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PubMed2005

Response rates to a mailed survey targeting childhood cancer survivors: a comparison of conditional versus unconditional incentives.

OBJECTIVE: Mailed surveys are widely used to collect epidemiologic and health service data. Given that nonresponse can threaten the validity of surveys, modest incentives are often used to increase response rates. A study was undertaken among childhood cancer survivors and their parents to determine if response rate to a mailed survey differed with provision of immediate versus delayed incentives. DESIGN: A self-administered survey designed to ascertain health behaviors was mailed to 397 childhood cancer survivors (and their parents if the survivor was <18 years of age). Subjects were randomized into two groups based on gender, age, race, and cancer type. One group received a 10 US dollars incentive with their blank survey (unconditional incentive), whereas the other group received the incentive upon receipt of their completed survey (conditional incentive). If children were minors, both the parent and the child received incentives. RESULTS: No significant differences in response rates were observed with respect to gender, age, race, or cancer type. However, significant differences in response rates were observed between incentive groups, with unconditional incentives yielding significantly higher response rates than conditional incentives for child survivors who were > or =18 years (64.4% versus 49.0%), as well as younger child survivors (62.5% versus 43.6%) and their parents (64.8% versus 41.5%; all P < 0.05). CONCLUSIONS: The provision of an immediate incentive generated significantly higher response rates to this mailed health survey among childhood cancer survivors and their parents. Given that survey studies are commonly conducted across various pediatric populations, these findings may help inform the design of future pediatric survey research.

Adolescent↗

PubMed2005

The prevalence and characteristics of incentive plans for clinical productivity among academic anesthesiology programs.

Performance-based compensation is encouraged in medical schools to improve faculty productivity. Medical specialties other than anesthesiology have used financial incentives for clinical work. The goal of this study was to determine the prevalence and the types of clinical incentive plans among academic anesthesiology departments. We performed an electronic survey of the members of the Society of Academic Anesthesiology Chairs and the Association of Anesthesiology Program Directors in the spring of 2003. The survey included questions about departmental size, presence of a clinical incentive plan, characteristics of existing incentive plans, primary quantifiers of productivity, and factors used to modify productivity measurements. An incentive plan was considered to be present if the department measured clinical productivity and varied compensation according to the measurements. The plans were grouped by the primary measure used into the following categories: None, Charges, Time, Shift, Late/Call (only late rooms and call), and Other. Eighty-eight (64%) of 138 programs responded to the survey, and 5 were excluded for incomplete data. Of the responding programs, 29% had no system, 30% used a Late/Call system, 20% used a Shift system, 11% used a Charges system, 6% used a Time system, and 3% fit in the Other category. Larger groups (>40 faculty members) had a significantly more frequent prevalence of incentive plans compared with smaller groups (<20 faculty members). Incentives were paid monthly or quarterly in 85% of the groups. In 90% of groups, incentive payments accounted for <25% of total compensation. Adjustments for operating room schedule supervisors, personally performed cases, day surgery preoperative clinics, pain-management services, and critical care services were included in less than half of the programs that reported incentive plans. Call and late room compensation was based on varied formulas. Sixty-nine percent of academic anesthesiology departments did not vary compensation according to clinical activity during regular hours. Most did vary payments on the basis of call and/or late rooms worked. Larger departments were more likely to use clinical incentive plans.

Academic Medical Centers↗

PubMed1999

Perceived financial incentives, HMO market penetration, and physicians' practice styles and satisfaction.

OBJECTIVE: To estimate the effects of physicians' personal financial incentives and other measures of involvement with HMOs on three measures of satisfaction and practice style: overall practice satisfaction, the extent to which prior expectations about professional autonomy and the ability to practice good-quality medicine are met, and several specific measures of practice style. DATA SOURCES: A telephone survey conducted in 1997 of 1,549 physicians who were located in the 75 largest Metropolitan Statistical Areas in 1991. Eligible physicians were under age 52, had between 8 and 17 years of post-residency practice experience, and spent at least 20 hours per week in patient care. The response rate was 74 percent. STUDY DESIGN: Multivariate binomial and multinomial ordered logistic regression models were estimated. Independent variables included physicians' self-reported financial incentives, measured by the extent to which their overall financial arrangements created an incentive to either reduce or increase services to patients, the level of HMO penetration in the market, employment setting, medical specialty, exposure to managed care while in medical training, and selected personal characteristics. PRINCIPAL FINDINGS: About 15 percent of survey respondents reported a moderate or strong incentive to reduce services; 70 percent reported a neutral incentive; and 15 percent reported an incentive to increase services. Compared to physicians with a neutral incentive, physicians with an incentive to reduce services were from 1.5 to 3.5 times more likely to be very dissatisfied with their practices and were 0.2 to 0.5 times as likely to report that their expectations regarding professional autonomy and ability to practice good-quality medicine were met. They were also 0.2 to 0.6 times as likely to report having the freedom to care for patients the way they would like along several specific measures of practice style, such as sufficient time with patients, ability to hospitalize, ability to order tests and procedures, and ability to make referrals. These effects were generally reinforced by practicing in an area with a high level of HMO penetration and were offset to some extent by having had exposure to HMOs and the practice of cost-effective medicine while in medical training. CONCLUSIONS: Although financial incentives to reduce services are not widespread, there is a legitimate reason to be concerned about possible adverse affects on the quality of care. More research is needed to investigate directly whether changes in patients' health are affected by their physicians' financial incentives.

Health Maintenance Organizations↗

PubMed2002

How acceptable are financial incentives and written feedback for improving hypertension control? Perspectives from physicians, clinic administrators, and patients.

OBJECTIVES: To assess attitudes of physicians, clinic administrators, and patients within a health maintenance organization (HMO) toward using financial incentives to improve the control of hypertension. STUDY DESIGN: Descriptive study of attitudes toward use of financial incentives paid to physicians or to clinic systems. METHODS: Data were collected through physician survey (n = 104), interviews with clinic administrators (n = 24), and patient focus groups (n = 3) during the winter of 1999 and the spring of 2000. Analyses included both qualitative and quantitative approaches. RESULTS: Most physicians (80%) supported additional funding to clinics to create systems to improve hypertension care. However, less than half supported direct payment to either groups of physicians (38%) or individual physicians (24%). Sixty-four percent of clinic administrators supported incentive payments to clinics to improve quality of care, whereas only 42% favored incentives to physicians. Patients had a uniformly favorable view of incentives paid to clinics, but were strongly opposed to direct physician incentives. Written feedback was supported by both clinic administrators (54%) and physicians (74%). CONCLUSIONS: In this nonprofit HMO, none of the stakeholder groups supported direct incentive payments to physicians to improve hypertension control. Trials of financial incentives within managed care organizations should include study arms with clinic-based incentives. Further study is needed to determine if incentives to clinics, which appear to be acceptable, can actually improve blood pressure control.

Administrative Personnel↗

PubMed1990

The effects of memory skills training and incentives on free recall in older learners.

The impact of memory skills training and external reward on free recall of serial word lists was assessed in 60 elderly community-dwelling adults. Participants were divided into four groups: (a) skills training plus incentive, (b) skills training only, (c) placebo plus incentive, and (d) placebo without incentive. The memory skills training involved 2 hours of class instruction and a take-home manual. The incentive was introduced following the posttest study interval, prior to recall, and was in the form of a lottery. The three experimental groups (skills only, skills plus incentive, and incentive only) recalled more words at the posttest interval than the placebo group. Skills training was associated with the greatest number of words recalled, followed by the incentive. No additional performance gains were found when skills training was coupled with incentive. A significant relationship between study time and word recall performance was found at posttest. Those who received skills training used more study time than did the no skills groups. The results suggest that teaching an active memory skill enhances free recall performance. Additionally, incentives were superior to no training. Combining incentives with skills, however, does not extend memory performance over skills training alone.

Aging↗

PubMed1994

Financial incentives in residency recruiting for primary care: scope, characteristics, and students' perceptions.

BACKGROUND: One response to the decline in interest among medical students in residency training in primary care has been the offering, by residency programs and hospitals, of financial recruitment incentives to medical students during their residency interviews. Few data on the breadth and effectiveness of this practice have been available. METHOD: To gain insight into how hospitals and/or programs offered incentives, the authors compared 1990 and 1992 survey data on this topic from the members of the Association of American Medical Colleges' Council of Teaching Hospitals (AAMC/COTH) with 1992 data from the members of the Association for Hospital Medical Education (AHME), employing responses to identical questionnaire items. Complementary data on students' experiences with recruitment incentives in 1991 and 1992 were also analyzed. These data have been collected since 1991 in the Medical School Graduation Questionnaire (GQ) of the AAMC's Section for Educational Research, but little or no information had been available on medical students' perceptions of the effectiveness of these incentives. Therefore, one of the authors surveyed members of the classes of 1992 at four Midwestern medical schools about their residency interviewing experiences, including their reactions to financial incentives they encountered. RESULTS: The outcomes from these surveys indicate that, as expected, family practice, internal medicine, and pediatrics were the specialties most likely to offer financial incentives; that a wide variety of recruitment incentives was available to students; that the proportion of programs and hospitals offering such incentives was increasing (e.g., from 37% in the 1990 COTH survey to 54% in the 1992 survey); and that a large majority (79%) of students who encountered these incentives viewed them as at least somewhat effective in persuading them to consider matching with the programs that offered them. CONCLUSION: The prevalence and persuasiveness of financial incentives raise a number of serious questions, including whether competition for residents will divert funds from improving educational quality to recruitment.

Career Choice↗

PubMed2005

Incentives for lifestyle changes in patients with coronary heart disease.

AIM: This paper reports a study exploring how patients in the rehabilitation phase of coronary heart disease experience facilitating and constraining factors related to lifestyle changes of importance for wellbeing and prognosis. BACKGROUND: Lifestyle change is important but complex during rehabilitation after a myocardial infarction or angina pectoris. The intentions to perform behaviours and to experience control over facilitators and constraints are important determinants of behaviour. METHODS: A total of 113 consecutive patients below 70 years of age (84 men and 29 women) were interviewed within 6 weeks of a cardiac event and again after 1 year. Interview transcriptions and notes taken by hand were qualitatively analysed using the phenomenographic framework. The distribution of statements among the categories identified was quantitatively analysed. The data were collected in 1998-2000. FINDINGS: Four main categories portrayed patients' experiences of facilitating or constraining incentives for lifestyle changes. 'Somatic incentives' featured bodily signals indicating improvements/illness. 'Social/practical incentives' involved shared concerns, changed conditions including support/demand from social network, and work/social security issues. Practical incentives concerned external environmental factors in the patients' concrete context. 'Cognitive incentives' were characterized by active decisions and appropriated knowledge, passive compliance with limited insights, and routines/habits. 'Affective incentives' comprised fear of and reluctance in the face of lifestyle changes/disease, lessened self-esteem, and inability to resist temptations. Cognitive incentives mostly facilitated physical exercise and drug treatment. Social/practical incentives facilitated physical exercise and diet change. Physical exercise and diet changes were mainly constrained by somatic, social, and affective incentives. CONCLUSION: The results illustrate important incentives that should be considered in contacts with patients and their families to improve the prospects of positively affecting co-operation with suggested treatment and lifestyle changes.

Aged↗

PubMed2006

A randomized controlled trial of financial incentives for smoking cessation.

BACKGROUND: Although 435,000 Americans die each year of tobacco-related illness, only approximately 3% of smokers quit each year. Financial incentives have been shown to be effective in modifying behavior within highly structured settings, such as drug treatment programs, but this has not been shown in treating chronic disease in less structured settings. The objective of this study was to determine whether modest financial incentives increase the rate of smoking cessation program enrollment, completion, and quit rates in a outpatient clinical setting. METHODS: 179 smokers at the Philadelphia Veterans Affairs Medical Center who reported smoking at least 10 cigarettes per day were randomized into incentive and non-incentive groups. Both groups were offered a free five-class smoking cessation program at the Philadelphia Veterans Affairs Medical Center. The incentive group was also offered $20 for each class attended and $100 if they quit smoking 30 days post program completion. Self-reported smoking cessation was confirmed with urine cotinine tests. RESULTS: The incentive group had higher rates of program enrollment (43.3% versus 20.2%; P<0.001) and completion (25.8% versus 12.2%; P=0.02). Quit rates at 75 days were 16.3% in the incentive group versus 4.6% in the control group (P=0.01). At 6 months, quit rates in the incentive group were not significantly higher (6.5%) than in the control group (4.6%; P>0.20). CONCLUSION: Modest financial incentives are associated with significantly higher rates of smoking cessation program enrollment and completion and short-term quit rates. Future studies should consider including an incentive for longer-term cessation.

Cotinine↗

PubMedDate not supplied

The impact of incentives and competitions on participation and quit rates in worksite smoking cessation programs.

PURPOSE: The purpose of this review is to determine whether incentive-based programs conducted at worksites increase participation and long-term smoking cessation rates. METHODS: Published studies of workplace smoking cessation programs involving incentives and competition were identified through all available years up to winter of 1992 in MEDLINE (1966-1992), Psychlit (1967-1992), Smoking and Health (1960-1992), and Combined Health Information (1973-1992) computer databases and article reference lists. Programs were considered incentive programs when they involved either cash or other prizes paid to the participant for quitting smoking. Incentive competition programs typically involve groups contesting for prizes by having the greatest smoking cessation rates. Thirty studies were found, out of which 15 quasi-experimental and experimental studies are reviewed. The 15 studies that did not have comparison groups were excluded from this report. RESULTS: Only eight studies had a comparison group in which the effects of incentives and competition were separated from the effects of other interventions. Only one study separated the effects of competition from incentives. Five of these studies evaluated smoking rates after six months, and three after 12 months from the program start. Three of these studies showed that incentives increased participation rates, and five enhanced smoking reduction. No study showed, however, that incentives and/or competition enhanced smoking cessation past six months. CONCLUSIONS: It appears that incentives/competition may be useful for increasing participation and smoking reduction. Further research needs to be conducted to determine whether incentives and/or competition enhance long-term quit rates, and what are the most effective types of incentive procedures.

Follow-Up Studies↗

PubMed1990

Managing physician incentives in managed care. The role of for-profit ownership.

The recent rapid growth of HMOs has resulted in a proliferation of contractual arrangements that offer financial incentives to induce primary care doctors to change the way they practice medicine. The impact of these incentives varies with the different incentives and with the environments in which the incentives are implemented. Although financial incentives exist in some form in the great majority of HMOs, there has been no detailed and valid information available on the way these physician incentives are managed or on the characteristics of the standard operating "climate" in which the incentives exist. This study was designed to measure a firm (organizational) characteristic hypothesized to be related to the firm's effort, ability, or desire to make financial incentives work strongly. The characteristic considered is whether the firm is a for-profit or a not-for-profit organization. The goal of this study was to provide a direct test of the relationship between HMO ownership type and the effectiveness of primary care physician incentives. Results of the study indicate that for-profit ownership does enhance the power (or the need) of management to offer effective rewards for parsimonious use of health care resources.

Capitation Fee↗

PubMed2001

The use of monetary incentives in a community survey: impact on response rates, data quality, and cost.

OBJECTIVES: To assess the effect of incentive size on response rates, data quality, and cost in a digestive health status mail survey of a community sample of health plan enrollees. DATA SOURCES/SETTING: The study population was selected from a database of enrollees in various health plans obligated to receive care at Park Nicollet Clinic-HealthSystem Minnesota, a large, multispecialty group in Minneapolis, Minnesota, and the nearby suburbs. STUDY DESIGN: A total of 1,800 HealthSystem Minnesota enrollees were randomly assigned to receive a survey with an incentive of $5 or $2. The response rates for each incentive level were determined. Data quality, as indicated by item nonresponse and scale scores, was measured. Total cost and cost per completed survey were calculated. PRINCIPAL FINDINGS: The response rate among enrollees receiving $5 (74.3 percent) was significantly higher than among those receiving $2 (67.4 percent); differences were more pronounced in the first wave of data collection. Data quality did not differ between the two incentive groups. The total cost per completed survey was higher in the $5 condition than in the $2 condition. CONCLUSIONS: A $5 incentive resulted in a higher response rate among a community patient sample with one mailing than did a $2 incentive. However, the response rates in the $2 condition approached the level of the $5 incentive, and costs were significantly lower when the full follow-up protocol was completed. Response rates were marginally increased by follow-up phone calls. The incentive level did not influence data quality. The results suggest if a survey budget is limited and a timeline is not critical, a $2 incentive provides an affordable means of increasing participation.

Adult↗

PubMed2005

Response rates and representativeness: a lottery incentive improves physician survey return rates.

PURPOSE: To test the effect of a AU dollars 2 scratch lottery ticket on response rates to a national mailed questionnaire of Australian general practitioners (GPs) and medical specialists. METHODS: A randomized controlled trial was conducted and the incentive sent to half of the participants with the first mailing. A single follow-up mailing without incentive was sent to all non-respondents. Survey respondents were then informed of the research question regarding incentives and allowed to withdraw their study data. Differences in response rates between doctors receiving and not receiving the incentive, and between respondents and non-respondents, were examined. RESULTS: The overall response rate was 47% (443 respondents). Twenty-two respondents (5%) withdrew their data after being informed of the research question. Of the remaining 421 respondents, 233 had received the incentive (response rate 49.7%) and 188 had not (40.1%, p=0.0032). The absolute increase in response rate with the incentive (9.6%, 95%CI 3.2, 15.9) was quantitatively similar in effect to the reminder mailing (11.8%). The incentive had a larger effect among the GP sample compared with specialists (13.4 vs. 5.9%), although the difference was not statistically significant (p=0.20). There were no systematic differences in demographic characteristics between respondents and non-respondents. CONCLUSIONS: Increased response rates associated with a small incentive may reduce the need for a second mailed reminder, but strong views about the use of incentives may negatively influence the participation of some practitioners. While the overall response rate was low, there was no evidence of bias in our sample.

Adult↗

PubMed2004

Physician response rates to a mail survey by specialty and timing of incentive.

BACKGROUND: Historically, achieving a high response rate on physician surveys has been a challenging task. Given such concerns, understanding research strategies that facilitate adequate response rates is important. Primary care physician responses to a mail survey on smoking cessation are summarized by physician specialty and timing of incentive. METHODS: A stratified random-sample design, stratified by patient populations-adults, adolescents, and pregnant women-was used. The sampling frame included New Jersey internists, general practitioners, family physicians, pediatricians, and obstetrician-gynecologists. A total of 2100 physicians, 700 physicians from each patient strata, were sampled and mailed a smoking-cessation survey in summer 2002. The sample was randomized by incentive timing: Half received the incentive (i.e., 25 dollars gift card) with the first survey mailing, and half received the incentive on receipt of their completed survey. RESULTS: The promised-incentive group achieved a significantly lower response rate (56%) compared with the up-front-incentive group (71.5%). Response rates by medical specialty varied overall and within incentive groups. The difference between the incentive groups was greatest among obstetrician-gynecologists (i.e., 20.2 percentage points) and was least among pediatricians (i.e., 5.8 percentage points). CONCLUSIONS: Physician response rates to mail surveys are greatly improved, especially among certain medical specialties, by using up-front incentives.

Adolescent↗

PubMed2004

A structured review of the effect of economic incentives on consumers' preventive behavior.

Improving participation in preventive activities will require finding methods to encourage consumers to engage in and remain in such efforts. This review assesses the effects of economic incentives on consumers' preventive health behaviors. A study was classified as complex preventive health if a sustained behavior change was required of the consumer; if it could be accomplished directly (e.g., immunizations), it was considered simple. A systematic literature review identified 111 randomized controlled trials of which 47 (published between 1966 and 2002) met the criteria for review. The economic incentives worked 73% of the time (74% for simple, and 72% for complex). Rates varied by the goal of the incentive. Incentives that increased ability to purchase the preventive service worked better than more diffuse incentives, but the type matters less than the nature of the incentive. Economic incentives are effective in the short run for simple preventive care, and distinct, well-defined behavioral goals. Small incentives can produce finite changes, but it is not clear what size of incentive is needed to yield a major sustained effect.

Community Participation↗

PubMed2006

The adrenergic alpha2 receptor and sexual incentive motivation in male rats.

The purpose of the present series of experiments was to determine whether drugs acting at the alpha2-adrenoceptor modify unconditioned sexual incentive motivation in the male rat. To that end a highly specific agonist, dexmedetomidine, a corresponding antagonist, atipamezole, and a less specific antagonist, yohimbine, were administered to groups of sexually inexperienced male rats. The subjects were tested in a large rectangular arena, where a sexually receptive female and an intact male were employed as incentives. The incentive animals were confined behind a wire mesh in opposite corners of the arena. The animals could see, hear and smell each other, but no sexual interaction was possible. Approach to the incentives constituted the measure of incentive motivation. In addition, the test provided data on ambulatory activity and general arousal. Dexmedetomidine, at a dose of 8 microg/kg, produced a slight reduction of sexual incentive motivation. Ambulatory activity and general arousal were also inhibited. Atipamezole, in doses of 0.1 and 0.3mg/kg enhanced the positive incentive properties of the receptive female. A high dose of 1mg/kg did not have any significant effect. Ambulatory activity was slightly reduced by the two larger doses of atipamezole. Yohimbine had a slight stimulatory effect on sexual incentive motivation at a dose (4 mg/kg) that also reduced ambulatory activity and general arousal. It is concluded that blockade of the adrenergic alpha2 receptor stimulates sexual incentive motivation in the male rat whereas stimulation of it has the opposite effect. At present it is not clear if these drug effects are caused by pre- or postsynaptic actions of the drugs, and the importance of secondary changes in other neurotransmitter systems remains unknown.

Adrenergic alpha-Agonists↗

PubMed2001

Incentives vs outreach workers for latent tuberculosis treatment in drug users.

BACKGROUND: Drug users are at increased risk for latent tuberculosis infection (LTBI) and also at increased risk for noncompletion of medication regimens for treatment of LTBI or tuberculosis disease. Directly observed therapy (DOT) provided by outreach workers, the use of incentives, or both have been suggested as a means to increase adherence. OBJECTIVE: To compare the independent and combined effects of monetary incentives and outreach worker provision of DOT for LTBI treatment in a sample of active drug users. METHODS: The research design was a randomized controlled trial in a community outreach program setting. Participants consisted of a volunteer sample of 163 active injection drug and crack cocaine users placed on twice weekly DOT. Condition 1 of the interventions consisted of provision of DOT by an outreach worker at a location chosen by the participant (active outreach) and a $5 per visit incentive. Condition 2 was comprised of active outreach with no monetary incentive, and Condition 3, provision of DOT at the study community site and a $5 per visit incentive. The main outcome measures were percentage of medication taken as prescribed and completion of medication regimen. RESULTS: The percentage of prescribed medication taken was higher for those who received incentives, either with (71%) or without (68%) active outreach, compared to those who received active outreach alone (13%). Only 4% of participants assigned to Condition 2 completed treatment, compared to 53% of Condition 1 participants, and 60% of Condition 3 participants. CONCLUSIONS: Monetary incentives were clearly superior to active outreach. Active outreach in combination with monetary incentives did not increase adherence over incentives alone.

Adolescent↗

PubMed1999

Neurobiology of the structure of personality: dopamine, facilitation of incentive motivation, and extraversion.

Extraversion has two central characteristics: (1) interpersonal engagement, which consists of affiliation (enjoying and valuing close interpersonal bonds, being warm and affectionate) and agency (being socially dominant, enjoying leadership roles, being assertive, being exhibitionistic, and having a sense of potency in accomplishing goals) and (2) impulsivity, which emerges from the interaction of extraversion and a second, independent trait (constraint). Agency is a more general motivational disposition that includes dominance, ambition, mastery, efficacy, and achievement. Positive affect (a combination of positive feelings and motivation) is closely associated with extraversion. Extraversion is accordingly based on positive incentive motivation. Parallels between extraversion (particularly its agency component) and a mammalian behavioral approach system based on positive incentive motivation implicate a neuroanatomical network and modulatory neurotransmitters in the processing of incentive motivation. A corticolimbic-striatal-thalamic network (1) integrates the salient incentive context in the medial orbital cortex, amygdala, and hippocampus; (2) encodes the intensity of incentive stimuli in a motive circuit composed of the nucleus accumbens, ventral pallidum, and ventral tegmental area dopamine projection system; and (3) creates an incentive motivational state that can be transmitted to the motor system. Individual differences in the functioning of this network arise from functional variation in the ventral tegmental area dopamine projections, which are directly involved in coding the intensity of incentive motivation. The animal evidence suggests that there are three neurodevelopmental sources of individual differences in dopamine: genetic, "experience-expectant," and "experience-dependent." Individual differences in dopamine promote variation in the heterosynaptic plasticity that enhances the connection between incentive context and incentive motivation and behavior. Our psychobiological threshold model explains the effects of individual differences in dopamine transmission on behavior, and their relation to personality traits is discussed.

Animals↗

PubMed2003

Attitudes toward blood donation incentives in the United States: implications for donor recruitment.

BACKGROUND: The potential effectiveness of various donation incentive programs may vary by demographics, first-time or repeat status, and collection site. STUDY DESIGN AND METHODS: Attitudes toward future incentives were obtained from a 1998 anonymous survey sent to 92,581 US blood donors. Responses (encouraged, discouraged, no difference) to incentives were compared within demographic groups, donations sites, and between first-time and repeat community whole-blood (WB) donors using chi-square tests and logistic regressions adjusted for sample design. RESULTS: Incentives most likely to encourage donation return among all 45,588 WB respondents were blood credits (61%), cholesterol screening (61%), and prostate-specific antigen (PSA) screening (73% of men). Younger donors (< or = 25 years old) were 4 to 5 times more likely to be encouraged to donate if offered compensatory incentives (tickets to events, discounts or lottery and/or raffle tickets), gifts, or a token of appreciation than were those donors older than 55. This age effect influenced positive attitudes toward incentives in first-time donors and in donors giving at schools, universities, or military sites. Among all donors, up to 7 to 9 percent reported they would be discouraged to return if offered compensatory incentives. CONCLUSIONS: Blood credits and cholesterol and PSA screening would be well received at all donation sites. Gifts, compensatory incentives, and tokens of appreciation appeal more to younger donors. These data may allow blood centers to optimize recruitment by tailoring limited incentive resources more effectively.

Adult↗