Do financial incentives increase mental health treatment engagement? A meta-analysis.
Do financial incentives increase mental health treatment engagement? A meta-analysis.
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DOI：
10.1037/ccp0000737
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发表时间：
2022-06
影响因子：
5.9
通讯作者：
Thase, Michael E
中科院分区：
文献类型：
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作者：
Khazanov, Gabriela K;Morris, Paige E;Beed, Alexander;Jager-Hyman, Shari;Myhre, Karoline;McKay, James R;Feinn, Richard S;Boland, Elaine M;Thase, Michael E
心理健康治疗参与度低，这可能导致不良结果。我们评估了向患者提供经济激励以增加他们的精神健康治疗参与度的有效性，也称为应急管理。我们对为精神健康治疗参与度提供经济激励的研究进行了荟萃分析，包括增加治疗出勤率、服药依从性和治疗目标完成。分析是在多层次框架内进行的。所有的研究设计都包括在内，敏感性分析只包括随机和高质量的研究。大约80%的干预措施鼓励治疗药物使用障碍。经济激励显著增加了治疗出勤率(赫奇斯的g=0.49，[0.33，0.64]，k=30，I2=83.14)，服药依从性(赫奇斯的g=0.95，[0.47，1.44]，k=6，I2=87.73)和治疗目标完成率(赫奇斯的g=0.61，[0.22，0.99]，k=5，I2=60.55)，包括完成家庭作业，签署治疗计划，减少问题行为。财政激励措施增加了中到大效应规模的治疗参与度。我们提供了强有力的证据，证明它们在提高药物使用和治疗参与度方面的有效性，并提供初步证据，证明它们在提高其他精神健康障碍的治疗参与度方面的有效性。未来的研究应该优先测试激励治疗精神健康障碍的有效性，而不是物质使用。研究还必须确定激励治疗参与的方法，以改善功能和长期结果，并解决实施这些干预措施的伦理和系统性障碍。
Engagement in mental health treatment is low, which can lead to poor outcomes. We evaluated the efficacy of offering patients financial incentives to increase their mental health treatment engagement, also referred to as contingency management. We meta-analyzed studies offering financial incentives for mental health treatment engagement, including increasing treatment attendance, medication adherence, and treatment goal completion. Analyses were run within a multilevel framework. All study designs were included, and sensitivity analyses were run including only randomized and high-quality studies. About 80% of interventions incentivized treatment for substance use disorders. Financial incentives significantly increased treatment attendance (Hedges’ g = 0.49, [0.33, 0.64], k = 30, I2 = 83.14), medication adherence (Hedges’ g = 0.95, [0.47, 1.44], k = 6, I2 = 87.73) and treatment goal completion (Hedges’ g = 0.61, [0.22, 0.99], k = 5, I2 = 60.55), including completing homework, signing treatment plans, and reducing problematic behavior. Financial incentives increase treatment engagement with medium to large effect sizes. We provide strong evidence for their effectiveness in increasing substance use treatment engagement and preliminary evidence for their effectiveness in increasing treatment engagement for other mental health disorders. Future research should prioritize testing the efficacy of incentivizing treatment engagement for mental health disorders aside from substance use. Research must also identify ways to incentivize treatment engagement that improve functioning and long-term outcomes and address ethical and systemic barriers to implementing these interventions.
影响因子：
4.4
作者：
Noordraven EL;Wierdsma AI;Blanken P;Bloemendaal AFT;Mulder CL
通讯作者：
Mulder CL