The Impact of Alternative Incentive Schemes on Completion of Health Risk Assessments
ABSTRACT The biggest challenge for corporate wellness initiatives is low rates of employee participation. We test whether a behavioral economic approach to incentive design (i.e., a lottery) is more effective than a direct economic payment of equivalent monetary value (i.e., a grocery gift certificate) in encouraging employees to complete health risk assessments (HRAs).
Employees were assigned to one of three arms. Assignment to a treatment arm versus the nontreatment arm was determined by management. Assignment to an arm among those eligible for treatment was randomized by office.
A large health care management and information technology consulting company.
A total of 1299 employees across 14 offices participated.
All employees were eligible to receive $25 for completing the HRA. Those in the lottery condition were assigned to teams of four to eight people and, conditional on HRA completion, were entered into a lottery with a prize of $100 (expected value, $25) and a bonus value of an additional $25 if 80% of team members participated. Those in the grocery gift certificate condition who completed an HRA received a $25 grocery gift certificate. Those in the comparison condition received no additional incentive.
HRA completion rates.
Logistic regression analysis.
HRA completion rates were significantly higher among participations in the lottery incentive condition (64%) than in both the grocery gift certificate condition (44%) and the comparison condition (40%). Effects were larger for lower-income employees, as indicated by a significant interaction between income and the lottery incentive.
Lottery incentives that incorporate regret aversion and social pressure can provide higher impact for the same amount of money as simple economic incentives.
SourceAvailable from: Suzanne Heurtin-Roberts[Show abstract] [Hide abstract]
ABSTRACT: Background: Beyond geographic location, “Healthography” can be interpreted as health research sites’ locations in organizational, financial and cultural systems. Research location influences a study’s reach, validity, and outcomes. The aims of this study are to: (1) describe variation in research location; and (2) discuss how location influenced reach in the My Own Health Report (MOHR) study. MOHR is an evidence-based patient-reported behavioral health assessment tool that includes physician-led counseling and goal-setting. Methods: MOHR was federally funded as a cluster-randomized pragmatic implementation trial. Nine pairs of diverse primary care practices (either FQHC or PBRN sites) were randomized to field MOHR in 6 states across the U.S. Reach, % of eligible patients that were offered and completed the MOHR tool, was computed for each practice. Location was measured qualitatively at three time points, via practice-based observation and key informant interviews. Data were coded by four independent coders using qualitative analysis software. Content analysis was performed to identify salient practice characteristics by which each location differed. Results: Overall reach for the nine practices was 40.0%, ranging from 27.0%-89.5% across sites. Variation in reach can be explained by five practice characteristics that differed by location: (1) clinician and staff attitudes and motivations towards MOHR, (2) mode of MOHR administration (3) impact of the research process on the practice, (4) patient populations and (5) staffing constraints. The motivation of practice leaders and autonomy of MOHR champions aided efforts to administer MOHR. Mode of administration (e.g., via web, paper and pencil, or telephone) based upon patient/practice preference and capacity resulted in significant differences in reach. Practice resources such as staff time and access to technology, and patient literacy differed by location and influenced reach. Although clinicians found MOHR valuable to initiate health behavior discussions, aspects of location limited MOHR's sustainability in routine practice. Conclusion. Understanding how and why implementation trials reach their target population requires knowledge of location, since implementation happens in diverse, real-world settings. Implementation success of evidence-based interventions depends largely on the location of research sites.142nd APHA Annual Meeting and Exposition 2014; 11/2014
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ABSTRACT: Guidelines recommend screening patients for unhealthy behaviors and mental health concerns. Health risk assessments can systematically identify patient needs and trigger care. This study seeks to evaluate whether primary care practices can routinely implement such assessments into routine care.The Annals of Family Medicine 11/2014; 12(6):525-33. DOI:10.1370/afm.1710 · 4.57 Impact Factor
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ABSTRACT: ObjectiveaEuro integral To summarize previous adult research on behavioral economics (BE) and consider the largely unexplored relevance of BE for promoting adherence to pediatric regimens across a wide variety of illnesses.aEuro integral MethodsaEuro integral Literature review.aEuro integral ResultsaEuro integral Default bias, loss aversion, overestimation of rare events, and social norms are four BE concepts that have not been fully incorporated in adherence research for pediatric regimens yet offer promising opportunities for novel intervention development. The possible applications of these four strategies are offered in regards to asthma, cystic fibrosis, migraines, and diabetes, respectively.aEuro integral ConclusionsaEuro integral BE offers pediatric psychology not only low-intensity approaches for promoting adherence but also highly attractive ways of obtaining the attention of health care administrators and policymakers.Journal of Pediatric Psychology 09/2014; 39(10). DOI:10.1093/jpepsy/jsu071 · 2.91 Impact Factor