6014.0: Thursday, November 16, 2000 - 8:50 AM

Abstract #10912

A content analysis of the rationale for the use of incentives in public health: clarification of assumptions about provider responsibility and client autonomy

Lisa Dorothy Moore, DrPH, Department of Health Education, San Francisco State University, 1600 Holloway Ave, Science 389, San Francisco, CA 94132, (415) 338-2109, lisadee@sfsu.edu and Brian R. Edlin, MD, Director, Urban Health Study, University of California, San Francisco, 3180 18th St., Suite 302, San Francisco, CA 94110.

Objective: To examine how researchers and practitioners justify their use of incentives to encourage participation and adherence for indigent populations.

Background: Discussions about the use of incentives in public health are rooted in assumptions about responsibility and autonomy. People who don't support monetary incentives express concern that the people getting the incentives will not use the money responsibly or that such incentives will not encourage responsibility in health behavior formation. Others argue that client autonomy is paramount and that people should be compensated for their time and efforts, whether they are researchers or research subjects. Whether incentives are offered and which kind of incentives are used offers a lens on the assumptions of public health personnel regarding where their responsibility ends and where client autonomy begins

Methods: The author will do an content analysis of studies and interventions indexed in MEDLINE and in social science indexes from 1995 to the present. The studies examined will be limited to those with keywords of HIV, family planning and tuberculosis. All abstracts will be coded for the presence or absence of the use of incentives and narrowed further by focusing upon poor populations. Those articles where the authors indicated that incentives were used will be coded for the types of incentives used and the justifications, if any, made for their use.

Discussion: The use of incentives can be viewed as a reflection of assumptions about power and agency. Revealing these assumptions can lead to providers using their power appropriately while maximizing the agency of their clients.

Learning Objectives: 1. Participants will be able to identify three reasons for and three reasons against the use of incentives for indigent populations 2. Participants will be exposed to how others in the field are addressing this dilemma. 3. Participants will be afforded an opportunity to discuss their beliefs about provider responsibility and client autonomy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA