Behavior, Cardiovascular Risk Factor, Influenza
Conditions
Brief summary
Reducing racial disparities in health outcomes is a major policy concern in the United States. Although there has been recent progress to close the gap, black men continue to experience earlier morbidity and mortality from preventable and manageable medical conditions, and live on average 4.2 years less than their white male peers. An oft-prescribed solution to close this stubborn gap is to increase the diversity of the healthcare workforce. Another common policy tool to increase take-up of preventative healthcare services is financial incentives. In this randomized evaluation, we will estimate the effects of financial incentives and a racially concordant physician on the uptake of preventive health services in Oakland, California.
Interventions
BEHAVIORALConcordant
We will be randomizing across providers - we are particularly interested in racial concordance.
Sponsors
Stanford University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Caregiver)
Intervention model description
RCT
Eligibility
Sex/Gender
MALE
Age
18 Years to 100 Years
Healthy volunteers
Yes
Inclusion criteria
* African American male adults
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Average Take-up of Preventive Services (Post-consultation) | 1 day | Take-up of preventative services was scored as either zero (did not utilize any post-consultation services) or 1 (utilized at least 1 post-consultation service). Four non-incentivized post-consultation preventive services were offered (for BMI, blood pressure, cholesterol, and/or diabetes); the subject had the opportunity to select service(s) after meeting with their assigned doctor. |
Countries
United States
Participant flow
Recruitment details
We recruited 1374 black men in barbershops and flea markets to take the baseline survey. The subjects were given a coupon which allowed them entrance to the clinic.
Pre-assignment details
1374 participants were recruited and completed the baseline survey prior to coming to the clinic. 667 filled out the baseline survey but did not come to the clinic and were not randomized. 70 additional participants were excluded from participation and were not randomized.
Participants by arm
| Arm | Count |
|---|---|
| Discordant Does not receive the concordant provider.
Concordant: We will be randomizing across providers - we are particularly interested in racial concordance. | 324 |
| Concordant The intervention is that the subject receives the concordant provider.
Concordant: We will be randomizing across providers - we are particularly interested in racial concordance. | 313 |
| Total | 637 |
Baseline characteristics
| Characteristic | Concordant | Discordant | Total |
|---|---|---|---|
| Age, Continuous | 42.6 years STANDARD_DEVIATION 17.1 | 43.4 years STANDARD_DEVIATION 16.3 | 43.0 years STANDARD_DEVIATION 16.7 |
| Average education level | .64 score on a scale STANDARD_DEVIATION 0.48 | .62 score on a scale STANDARD_DEVIATION 0.49 | .63 score on a scale STANDARD_DEVIATION 0.48 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 313 Participants | 324 Participants | 637 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Male | 313 Participants | 324 Participants | 637 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 324 | 0 / 313 |
| other Total, other adverse events | 0 / 324 | 0 / 313 |
| serious Total, serious adverse events | 0 / 324 | 0 / 313 |
Outcome results
Primary
Average Take-up of Preventive Services (Post-consultation)
Take-up of preventative services was scored as either zero (did not utilize any post-consultation services) or 1 (utilized at least 1 post-consultation service). Four non-incentivized post-consultation preventive services were offered (for BMI, blood pressure, cholesterol, and/or diabetes); the subject had the opportunity to select service(s) after meeting with their assigned doctor.
Time frame: 1 day
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Discordant | Average Take-up of Preventive Services (Post-consultation) | 0.52 score on a scale | Standard Deviation 0.36 |
| Concordant | Average Take-up of Preventive Services (Post-consultation) | .71 score on a scale | Standard Deviation 0.36 |