Is a chance at $50 enough to break the stool sample ick factor?

A colonoscopy has never been advertised as a pleasant experience. However, it’s an important procedure and awareness for detecting cancer early on is essential. Turns out, all people really need in order to be proactive is a slight financial nudge  – the potential for a $50 reward. In a new study led by a researcher at […]

A colonoscopy has never been advertised as a pleasant experience. However, it’s an important procedure and awareness for detecting cancer early on is essential.

Turns out, all people really need in order to be proactive is a slight financial nudge  – the potential for a $50 reward.

In a new study led by a researcher at the VA Ann Arbor Healthcare System and University of Michigan, patients showed an increased interest in the preventative measure to complete home stool blood tests that help screen for colon cancer when they were told they would have a 1-in-10 chance of winning $50.

“Our study is another example of how modest financial incentives may go a long way in improving health behaviors and health care quality,” says Jeffrey Kullgren, M.D., M.S. M.P.H., a research scientist in the VA Ann Arbor Healthcare System, an assistant professor of internal medicine at the U-M Medical School and a former Robert Wood Johnson Foundation Clinical Scholar. “Integrating a small lottery incentive into usual care is a low cost tool with potential to promote patients’ use of a service proven to saves lives by catching cancer early.”

A fetal occult blood test home kit allows patients to take a sample of their bowel movement on their own and mail it to a lab. Microscopic blood in the stool that could be an early sign of colon cancer could be found in the results. People over the age of 50 are encouraged to do procedure, especially because the at-home test is less expensive, but usually only about one third actually do.

Researchers wanted to see what price might help reverse the trend, looking at whether flat dollar amounts of up to $20, a chance to win $50 or raffle for $500 could be an effective incentive. The $50 lottery approach had the greatest impact, increasing the test completion rate by 20 percent. The study was done at the Philadelphia Veterans Affairs Medical Center among 1,549 patients who were prescribed the blood stool test.

“Our work supports growing evidence that low cost innovations may be under-utilized in health care,” said Kullgren. “We need to explore more ways to identify how, when and where financial incentives can improve prevention of chronic disease.”

The findings appear in a special issue of Annals of Internal Medicine.

[Photo from flickr user Karen Moran]