Incentives and Disincentives for the Treatment of Depression and Anxiety: A Scoping Review

Objective:

There is widespread support for primary care to help address growing mental health care demands. Incentives and disincentives are widely used in the design of health care systems to help steer toward desired goals. The absence of a conceptual model to help understand the range of factors that influence the provision of primary mental health care inspired a scoping review of the literature. Understanding the incentives that promote and the disincentives that deter treatment for depression and anxiety in the primary care context will help to achieve goals of greater access to mental health care.

Method:

A review of the literature was conducted to answer the question, how are incentives and disincentives conceptualized in studies investigating the treatment of common mental disorders in primary care? A comprehensive search of MEDLINE, PsycINFO, CINAHL, and Google Scholar was undertaken using Arksey and O’Malley’s 5-stage methodological framework for scoping reviews.

Results:

We identified 27 studies. A range of incentives and disincentives influence the success of primary mental health care initiatives to treat depression and anxiety. Six types of incentives and disincentives can encourage or discourage treatment of depression and anxiety in primary care: attitudes and beliefs, training and core competencies, leadership, organizational, financial, and systemic.

Conclusions:

Understanding that there are 6 different types of incentives that influence treatment for anxiety and depression in primary care may help service planners who are trying to promote improved mental health care.     

The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks

Introduction

The objective of this article is to present the rationale and baseline results for a randomized controlled pilot trial using economic incentives to reduce HIV and sexually transmitted infection (STI) risk among male sex workers (MSWs) in Mexico City.

Methods

Participants (n=267) were tested and treated for STIs (chlamydia, gonorrhoea, syphilis and HIV) and viral hepatitis (hepatitis B and C), received HIV and STI prevention education and were randomized into four groups: (1) control, (2) medium conditional incentive ($50/six months), (3) high conditional incentive ($75/six months) and (4) unconditional incentive ($50/six months). In the conditional arms, incentives were contingent upon testing free of new curable STIs (chlamydia, gonorrhoea and syphilis) at follow-up assessments.

Results

Participants’ mean age was 25 years; 8% were homeless or lived in a shelter, 16% were unemployed and 21% lived in Mexico City less than 5 years. At baseline, 38% were living with HIV, and 32% tested positive for viral hepatitis or at least one STI (other than HIV). Participants had a mean of five male clients in the previous week; 18% reported condomless sex with their last client. For 37%, sex work was their main occupation and was conducted mainly on the streets (51%) or in bars/discotheques (24%) and hotels (24%). The average price for a sex transaction was $25 with a 35% higher payment for condomless sex.

Conclusions

The findings suggest that economic incentives are a relevant approach for HIV prevention among MSWs, given the market-based inducements for unprotected sex. This type of targeted intervention seems to be justified and should continue to be explored in the context of combination prevention efforts.     

Using Online Social Media for Recruitment of Human Immunodeficiency Virus-Positive Participants: A Cross-Sectional Survey

Background

There are many challenges in recruiting and engaging participants when conducting research, especially with HIV-positive individuals. Some of these challenges include geographical barriers, insufficient time and financial resources, and perceived HIV-related stigma.

Objective

This paper describes the methodology of a recruitment approach that capitalized on existing online social media venues and other Internet resources in an attempt to overcome some of these barriers to research recruitment and retention.

Methods

From May through August 2013, a campaign approach using a combination of online social media, non-financial incentives, and Web-based survey software was implemented to advertise, recruit, and retain participants, and collect data for a survey study with a limited budget.

Results

Approximately US $5,000 was spent with a research staff designated at 20% of full-time effort, yielding 2034 survey clicks, 1404 of which met the inclusion criteria and initiated the survey, for an average cost of US $3.56 per survey initiation. A total of 1221 individuals completed the survey, yielding 86.97% retention.

Conclusions

These data indicate that online recruitment is a feasible and efficient tool that can be further enhanced by sophisticated online data collection software and the addition of non-financial incentives.     

意大利辅助用具免费供给残疾人体系(英文)

Aids are only one of the instruments with which the disabled person can often reach a good level of autonomy,he can improve his conditions of life and prevent the aggravating of his situation.Aids serve also to facilitate care on the part of the family.The rights confirmed by Law 104 can also be achieved through the use of aids.The Italian state has planned a system of care with regards to aids so that some of them can be purchased with different tax concessions but essential aids,those necessary for the reaching of autonomy goals and prevention defined by an individual rehabilitative project,are supplied free of charge.In Italy essential aids are part therefore of a rehabilitation plan that is identified for each person with disabilities by a team made up of different professionals.     

Aids to Overcome Architectural Barriers:Normatives,Contributions and Concessions:Government contribution in removing physical barriers to improve integration of people with impaired mobility—ltalian case

In previous articles we described how the Italian system of aid for people with disabilities also provides a system of incentives and subsidies for devices that are very useful,in addition to the provision of aids that are granted free of charge as required under an individual rehabilitation plan.We have also seen as aids for overcoming architectural barriers are (rightly!) in the first place among those who are essential for people with disabilities to lead an independent life and to be able to access public and private places,in particular workplaces.Without removing of architectural barriers it is impossible to achieve many of the rights decreed by the Italian law n.104 and n.68 (work integration of disabled people).Here you can find the incentives provided by Italian law and the features of the two most common systems:stairlifts and platform lifts.     

医院薪酬体系改革的实践和体会

建立科学有效的薪酬制度是现有条件下公立医院革新机制、激发活力的重要途径。结合医院实践，介绍了医院薪酬体系改革的主要目的、薪酬体系设计与实施原则、薪酬模式选择等，提出了包括基本薪酬体系和补充薪酬体系共同构成的新型薪酬体系架构，其中基本薪酬体系由岗位工资、绩效工资、风险工资、公共福利、其他收入（如奖励等）组成：补充薪酬体系由年薪制、项目奖励制、协议工资制、独立核算制等。强调薪酬体系改革与人事制度改革密切相关，两者相辅相成，完善的薪酬体系的有效激励作用才能巩固人事制度改革的成果。     

上海市34所医院护理人员薪资调查

目的:通过现况调查掌握目前上海市护理人员薪资的基本情况及护士对薪资的满意度,根据结果提出建议。方法:采用分层随机抽样法、现况调查法,最后数据经过统计学处理。结果:得出上海市34所医院护理人员年薪情况及护理人员的满意度。2005年上海市护理人员平均年薪为26 944.19元(人民币),护理人员对年薪满意度较低,不满意者占被调查人数的67.80%。结论:增加护理人员薪资,使其劳动与收入匹配,对提升护理人员工作满意度,稳定护理队伍至关重要。