Influence of Financial Incentives on Oral Disease Management in Young Children

经济激励对幼儿口腔疾病管理的影响

基本信息

批准号：
9146310
负责人：
STUART A GANSKY
金额：
$ 69.5万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-18 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9146310
关键词：
3 year old 5 year old Adherence Adopted Adoption Age Award Behavior Behavioral Blood Glucose Self-Monitoring Blood Pressure Caregivers Caries prevention Child Child Behavior Child Rearing Childhood Cognitive Science Collaborations Color Communities Counseling Country County Dental Dental caries Development Disease Management Early Intervention Educational Intervention Elements Enrollment Family Feeling Focus Groups Frequencies Gender Gifts Goals Habits Head Start Program Health Health Promotion Health behavior Health education Incentives Individual Infant Informed Consent Intervention Investments Latin America Latino Lead Los Angeles Manuals Measures Modality Modeling Motivation Mouth Diseases Office Visits Oral health Outcome Measure Parents Participant Phase Pilot Projects Population Populations at Risk Prevention strategy Prevention trial Preventive Preventive dental care Procedures Protocols documentation Qualitative Methods Randomized Randomized Clinical Trials Randomized Controlled Trials Recruitment Activity Rewards Risk Running Structure Surveys Target Populations Testing Time Toddler Tooth structure Toothbrushing Toothpaste Visit Water Weight Woman base behavior change behavioral economics behavioral outcome cost cost effective cost effectiveness design digital early childhood evidence base financial incentive follow-up high risk improved insight intrinsic motivation low socioeconomic status meetings nutrition oral care patient oriented prevent primary outcome programs residence secondary outcome smoking cessation theories trial design voucher

项目摘要

DESCRIPTION (provided by applicant): We propose an individually randomized Early Childhood Caries (ECC) controlled prevention trial to test the impact of micro-incentives (combined with infant oral care and tiered digital Anticipatory Guidance) on increasing attendance of regular oral care visits and parental adoption of ECC prevention behaviors in an at- risk population from Early Head Starts and Women and Infant and Children (WIC) programs in Los Angeles County. Previous studies have shown that mere health education is insufficient to make a lasting impact on health behaviors. Despite growing evidence that small, cost-effective interventions that leverage theories and insights from behavioral economics, which incorporate elements of cognitive psychology to understanding health behaviors, can promote behavior change, none have been applied to oral health interventions. Our proposed behavioral economics theory-driven study explores the use of micro-incentive mechanisms to motivate adoption of ECC prevention habits, and, through a phased approach, will identify the most effective micro-incentive and test its impact and cost-effectiveness. The target population of the trial is underserved Los Angeles Country children between 0 to 3 years old at enrollment and their caregivers. Both genders will be recruited. Eligible children must meet the following criteri: (1) Age 0-3 years; (2) Family geographic stability (greater Los Angeles residence); (3) Parental informed consent in English or Spanish; (4) Children registered as participants at EHS or WIC; and (5) Children at high caries risk. During the pilot phase (UH2), the study will explore the feasibility, acceptability, and appropriateness of different modalities of structuring micro-incentives and determine whether the community finds cash, noncash equivalent-value gift card/voucher, or lottery payouts acceptable through qualitative methods (focus group) and quantitative measures (surveys). The incentive size and modality likely to be effective will be used to design the UH3 phase trial. In addition, the pilot study will validate primary outcome measures, such as toothbrushing adherence and timely attendance to office visits, and will inform identification of secondary outcome measures, such as change in parental/caregiver behaviors for oral health promotion and disease management. The UH3 phase will randomize individual parents/caregivers in up to five Los Angeles County EHS and WIC centers to micro-incentives (as determined in the pilot phase) or no incentives for behavioral change and measure ECC preventive behaviors and child's oral health. The goal is to estimate the cost effectiveness and return on investment of micro-incentives in improving parent/caregiver behaviors and children's oral health.

描述（适用提供）：我们提出了一个单独的幼儿龋齿（ECC）对照预防试验，以测试微观侵害的影响（与婴儿口腔护理和分层数字预期指导相结合）对日常口腔护理访问的出席性以及在ECC预防范围内的常规前往eCC预防行为的上升，并在早期的妇女和妇女中（妇女和妇女妇女和妇女）（妇女和妇女）（妇女和妇女妇女）（妇女和妇女）（f）（先前的研究表明，仅健康教育不足以对健康行为产生持久影响。尽管有越来越多的证据表明，少量，具有成本效益的干预措施利用了行为经济学的理论和见解，这些干预措施结合了认知心理学的要素以了解健康行为，可以促进行为的改变，但没有任何应用于口腔健康干预措施。我们提出的行为经济学理论驱动的研究探讨了微观启动机制激励采用ECC预防习惯的使用，并通过分阶段的方法将确定最有效的微观侵害并测试其影响和成本效益。目标人群审判是服务不足的洛杉矶乡村儿童，在入学人数及其护理人员时，审判是0至3岁的儿童。将招募两个性别。符合条件的儿童必须符合以下标准：（1）年龄0-3岁；（2）家庭地理稳定（大洛杉矶住宅）；（3）英语或西班牙语的父母知情同意；（4）在EHS或WIC注册为参与者的儿童；（5）高车风险。在试点阶段（UH2）期间，该研究将探讨不同模式的构造微观攻击方式的可行性，可接受性和适当性，并确定社区是否找到现金，非现金等效的礼品卡/凭证/优惠券，或通过定性方法（焦点小组）和定量衡量标准（Surveys）可接受的款项。可能有效的激励大小和方式将用于设计UH3相试验。此外，试点研究将验证主要的结局指标，例如牙刷的依从性和及时参加办公室就诊，并将为次要结局指标的识别提供信息，例如父母/照顾者的口腔健康促进和疾病管理行为的变化。 UH3阶段将在多达五个洛杉矶县EHS和WIC中心中随机将单个父母/照顾者随机，并将其中心与微观侵害（在试点阶段确定）或没有激励行为改变并衡量ECC预防行为和儿童的口腔健康。目的是估算微观增益的成本效益和投资回报，以改善父母/照料者的行为和儿童口腔健康。