Incentives for breastfeeding and for smoking cessation in pregnancy

An exploration of types and meanings

Bibliographic Data

ID4593905
AuthorsNicola Crossland (0000-0003-1063-8123, University of Lancashire, corresponding author), Gill Thomson (0000-0003-3392-8182, University of Lancashire), Heather Morgan (0000-0002-6118-8911, University of Aberdeen), Stephan U Dombrowski (0000-0001-9832-2777, University of Stirling), Pat Hoddinott (0000-0002-4372-9681, University of Stirling)
Year2015
Volume128
Pages10-17
Publication date2015-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2014.12.019
PMID25569610
OpenAlexW2166246995
LanguageEN
Citations received4
References cited51

Financial or tangible incentives are a strategy for improving health behaviours. The mechanisms of action of incentives are complex and debated. Using a multidisciplinary integrated mixed methods study, with service-user collaboration throughout, we developed a typology of incentives and their meanings for initiating and sustaining smoking cessation in pregnancy and breastfeeding. The ultimate aim was to inform incentive intervention design by providing insights into incentive acceptability and mechanisms of action. Systematic evidence syntheses of incentive intervention studies for smoking cessation in pregnancy or breastfeeding identified incentive characteristics, which were developed into initial categories. Little published qualitative data on user perspectives and acceptability was available. Qualitative interviews and focus groups conducted in three UK regions with a diverse socio-demographic sample of 88 women and significant others from the target population, 53 service providers, 24 experts/decision makers, and conference attendees identified new potential incentives and providers, with and without experience of incentives. Identified incentives (published and emergent) were classified into eight categories: cash and shopping vouchers, maternal wellbeing, baby and pregnancy-related, behaviour-related, health-related, general utility, awards and certificates, and experiences. A typology was refined iteratively through concurrent data collection and thematic analysis to explore participants' understandings of 'incentives' and to compare and contrast meanings across types. Our typology can be understood in three dimensions: the degree of restriction, the extent to which each is hedonic and/or utilitarian, and whether each has solely monetary value versus monetary with added social value. The layers of autonomy, meanings and the social value of incentive types influence their acceptability and interact with structural, social, and personal factors. Dimensions of incentive meaning that go beyond the simple incentive description should inform incentive programme design and are likely to influence outcomes

Breastfeeding · Economics · Family medicine · Incentive · Market economy · Obstetrics · Pregnancy · Smoking cessation · Breastfeeding Practices and Influences · Food Security and Health in Diverse Populations · Medicine · Nursing · Obesity, Physical Activity, Diet · Pediatrics