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A4872 - A Randomized Control Trial of Different Trajectories of Financial Incentives to Optimize Recruitment and Retention in Research
Author Block: D. Krutsinger1, K. R. Courtright2, K. Yadav3, E. Cooney3, S. D. Halpern4; 1Pulmonary, HUP, Philadelphia, PA, United States, 2University of Pennsylvania, Ardmore, PA, United States, 3University of Pennsylvania, Philadelphia, PA, United States, 4Univ of Pennsylvania, Philadelphia, PA, United States.
Rationale: Difficulties recruiting and retaining patients in prospective longitudinal studies, particularly in randomized clinical trials (RCTS), remain major barriers to successful research completion. Evidence suggests that financial incentives may increase study enrollment, and that larger incentives are more effective than smaller ones. However, it is unknown how different financial incentive strategies for longitudinal studies may impact enrollment and retention rates.
Methods: We conducted a five-arm double-blind randomized controlled trial comparing the effectiveness of different financial incentive payment trajectories on recruitment and retention in a longitudinal study. We used the web-based Qualtrics Panels, which provided us access to diverse and on-demand research subjects. Individuals ages 50 and over were invited to participate in the study. Participants were randomized to one of five incentive strategies: 1) Constant, 2) Increasing, 3) U-shaped, 4) Surprise, or 5) Self-selection into one of the four other strategies. They were asked to complete one of four different versions of advanced directives at weeks 0, 2, 4, and 6. Upon participation at each time point, participants received a specific financial incentive with respect to their study arm. The total financial compensation was equal across all arms. We conducted descriptive statistics on participants’ demographics. We used bivariate regression to assess relationships between the participants' demographics and their recruitment and retention rates. Using multilevel linear regression, we explored the recruitment and retention rates across study arms.
Results: 962 (53.4%) of 1800 individuals who were invited to participate enrolled in the study. Demographics of both enrolled and declined individuals did not differ (all p>0.05 ). Recruitment rates for individual arms were as follows: Constant (n=187, 51.0%, 95% CI=45.8%-56.0%), Increasing (n=190, 51.6%, 46.5%-56.7%), U-shaped (n=199, 54.2%, 49.1%-59.3%), Surprise (n=200, 54.2%,49.2%-59.4%) and Self-selection (n=186, 50.7%, 45.6%-55.8%). There were no differences in recruitment or retention rates between the financial incentive arms (p>0.05). There were no associations between participants’ demographics and recruitment or retention rates.
Conclusions: Altering financial incentive payment trajectories did not influence web-based trial enrollment and retention rates. Limitations include the use of an online survey panel which limited the real world experience of trial enrollment as well as limitations in the amount of
compensation allowed for study completion. Further research is needed to determine if there is an effect in study recruitment and retention with varying funding amounts and trajectories.