Patients’ Reactions to Being Offered Financial Incentives to Increase Colorectal Screening: A Qualitative Analysis

Abstract

Purpose:

To explore financial incentives as an intervention to improve colorectal cancer screening (CRCS) adherence among traditionally disadvantaged patients who have never been screened or are overdue for screening.

Approach:

We used qualitative methods to describe patients’ attitudes toward the offer of incentives, plans for future screening, and additional barriers and facilitators to CRCS.

Setting:

Kaiser Permanente Washington (KPWA).

Participants:

KPWA patients who were due or overdue for CRCS.

Method:

We conducted semi-structured qualitative interviews with 37 patients who were randomized to 1 of 2 incentives (guaranteed $10 or a lottery for $50) to complete CRCS. Interview transcripts were analyzed using a qualitative content approach.

Results:

Patients generally had positive attitudes toward both types of incentives, however, half did not recall the incentive offer at the time of the interview. Among those who recalled the offer, 95% were screened compared to only 25% among those who did not remember the offer. Most screeners stated that staying healthy was their primary motivator for screening, but many suggested that the incentive helped them prioritize and complete screening.

Conclusions:

Incentives to complete CRCS may help motivate patients who would like to screen but have previously procrastinated. Future studies should ensure that the incentive offer is noticeable and shorten the deadline for completion of FIT screening.