The first component of this work over laps substantially with a recently funded NIHR Career Development Fellowship (CDF) awarded to the principal applicant (Jan 2012-Dec 2016). The CDF programme will include a systematic review of effectiveness of financial incentives for encouraging uptake of healthy behaviours in developed countries (Jan 2012-June 2013). Thus, the CDF review will be narrower in terms of intervention (i.e. focusing on financial incentives, rather than all incentives plus quasi-mandatory programmes), but broader in terms of outcome (i.e. focusing on all health promoting behaviours, rather than just on the uptake of pre-school immunisations) than the work proposed here. By the time the work described here begins, the CDF systematic review will be well underway, with searches completed. The systematic review described here will, therefore, be able to build on much of the preparatory work in developing search strategies conducted for the CDF, allowing existing search strategies to be refined, rather than developed afresh; and screening to be conducted in parallel. Conducting the present work in tandem with the CDF will, therefore, allow significant added value to be drawn from the CDF and minimise the costs of the current work.The third component of this work is offered as an addition to the research suggested in the Commissioning Brief. A DCE offers an additional method to explore acceptability of parental incentives and quasi-mandatory schemes for increasing uptake of pre-school immunizations. However, this component will not just complement the results of the qualitative study by helping to determine relative preference of parents for different potential components of immunization programmes, it will also help estimate predicted uptake rates of these. This answers a directly policy-relevant question that is likely to be one of the key next issues once effectiveness and acceptability are understood.2.1Research objectives The research objectives are to answer the following questions:
According to existing published and unpublished evidence, what is the effectiveness, acceptability, and balance of costs and effects to society of using parental incentives and quasi-mandatory schemes to increase uptake of immunizations in pre-school children in high income countries?
According to key stakeholders in the UK(including parents, health and other relevant professionals, and policy makers),what is and is not acceptable about parental incentives and quasi-mandatory schemes for increasing uptake of immunizations in pre-school children?Can anything be done to improve acceptability?
What are the relative preferences of UK parents of pre-school children for a range of characteristics associated with schemes designed to encourage uptake of immunizations, including parental incentives and quasi-mandatory schemes?
