1 RTI International, Rockville, MD, USA.
2 RTI International, Research Triangle Park, NC, USA.
Am J Health Promot. 2019 Mar;33(3):381-390. doi: 10.1177/0890117118785351. Epub 2018 Jul 16.
Evaluate the Centers for Medicare & Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) program in terms of participant satisfaction and self-reported program impact.
Participant survey (mail/telephone follow-up), English and Spanish (N = 2274).
Ten states in MIPCD program.
Medicaid beneficiaries.
Incentive-based health promotion programs targeting diabetes prevention and management, smoking cessation, and weight, hypertension, and cholesterol management.
Dependent measures are (1) overall program satisfaction and (2) self-reported program impact, operationalized as whether program helped with understanding health issues, learning ways to take care of health, and encouraging healthy lifestyle changes.
Multilevel multivariable ordinal logistic regression models to identify predictors of overall program satisfaction and program impact.
Sixty-seven percent were very satisfied with the program, and 76% strongly agreed the program encouraged healthy lifestyle changes. Age (59+ vs <45 years) and being female predicted overall program satisfaction. Satisfaction with specific aspects of the program including communication with staff, accessibility, and incentives predicted higher overall satisfaction. Age (45-52 vs <45 years) and being black or Hispanic predicted higher program impact. Points redeemable for rewards performed worse than money-valued incentives in terms of encouraging lifestyle changes (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.11-0.82). Participants receiving incentives valued at $25 to <$100 were more likely to report higher agreement that the program helped them learn ways to care for their health (OR, 1.72; 95% CI, 1.21-2.44) and encouraged lifestyle changes (OR, 1.46; 95% CI, 1.02-2.10), compared to participants receiving incentives valued at $0 to <$25. Incentives valued at $100 to <$400 predicted higher agreement that the program helped with understanding of health issues (OR, 1.62; 95% CI, 1.13-2.33), compared to incentives valued at $0 to <$25.
Effective chronic disease prevention programs are needed for Medicaid populations. Study findings highlight important considerations for incentive-based programs.
评估医疗保险和医疗补助激励预防慢性病计划（MIPCD）在参与者满意度和自我报告的项目影响方面的效果。
参与者调查（邮件/电话随访），英语和西班牙语（N=2274）。
MIPCD 计划中的十个州。
医疗补助受益人。
基于激励的健康促进计划，针对糖尿病预防和管理、戒烟以及体重、高血压和胆固醇管理。
因变量是（1）整体计划满意度和（2）自我报告的计划影响，具体表现为计划是否有助于理解健康问题、学习照顾健康的方法和鼓励健康的生活方式改变。
多层次多变量有序逻辑回归模型，以确定整体计划满意度和计划影响的预测因素。
67%的人对该计划非常满意，76%的人强烈同意该计划鼓励健康的生活方式改变。年龄（59+ 岁与 <45 岁）和女性是整体计划满意度的预测因素。对计划的特定方面的满意度，包括与工作人员的沟通、可及性和激励措施，预测了更高的整体满意度。年龄（45-52 岁与 <45 岁）和黑人和西班牙裔是计划影响的预测因素。可兑换积分的奖励在鼓励生活方式改变方面表现不如货币价值奖励（优势比[OR]，0.30；95%置信区间[CI]，0.11-0.82）。收到价值 25 美元至 <100 美元的激励措施的参与者更有可能报告说，该计划帮助他们学习了照顾健康的方法（OR，1.72；95%CI，1.21-2.44）并鼓励生活方式改变（OR，1.46；95%CI，1.02-2.10），与收到价值 0 美元至 <25 美元的激励措施的参与者相比。价值 100 美元至 <400 美元的激励措施预测参与者更同意该计划有助于理解健康问题（OR，1.62；95%CI，1.13-2.33），与价值 0 美元至 <25 美元的激励措施相比。
需要为医疗补助人群提供有效的慢性病预防计划。研究结果强调了基于激励的计划的重要考虑因素。
