Should young people be paid for getting tested? A national comparative study to evaluate patient financial incentives for chlamydia screening

<p>Abstract</p> <p>Background</p> <p>Patient financial incentives ("incentives") have been widely used to promote chlamydia screening uptake amongst 15-24 year olds in England, but there is scarce evidence of their effectiveness. The objectives of the study were to describe incentives used to promote chlamydia screening in Primary Care Trusts (PCTs) in England and to evaluate their impact on coverage and positivity rate.</p> <p>Methods</p> <p>PCTs that had used incentives between 1/1/2007 and 30/6/2009 (exposed) were matched by socio-demographic profile and initial screening coverage with PCTs that had not (unexposed). For each PCT, percentage point change in chlamydia screening coverage and positivity for the period before and during the incentive was calculated. Differences in average change of coverage and positivity rate between exposed and unexposed PCTs were compared using linear regression to adjust for matching and potential confounders.</p> <p>Results</p> <p>Incentives had a significant effect in increasing average coverage in exposed PCTs (0.43%, CI 0.04%-0.82%). The effect for voucher schemes (2.35%) was larger than for prize draws (0.16%). The difference was greater in females (0.73%) than males (0.14%). The effect on positivity rates was not significant (0.07%, CI -1.53% to 1.67%).</p> <p>Conclusions</p> <p>Vouchers, but not prize draws, led to a small absolute but large relative increase in chlamydia screening coverage. Incentives increased coverage more in females than males but had no impact on reported positivity rates. These findings support recommendations not to use prize draws to promote chlamydia screening and contribute to the evidence base of the operational effectiveness of using patient incentives in encouraging public health action.</p

All they need is love? Placing romantic stress in the context of other stressors: A 17-nation study

The present study focuses on romantic stress and coping styles in the context of identity and future-related stressors in 8,654 adolescents with a mean age of M = 15.3; SD = 1.84. The adolescents from 17 countries were grouped into seven regions, i.e., Mid-Europe, Northern Europe, Eastern Europe, Southern Europe, South Africa, South America, and the Middle East. Future-related stressors were perceived as being more stressful than romantic stressors by all adolescents, irrespective of the region in which they lived. Identity-related stressors were of greater concern to adolescents from South Africa, South America, and the Middle East. Romantic stress was much higher in adolescents from Mid-Europe and Southern Europe compared to adolescents from other regions. Roughly 80% of all adolescents employed adaptive coping styles in that they negotiated with the romantic partner, sought support from friends and others, and shared an overall positive outlook. Adolescents from Mid-, Northern, and Eastern Europe were the most active in negotiating and support-seeking when dealing with romantic stressors