PDF(Pubmed)
Abstract：
Contingency management (CM) involves provision of incentives for positive health behaviors via a well-defined protocol and is among the most effective treatments for patients with substance use disorders (SUDs). An understanding of laws affecting incentives for health behaviors and outcomes, including contexts in which incentives are already permitted, could inform efforts to disseminate CM. We conducted a systematic NexisUni legal database review of state statutes and regulations effective during 2022 to identify (a) laws that explicitly permit or prohibit delivery of incentives to patients, employees, or insurance beneficiaries for SUD-specific behaviors or outcomes, and (b) laws that explicitly permit delivery of incentives for any health behaviors or outcomes. We identified 27 laws across 17 jurisdictions that explicitly permit delivery of incentives for SUD-related behaviors or outcomes, with most occurring in the context of wellness programs. No state laws were identified that explicitly prohibit SUD-specific incentives. More broadly, we identified 57 laws across 29 jurisdictions permitting incentives for any health outcomes (both SUD- and non-SUD-related). These laws occurred in the contexts of wellness programs, K-12/early childhood education, government public health promotion, and SUD treatment provider licensing. Considering the urgent need to expand evidence-based SUD treatment in rural and underserved areas throughout the US, these findings could inform efforts to develop laws explicitly permitting provision of incentives in SUD care and enhance efforts to disseminate CM more broadly.
摘要：
应急管理（CM）涉及通过明确定义的方案为积极的健康行为提供激励措施，并且是针对物质使用障碍（SUD）患者的最有效治疗方法之一。了解影响健康行为和结果激励的法律，包括已经允许激励的环境，可以为传播CM的努力提供信息。我们对2022年生效的州法规和法规进行了系统的NexisUni法律数据库审查，以确定（a）明确允许或禁止向患者提供激励措施的法律，雇员,或SUD特定行为或结果的保险受益人，以及(b)明确允许为任何健康行为或结果提供激励措施的法律。我们在17个司法管辖区确定了27项法律，明确允许为SUD相关行为或结果提供激励，大多数发生在健康计划的背景下。没有确定明确禁止针对SUD的激励措施的州法律。更广泛地说,我们在29个司法管辖区确定了57项法律,允许对任何健康结局(SUD相关和非SUD相关)采取激励措施.这些法律发生在健康计划的背景下，K-12/幼儿教育，政府公共卫生促进，和SUD治疗提供者许可。考虑到迫切需要在整个美国的农村和服务不足地区扩大基于证据的SUD治疗，这些发现可以为制定明确允许在SUD护理中提供激励措施的法律的努力提供信息，并加强更广泛地传播CM的努力。
