Incentives in Diabetic Eye Assessment by Screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London

BMC Ophthalmology

Study Protocol

Laura Gunn¹  Ara Darzi²  Dominic King²  Gaby Judah²  Colin Bicknell²  Jonathan Valabhji³  Derek King⁴  Ivo Vlaev⁵ 

[1] Department of Integrative Health Science, Stetson University, 421 North Woodland Blvd., 32723, DeLand, Florida, USA;Department of Surgery and Cancer, Imperial College London, St. Mary’s Campus, Praed Street, W2 1NY, London, UK;Imperial College Healthcare NHS Trust, St. Mary’s Hospital, Praed Street, W2 1NY, London, UK;Personal Social Services Research Unit, London School of Economics & Political Science, Houghton Street, WC2A 2AE, London, UK;Warwick Business School, University of Warwick, Scarman Road, Coventry, CV4 7AL, Coventry, UK;

关键词: Financial incentives;    Behavioral economics;    Diabetes;    Diabetic retinopathy;    Screening;    Behavior change;   

DOI  :  10.1186/s12886-016-0206-4

 received in 2016-02-17, accepted in 2016-03-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundDiabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only 81 %, leaving many people at risk of preventable sight loss.MethodsThis is a three arm randomized controlled trial to investigate the impact of different types of financial incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within the last 24 months.Eligible participants will be randomized to one of three conditions:Control condition (usual invitation letter)Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment)Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000 if they attend their appointment).Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test whether the incentive scheme has a differential impact on patients from different demographic or socio-economic groups, information will be recorded on age, gender, distance from screening center, socio-economic status and length of time since they were last screened. A cost-effectiveness analysis will also be performed.DiscussionThis study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If effective, the intervention may suggest a cost-effective way to increase screening rates, thus reducing unnecessary blindness.Trial registrationISRCTN14896403, 25 February 2016

【 授权许可】

CC BY   
© Judah et al. 2016