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Acceptability of financial incentives to improve health outcomes in UK and US samples.

Promberger M, Brown RC, Ashcroft RE, Marteau TM - J Med Ethics (2011)

Bottom Line: Overall, participants supported funding more strongly for interventions when they judged members of the target group to be less responsible for their condition, and vice versa.These results reveal a striking similarity in negative attitudes towards the use of financial incentives, rewards as well as penalties, in improving outcomes across a range of contexts, in the UK and the USA.The basis for such negative attitudes awaits further study.

View Article: PubMed Central - PubMed

Affiliation: King's College London, London SE1 9RT, UK. marianne.promberger@kcl.ac.uk

ABSTRACT
In an online study conducted separately in the UK and the US, participants rated the acceptability and fairness of four interventions: two types of financial incentives (rewards and penalties) and two types of medical interventions (pills and injections). These were stated to be equally effective in improving outcomes in five contexts: (a) weight loss and (b) smoking cessation programmes, and adherence in treatment programmes for (c) drug addiction, (d) serious mental illness and (e) physiotherapy after surgery. Financial incentives (weekly rewards and penalties) were judged less acceptable and to be less fair than medical interventions (weekly pill or injection) across all five contexts. Context moderated the relative preference between rewards and penalties: participants from both countries favoured rewards over penalties in weight loss and treatment for serious mental illness. Only among US participants was this relative preference moderated by perceived responsibility of the target group. Overall, participants supported funding more strongly for interventions when they judged members of the target group to be less responsible for their condition, and vice versa. These results reveal a striking similarity in negative attitudes towards the use of financial incentives, rewards as well as penalties, in improving outcomes across a range of contexts, in the UK and the USA. The basis for such negative attitudes awaits further study.

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Related in: MedlinePlus

Differential support of penalties versus rewards for the different target groups (identified by basic treatment). Mean answers to the question ‘Should this be funded?’ (−3: definitely not; 3: definitely yes).
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Related In: Results  -  Collection

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fig3: Differential support of penalties versus rewards for the different target groups (identified by basic treatment). Mean answers to the question ‘Should this be funded?’ (−3: definitely not; 3: definitely yes).

Mentions: Rewards were judged more acceptable than penalties in some but not all contexts (figure 3). In a within-subject ANOVA (dependent variable: funding support; independent variables: type of intervention, basic treatment), the interaction between type of intervention (rewards vs penalties) and basic treatment was significant. For the UK participants, F(4)=4.07, p=0.003; for the US participants, F(4)=4.81, p<0.001.


Acceptability of financial incentives to improve health outcomes in UK and US samples.

Promberger M, Brown RC, Ashcroft RE, Marteau TM - J Med Ethics (2011)

Differential support of penalties versus rewards for the different target groups (identified by basic treatment). Mean answers to the question ‘Should this be funded?’ (−3: definitely not; 3: definitely yes).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3198007&req=5

fig3: Differential support of penalties versus rewards for the different target groups (identified by basic treatment). Mean answers to the question ‘Should this be funded?’ (−3: definitely not; 3: definitely yes).
Mentions: Rewards were judged more acceptable than penalties in some but not all contexts (figure 3). In a within-subject ANOVA (dependent variable: funding support; independent variables: type of intervention, basic treatment), the interaction between type of intervention (rewards vs penalties) and basic treatment was significant. For the UK participants, F(4)=4.07, p=0.003; for the US participants, F(4)=4.81, p<0.001.

Bottom Line: Overall, participants supported funding more strongly for interventions when they judged members of the target group to be less responsible for their condition, and vice versa.These results reveal a striking similarity in negative attitudes towards the use of financial incentives, rewards as well as penalties, in improving outcomes across a range of contexts, in the UK and the USA.The basis for such negative attitudes awaits further study.

View Article: PubMed Central - PubMed

Affiliation: King's College London, London SE1 9RT, UK. marianne.promberger@kcl.ac.uk

ABSTRACT
In an online study conducted separately in the UK and the US, participants rated the acceptability and fairness of four interventions: two types of financial incentives (rewards and penalties) and two types of medical interventions (pills and injections). These were stated to be equally effective in improving outcomes in five contexts: (a) weight loss and (b) smoking cessation programmes, and adherence in treatment programmes for (c) drug addiction, (d) serious mental illness and (e) physiotherapy after surgery. Financial incentives (weekly rewards and penalties) were judged less acceptable and to be less fair than medical interventions (weekly pill or injection) across all five contexts. Context moderated the relative preference between rewards and penalties: participants from both countries favoured rewards over penalties in weight loss and treatment for serious mental illness. Only among US participants was this relative preference moderated by perceived responsibility of the target group. Overall, participants supported funding more strongly for interventions when they judged members of the target group to be less responsible for their condition, and vice versa. These results reveal a striking similarity in negative attitudes towards the use of financial incentives, rewards as well as penalties, in improving outcomes across a range of contexts, in the UK and the USA. The basis for such negative attitudes awaits further study.

Show MeSH
Related in: MedlinePlus