Search

Many choices involve a more immediate or more probable outcome pitted against a delayed or less probable outcome. Examples include immediate spending versus investing, eating a high-calorie, high-fat meal versus [...], Discounting is a description of the devaluing of an outcome based on increased delay or decreased probability of that outcome. This framework can be extended to virtually any choice situation, including preventive medical procedures. One third of Americans will be diagnosed with cancer in their lifetimes. Identifying how key factors affect decisions to engage in preventive care could inform interventions that are designed to promote equitable access to care. Therefore, the purpose of this study was to better understand how individuals would weigh key factors in the decision to have surgery to remove a premalignant tumor. Two experiments were conducted. In each experiment, participants (n = 50) were provided with hypothetical situations in which they were faced with the decision to undergo surgery to remove a premalignant tumor. Probability of cancer, delay to onset of cancer, frame, and cost of surgery were varied across questions. Surgical cost and probability of malignancy had the most effect on tumor removal. Delay of cancer onset and the question being framed as malignant or benign also had a small effect on tumor removal. Most participants also reported having delayed a real medical procedure due to cost, indicating that cost is a major factor in health-related decision making. Likelihood of cancer and cost of health care is a major determinant of decision making when removing a premalignant tumor. Changes in the U.S. health-care system that decrease direct costs to patients could encourage important preventative procedures, and lower potentially worse long-term cancer outcomes and increased costs due to treatment. Keywords Cancer * Discounting Decisionmaking * Surgical cost * Behavioral economics

Contingency management is especially effective in supporting medication adherence and drug abstinence among people with opioid use disorder. However, the incorporation of contingency management into clinical practice has been slow. The present study was designed to evaluate the feasibility, acceptability, and usability of incentives for providers as a means of accelerating collaborative care with contingency management. Thirteen buprenorphine prescribers served as participants in a nonexperimental study. The prescribers who referred patients to a contingency‐management service received monetary incentives for reviewing patient performance data and describing their use of these data in treatment decisions. The results show that this approach is feasible, acceptable, and easy to use for everyone involved. Self‐reports indicate improved prescriber–patient relationships and more informed care. However, prescriber‐focused incentives did not appear to greatly enhance access to contingency‐management services for patients. Thus, provider incentives may be beneficial but further research is needed to advance adoption of contingency management. [ABSTRACT FROM AUTHOR]

Purpose: The lack of progress toward equity in the U.S. is evident across many spheres of society, academia notwithstanding. Women academicians, in particular, face many barriers that prevent them from advancing–including a continued unsupportive climate, competing work and family demands, and interpersonal discrimination. This paper reflects on a collaborative research effort in the United States to enhance allyship for women in academia. Design/methodology/approach: The authors partnered with a major university to hold ally training for department chairs during a university-wide department chair meeting. The authors developed a methodology for creating and implementing training content using a focus-group-based training needs analysis and a diversity science grounded approach to allyship training. The authors followed this up with surveys to assess impact. Findings: Participants indicated that they learned from the training, but participation in follow-up data collection was limited, hampering the ability to conduct rigorous quantitative analyses around intervention impact. Research limitations/implications: Although the sample size may have been too limited to detect effects, the current study provides an approach that furthers the way in which researchers and practitioners can better assess the impact of allyship to women academicians. Practical implications: Published research on allies is very limited. The current research examines allies in the context of helping women in academia. Originality/value: Despite widespread recognition of the importance of first-line supervisors in support of diversity, limited intervention designs are available. The authors add to the extant literature on diversity interventions, while highlighting barriers to rigorous intervention evaluation. [ABSTRACT FROM AUTHOR]