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Using incentives to increase participation in prenatal care
Obstetrics and Gynecology
|March 1, 1995
Summary
Incentives did not improve prenatal care attendance for low-income women. Barriers like transportation and illness prevented participation despite gift certificates and raffle chances.
Area of Science:
- Public Health
- Maternal Health
- Health Services Research
Background:
- Prenatal and postpartum care are crucial for maternal and infant health.
- Low-income women face significant barriers to accessing consistent healthcare.
- Incentives are sometimes used to improve healthcare engagement.
Purpose of the Study:
- To evaluate the effectiveness of two incentive types in increasing prenatal and postpartum care participation among low-income women.
- To determine if incentives can overcome common barriers to care access.
Main Methods:
- A randomized controlled trial involving 205 Medicaid-eligible women.
- Intervention groups received gift certificates or gift certificates plus a raffle entry for prenatal appointments.
- Outcomes measured included appointment attendance, satisfaction, gestation length, and birth weight.
Main Results:
- No significant differences in appointment attendance or other outcomes were observed between incentive groups and the control group.
- High rates of missed appointments persisted, with 39% missing prenatal and 45% missing postpartum appointments.
- Commonly cited reasons for missed appointments included lack of transportation, inclement weather, and illness.
Conclusions:
- Financial incentives and raffle chances are ineffective in overcoming barriers to prenatal care for low-income women.
- Addressing practical barriers such as transportation is essential for improving access to maternal healthcare.
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