Unintended Consequences of Incentive Provision for Behaviour Change and Maintenance around Childbirth
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{"title"=>"Unintended consequences of incentive provision for behaviour change and maintenance around childbirth", "type"=>"journal", "authors"=>[{"first_name"=>"Gill", "last_name"=>"Thomson", "scopus_author_id"=>"55737348500"}, {"first_name"=>"Heather", "last_name"=>"Morgan", "scopus_author_id"=>"55491074900"}, {"first_name"=>"Nicola", "last_name"=>"Crossland", "scopus_author_id"=>"36677214200"}, {"first_name"=>"Linda", "last_name"=>"Bauld", "scopus_author_id"=>"55888724100"}, {"first_name"=>"Fiona", "last_name"=>"Dykes", "scopus_author_id"=>"55520735200"}, {"first_name"=>"Pat", "last_name"=>"Hoddinott", "scopus_author_id"=>"6603560550"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"25357121", "doi"=>"10.1371/journal.pone.0111322", "sgr"=>"84908681860", "isbn"=>"1932-6203", "scopus"=>"2-s2.0-84908681860", "issn"=>"19326203", "pui"=>"600319883"}, "id"=>"c0002157-5af0-3219-b68c-fe638d8650e9", "abstract"=>"Financial (positive or negative) and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding. A multi-disciplinary, mixed-methods approach included involving two service-user mother and baby groups from disadvantaged areas with experience of the target behaviours as study co-investigators. Systematic reviews informed the shortlist of incentive strategies. Qualitative semi-structured interviews and a web-based survey of health professionals asked open questions on positive and negative consequences of incentives. The participants from three UK regions were a diverse sample with and without direct experience of incentive interventions: 88 pregnant women/recent mothers/partners/family members; 53 service providers; 24 experts/decision makers and interactive discussions with 63 conference attendees. Maternity and early years health professionals (n = 497) including doctors, midwives, health visitors, public health and related staff participated in the survey. Qualitative analysis identified ethical, political, cultural, social and psychological implications of incentive delivery at population and individual levels. Four key themes emerged: how incentives can address or create inequalities; enhance or diminish intrinsic motivation and wellbeing; have a positive or negative effect on relationships with others within personal networks or health providers; and can impact on health systems and resources by raising awareness and directing service delivery, but may be detrimental to other health care areas. Financial incentives are controversial and generated emotive and oppositional responses. The planning, design and delivery of future incentive interventions should evaluate unexpected consequences to inform the evidence for effectiveness, cost-effectiveness and future implementation.", "link"=>"http://www.mendeley.com/research/unintended-consequences-incentive-provision-behaviour-change-maintenance-around-childbirth", "reader_count"=>81, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Librarian"=>5, "Researcher"=>21, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>17, "Student > Postgraduate"=>5, "Other"=>2, "Student > Master"=>12, "Student > Bachelor"=>7, "Professor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Librarian"=>5, "Researcher"=>21, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>17, "Student > Postgraduate"=>5, "Other"=>2, "Student > Master"=>12, "Student > Bachelor"=>7, "Professor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>9, "Agricultural and Biological Sciences"=>2, "Philosophy"=>1, "Business, Management and Accounting"=>1, "Chemistry"=>1, "Computer Science"=>2, "Economics, Econometrics and Finance"=>2, "Environmental Science"=>1, "Nursing and Health Professions"=>11, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>23, "Sports and Recreations"=>1, "Psychology"=>10, "Social Sciences"=>15}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>23}, "Social Sciences"=>{"Social Sciences"=>15}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Psychology"=>{"Psychology"=>10}, "Unspecified"=>{"Unspecified"=>9}, "Environmental Science"=>{"Environmental Science"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Computer Science"=>{"Computer Science"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>11}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"New Zealand"=>1, "Netherlands"=>1, "Romania"=>1, "France"=>1}, "group_count"=>7}

Scopus | Further Information

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  • {"files"=>["https://ndownloader.figshare.com/files/1772146"], "description"=>"<p>Key emergent themes for unintended consequences of incentives.</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223188, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t011", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Key_emergent_themes_for_unintended_consequences_of_incentives_/1223188", "title"=>"Key emergent themes for unintended consequences of incentives.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772143"], "description"=>"1<p> 14 CPIT providers took part in focus groups; one expert was involved in NW England breastfeeding incentive intervention.</p>2<p> Participant also took part in FG10.</p>3<p> Participant also took part in FG12.</p><p>* Participants took part in focus groups with women.</p>4<p> Interactive discussions that involved a mixture of practitioners and experts, a number of who had been involved in smoking cessation/breastfeeding incentive interventions.</p><p>Focus groups & interactive discussions – providers/experts<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111322#nt128\" target=\"_blank\"><sup>1</sup></a>.</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223185, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t008", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Focus_groups_interactive_discussions_providers_experts_1_/1223185", "title"=>"Focus groups & interactive discussions – providers/experts<sup>1</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772141"], "description"=>"<p>N/A = not applicable; N/R = not recorded.</p>1<p>T relates to a telephone interview; no letter refers to a face to face interview.</p>2<p>Mother relates to those who have older children (who may/may not be currently pregnant); mother* relates to women who have older children and who are pregnant; Woman relates to those who are pregnant/expecting first child.</p>3<p>1 – Participant married/living together/in a relationship; 2 – Single/divorced.</p>4<p>1 - White; 2 - Black or Minority Ethnic classifications (BME).</p>5<p>1- Degree level qualification; 2 - A level or equivalent; 3 - GCSE/NVQ or equivalent; 4 - No formal qualifications; 5- Not recorded.</p>6<p>1 – Never smoked; 2 – Quit during pregnancy; 3 – Cut down during pregnancy; 4 – Quit prior to pregnancy; 5 – Currently smoking.</p>7<p>Code relates to women who are currently pregnant: 1 – Plan to breastfed; 2 – Plan to mixed feed; 3 – Plan to formula feed.</p>8<p>Code relates to families with older children/interviewed in post-natal period: 1 – Previous experience of breastfeeding; 2 – Never breastfed.</p>9<p>‘Other’ relates to those involved in Barnardo’s Early Years Early Action Fund; <a href=\"http://www.barnardos.org.uk/media_centre/press_releases.htm?ref=81644\" target=\"_blank\">http://www.barnardos.org.uk/media_centre/press_releases.htm?ref=81644</a>).</p><p>**Providers also took part in FG5, FG7 & FG8.</p><p>Focus groups – mothers.</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223183, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t006", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Focus_groups_8211_mothers_/1223183", "title"=>"Focus groups – mothers.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772142"], "description"=>"1<p>Nine CPIT providers/experts took part in an interview; two experts were involved in a voucher incentive intervention for smoking cessation.</p>2<p> T relates to a telephone interview; no letter refers to a face to face interview.</p><p>Interviews – providers/experts<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111322#nt126\" target=\"_blank\"><sup>1</sup></a>.</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223184, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t007", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Interviews_providers_experts_1_/1223184", "title"=>"Interviews – providers/experts<sup>1</sup>.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772140"], "description"=>"<p>N/A = not applicable; N/R = not recorded.</p>1<p>T relates to a telephone interview; no letter refers to a face to face interview.</p>2<p>Mother/father relates to those who have older children (who may/may not be currently pregnant); mother* relates to women who have older children and who are pregnant; Woman/man relates to those who are pregnant/expecting first child.</p>3<p>1 - Participant married/living together/in a relationship; 2– Single/divorced.</p>4<p>1 - White; 2 - Black or Minority Ethnic classifications (BME).</p>5<p>1- Degree level qualification; 2 - A level or equivalent; 3 - GCSE/NVQ or equivalent; 4 - No formal qualifications; 5- Not recorded.</p>6<p>1 – Never smoked; 2 – Quit during pregnancy; 3 – Cut down during pregnancy; 4 – Quit prior to pregnancy; 5 – Currently smoking.</p>7<p>Code relates to women who are currently pregnant: 1 – Plan to breastfed; 2 – Plan to mixed feed; 3 – Plan to formula feed.</p>8<p>Code relates to families with older children/interviewed in post-natal period: 1 – Previous experience of breastfeeding; 2 – Never breastfed.</p>9<p>SC – experience of smoking cessation incentive intervention; BF – experience of breastfeeding incentive intervention; ‘Other’ relates to those involved in Barnardo’s Early Years Early Action Fund; <a href=\"http://www.barnardos.org.uk/media_centre/press_releases.htm?ref=81644\" target=\"_blank\">http://www.barnardos.org.uk/media_centre/press_releases.htm?ref=81644</a>).</p>10<p>Mothers participated in an ante-natal and post-natal interview.</p><p>Interviews - mothers/partners/other family members.</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223182, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t005", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Interviews_mothers_partners_other_family_members_/1223182", "title"=>"Interviews - mothers/partners/other family members.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772137"], "description"=>"a<p>A total of 16 focus groups were conducted. At three focus groups with women/recent parents a provider was present and three focus groups were a mixture of providers and experts. Two women attended two different focus groups; as did two experts (they are counted once only).</p>b<p>Two pregnant women were involved in a follow-up postnatal interview (one of which had an older child at the time of the first interview).</p><p>Study participants.</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223179, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t003", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Study_participants_/1223179", "title"=>"Study participants.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772148"], "description"=>"<div><p>Financial (positive or negative) and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding. A multi-disciplinary, mixed-methods approach included involving two service-user mother and baby groups from disadvantaged areas with experience of the target behaviours as study co-investigators. Systematic reviews informed the shortlist of incentive strategies. Qualitative semi-structured interviews and a web-based survey of health professionals asked open questions on positive and negative consequences of incentives. The participants from three UK regions were a diverse sample with and without direct experience of incentive interventions: 88 pregnant women/recent mothers/partners/family members; 53 service providers; 24 experts/decision makers and interactive discussions with 63 conference attendees. Maternity and early years health professionals (n = 497) including doctors, midwives, health visitors, public health and related staff participated in the survey. Qualitative analysis identified ethical, political, cultural, social and psychological implications of incentive delivery at population and individual levels. Four key themes emerged: how incentives can address or create inequalities; enhance or diminish intrinsic motivation and wellbeing; have a positive or negative effect on relationships with others within personal networks or health providers; and can impact on health systems and resources by raising awareness and directing service delivery, but may be detrimental to other health care areas. Financial incentives are controversial and generated emotive and oppositional responses. The planning, design and delivery of future incentive interventions should evaluate unexpected consequences to inform the evidence for effectiveness, cost-effectiveness and future implementation.</p></div>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223190, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unintended_Consequences_of_Incentive_Provision_for_Behaviour_Change_and_Maintenance_around_Childbirth_/1223190", "title"=>"Unintended Consequences of Incentive Provision for Behaviour Change and Maintenance around Childbirth", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772145"], "description"=>"<p>Response rates to free text questions in the professional survey (n = 497).</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223187, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t010", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Response_rates_to_free_text_questions_in_the_professional_survey_n_8202_8202_497_/1223187", "title"=>"Response rates to free text questions in the professional survey (n = 497).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1772144"], "description"=>"<p>Characteristics of the maternity and early years health professional sample (n = 497).</p>", "links"=>[], "tags"=>["53 service providers", "years health professionals", "incentive strategies", "incentive interventions", "health care areas", "future incentive interventions", "incentive provision", "consequence", "lifestyle behaviour change", "63 conference attendees", "uk", "influence health behaviours"], "article_id"=>1223186, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Gill Thomson", "Heather Morgan", "Nicola Crossland", "Linda Bauld", "Fiona Dykes", "Pat Hoddinott"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0111322.t009", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_maternity_and_early_years_health_professional_sample_n_8202_8202_497_/1223186", "title"=>"Characteristics of the maternity and early years health professional sample (n = 497).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-10-30 02:55:04"}

PMC Usage Stats | Further Information

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Relative Metric

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