How financial incentives in parenting skills programs affect engagement and outcomes: a systematic review and meta-analysis protocol.

OBJECTIVE: This systematic review will investigate the effects of financial incentives on engagement with and outcomes of evidence-based parenting skills programs to prevent and treat disruptive behavior disorders. INTRODUCTION: Evidence-based parenting skills programs are a first-line treatment in disruptive behavior disorders (ie, oppositional defiant disorder, conduct disorder, and attention-deficit/hyperactivity disorder), but fewer than half of referred parents complete these programs. When untreated, children affected by disruptive behavior disorders are at elevated risk of incarceration, drug misuse, and educational under-performance. Financial incentives can improve parents' engagement with parenting skills programs, and are increasingly popular strategies in public health policy to increase rates of compliance with health interventions. However, no previous systematic review or meta-analysis of financial incentives in parenting skills programs has been conducted. INCLUSION CRITERIA: Randomized controlled trials or quasi-experimental studies (ie, studies with a control group allocated through a non-random process) testing the effects of financial incentives on engagement will be included. Study participants must be in a guardian role to a person under 18 years of age. There will be no restrictions on country setting. Only English-language publications will be included. METHODS: We will search PubMed, CINAHL, Sociological Abstracts, Cochrane Trials, and PsycINFO databases for relevant articles. Two independent reviewers will screen abstracts for eligibility. Data will be extracted from eligible articles by 2 researchers and results will be presented in tabular and narrative format, along with a meta-analysis using a random effects model and assessment of heterogeneity. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022336210.

Take patients seriously when they say financial incentives help with adherence.

Small financial incentives have been proven effective at promoting healthy behaviours across medicine, including in psychiatry. There are a range of philosophical and practical objections to financial incentives. Drawing on the existing literature, specifically attempts to use financial incentives to promote antipsychotic adherence, we propose a 'patient-centred' view of evaluating financial incentive regimes. We argue that there is evidence that mental health patients like financial incentives, considering them fair and respectful. The enthusiasm of mental health patients for financial incentives lends support to their use, although it does not invalidate all objections against them.