RTI International, Substance Use, Gender and Applied Research, Research Triangle Park, NC, USA.
Benten Technologies, Inc., Manassas, VA, USA.
Prev Med. 2021 Apr;145:106442. doi: 10.1016/j.ypmed.2021.106442. Epub 2021 Jan 27.
Use of financial incentives contingent on health outcomes has shown effective in health behavior change. Evidence-based information on the effect of incentive use for maternal health behavior change can inform whether and how to proceed with future research as well as incorporate incentive-based interventions in the existing healthcare system. This systematic literature review was conducted among prospective studies on incentive use for maternal health behavior change in a U.S. cohort according to the PRISMA methodology. Databases subject to the search included PubMed, Web of Science, PsycINFO, and EBSCOhost. Studies published in peer-reviewed journals on or before January 7, 2019, written in English, conducted in U.S., using incentives contingent on maternal health behavior change, and prospectively designed were included. Two authors independently searched titles and abstracts. An abstraction table was constructed, and the risk of bias was assessed using the GRADE approach. The review showed that incentives such as vouchers and other financial incentives were effective in improving outcomes especially related to substance use, tobacco use, and breastfeeding. Mixed evidence was found in improving treatment adherence outcomes; however the studies with randomized trials on the outcome of treatment adherence also showed low certainty. Continued improvements need to be made in implementing an incentive-based approach in the context of comprehensive treatment and routine healthcare, exploring electronic- or mobile-based implementation of the approach, and implementing the approach for a wider variety of outcomes during both prenatal and postpartum periods.
基于健康结果的财务激励措施在改变健康行为方面已被证明是有效的。关于激励措施用于改变产妇健康行为的效果的循证信息，可以为未来的研究提供参考，决定是否以及如何开展进一步的研究，并在现有的医疗保健系统中纳入基于激励的干预措施。本系统文献综述根据 PRISMA 方法，在美国队列中对激励措施用于改变产妇健康行为的前瞻性研究进行了研究。纳入的检索数据库包括 PubMed、Web of Science、PsycINFO 和 EBSCOhost。研究纳入标准为：发表在同行评议期刊上、发表时间在 2019 年 1 月 7 日之前、采用基于产妇健康行为改变的激励措施、以美国人群为研究对象、为前瞻性设计、使用英文撰写的研究。两名作者独立搜索标题和摘要。构建了一个摘要表，并使用 GRADE 方法评估偏倚风险。综述结果表明，优惠券和其他财务激励措施等激励措施在改善物质使用、吸烟和母乳喂养等方面的效果显著。在改善治疗依从性方面的证据则较为混杂；但在关于治疗依从性结果的随机试验研究中，也显示出低确定性。需要继续改进在综合治疗和常规医疗保健背景下实施基于激励的方法，探索该方法在电子或移动设备上的实施，并在产前和产后期间为更广泛的各种结果实施该方法。
