Randomized Trial of Four Financial- Incentive Programs for Smoking Cessation  

Oleh:

Halpern, Scott D. ; French, Benjamin ; Small, Dylan S. ; Saulsgiver, Kathryn

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 372 no. 22 (May 2015), page 2108-2117.
Topik: financial incentives; jaminan kesehatan; health behaviors; smoker; perokok; habit; kebiasaan merokok; smoking
Fulltext: nejmoa1414293.pdf (625.08KB)

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Perpustakaan FK Nomor Panggil: N08.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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BACKGROUND Financial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain. METHODS We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six partici - pants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the oth - ers entailed refundable deposits of $150 plus $650 in reward payments for success - ful participants. Usual care included informational resources and free smoking- cessation aids. RESULTS Overall, 2538 participants were enrolled. Of those assigned to reward-based pro - grams, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (P<0.001). In intention-to-treat analyses, rates of sus - tained abstinence from smoking through 6 months were higher with each of the four incentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (P<0.05 for all comparisons); the superiority of reward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were as - sociated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P = 0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, P<0.001). However, in instrumen - tal-variable analyses that accounted for differential acceptance, the rate of absti - nence at 6 months was 13.2 percentage points (95% confidence interval, 3.1 to 22.8) higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program. CONCLUSIONS Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group- oriented incentive programs were no more effective than individual-oriented programs.

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