HHS K08 CA234326NIDA NIH HHS T32 DA041898
6 · The paper itself

Abstract

backgroundDespite success in increasing other health behaviors, financial incentives have shown limited to no effect on colorectal cancer (CRC screening. Little is known about the factors shaping why and for whom incentives improve screening.

objectiveTo explore the perspective of participants enrolled in a larger, four-arm pragmatic trial at urban family medicine practices which assessed and failed to detect significant effects of financial incentives on at-home CRC screening completion.

designWe performed a mixed methods study with a subset of randomly selected patients, stratified by study arm, following completion of the pragmatic trial.

participantsSixty patients (46.9% enrollment rate) who were eligible and overdue for colorectal cancer screening at the time of trial enrollment and who continued to receive care at family medicine practices affiliated with an urban academic health system completed the interview and questionnaire. MAIN MEASURES: Using Andersen's behavioral model, a semi-structured interview guide assessed motivators, barriers, and facilitators to screening completion and the impact of incentives on decision-making. Participants also completed a brief questionnaire evaluating demographics, screening beliefs, and clinical characteristics. KEY

resultsThe majority of patients (n = 49; 82%) reported that incentives would not change their decision to complete or not complete CRC screening, which was confirmed by qualitative data as largely due to high perceived health benefits. Those who stated financial incentives would impact their decision (n = 11) were significantly less likely to agree that CRC screening is beneficial (72.7% vs 95.9%; p < 0.05) or that CRC could be cured if detected early (63.6% vs 98.0%; p < 0.05).

conclusionsFinancial incentives are likely not an effective behavioral intervention to increase CRC screening for all but may be powerful for increasing short-term benefit and therefore completion for some. Targeting financial incentive interventions according to patient screening beliefs may prove a cost-effective strategy in primary care outreach programs to increase CRC screening.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerHealth BehaviorHumansMass ScreeningMotivationColorectal cancer screeningFinancial incentivesMixed methods researchPopulation healthPrimary care

Identifiers

PMID35037172
PMCPMC9411475

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.