Incentives enhance postpartum compliance among adolescent prenatal patients.
OBJECTIVE
To test the hypothesis that incentives enhance compliance with postpartum appointments.


METHODS
We studied a multiracial group of 240, poor, 12-to-19 year olds. At 34 weeks gestation consecutively enrolled patients were randomized to incentive and non-incentive groups. Patients in the incentive group were told that they would receive a Gerry "Cuddler" if they returned for an examination within 12 weeks of delivery. The groups were compared with Student's t-tests and chi-square and logistic regression analyses.


RESULTS
We found no significant group differences in age, race, Medicaid status, gravidity, parity, the timing of the first prenatal visit, compliance with prenatal appointments, or well-baby care site. One hundred and seventy-five (73%) of the 240 patients returned for a postpartum examination. Patients randomized to the incentive group were significantly more likely to return for an examination within 12 weeks of delivery (82.4% vs. 65.2%, chi 2 = 9.0; p = .003). The logistic regression analysis revealed that in addition to membership in the incentive group, three characteristics were significantly associated with postpartum compliance: primiparity, compliance with prenatal care, and school enrollment.


CONCLUSIONS
Among adolescents who obtained prenatal care in a multidisciplinary adolescent-oriented maternity program, the offer of an incentive significantly improved compliance with the 6-week postpartum appointment. Since other factors associated with improved postpartum compliance are less amenable to change we recommend that health care providers consider offering a postpartum incentive, especially to their multiparous adolescent patients who are not enrolled in school and/or are non-compliant with prenatal appointments.
Stevens-Simon
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C
Division of Adolescent Medicine, School of Nursing, University of Colorado Health Science Center, Denver.
O'Connor
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P
Bassford
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K
D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D001071:Appointments and Schedules; D005260:Female; D006801:Humans; D016015:Logistic Models; D009042:Motivation; D010349:Patient Compliance; D011181:Postnatal Care / Q000523:psychology*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology; D011295:Prenatal Care; D012201:Reward