Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs.
Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs.
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DOI：
10.1016/j.pmedr.2018.04.007
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发表时间：
2018-06
影响因子：
2.8
通讯作者：
Wright DR
中科院分区：
文献类型：
--
作者：
Jacob-Files E;Powell J;Wright DR
激励可以促进成人健康。我们试图研究激励措施是否有助于克服参与儿童体重管理项目的障碍，以及激励措施的理想价值、类型和接受者。2017年，我们对≤17 岁、曾经或目前患有肥胖症、曾经（n = 11）或从未（n = 12）参加过以家庭为基础的肥胖症行为治疗（FBT）的儿童的父母进行了半结构化电话访谈。访谈探讨了家庭愿意接受的激励措施的范围和类型。访谈记录被编码，数据使用主题分析进行分析。我们发现一些家长对接受现金奖励持怀疑态度。然而，一旦确定了与治疗有关的费用，一些人就对自费报销更感兴趣了。大多数家长认为每月100美元就足够了，奖励应该与改变行为挂钩，而不是与BMI挂钩。一些受访者表示，比起现金奖励，他们更喜欢非现金奖励（如礼品卡）。父母愿意与青少年分享奖励，最高为每月50美元，但他们担心奖励会影响孩子改变行为的内在动机。所有家长都承认，仅靠适度的激励措施无法克服参与体重管理计划的结构性和家庭障碍。综上所述，我们确定了促进FBT参与的激励计划的可取和可行的实施方面。未来的定量工作可以揭示有效改善致肥性健康行为和结果的激励机制的价值和结构。我们定性地评估了儿童肥胖治疗所需的财政激励。一些父母不愿意接受以家庭为基础的肥胖治疗的奖励，他们担心奖励会破坏行为改变的内在动机。比起现金奖励，年幼孩子的父母更喜欢非现金奖励。家长们更喜欢基于健康行为而不是健康结果的激励措施。
Incentives can promote adult wellness. We sought to examine whether incentives might help overcome barriers to engagement in child weight management programs and the ideal value, type and recipient of incentives. In 2017, we conducted semi-structured phone interviews with parents of children ≤17 years old, formerly or currently affected by obesity, who had (n = 11) or had never (n = 12) participated in family-based behavioral treatment (FBT) for obesity. Interviews explored the range and type of incentives families would be willing to accept. Interview transcripts were coded and data were analyzed using a thematic analysis. We found that some parents were skeptical about receiving cash incentives. However, once treatment-related costs were identified, some became more interested in reimbursement for out of pocket expenditures. Most parents felt up to $100/month would be adequate and that incentives should be tied to changing behaviors, not BMI. Some interviewees expressed preferences for non-cash incentives (e.g. a gift card) over cash incentives. Parents were willing to share incentives with adolescents, up to $50/month, but there was concern about incentives affecting a child's intrinsic motivation for behavior change. All parents acknowledged that moderate incentives alone couldn't overcome the realities of structural and familial barriers to engaging in weight management programs. In summary, we identified aspects of an incentive program to promote engagement in FBT that would be desirable and feasible to implement. Future quantitative work can reveal the value and structure of incentives that are effective for improving obesogenic health behaviors and outcomes. We qualitatively assessed desired financial incentives for child obesity treatment. Some parents were reluctant to accept incentives for family-based obesity treatment Parents worried incentives could undermine intrinsic motivation for behavior change. Parents of young children preferred non-cash incentives to cash incentives. Parents preferred incentives be contingent on health behaviors, not health outcomes.