NCT01516489

Brief Summary

This is a 4-arm cluster randomized controlled trial to evaluate whether patient financial incentives directly integrated into primary care can improve fecal occult blood test (FOBT) completion rates. We will recruit primary care patients at the Philadelphia Veterans Affairs Medical Center (PVAMC) in 2 stages. In stage 1, we hypothesize that, compared to usual care, $5, $10, $20 incentives will each lead to a statistically significant increase in the rate of FOBT completion. We also hypothesize that there will be a direct dose-response relationship between the incentive amount and rates of FOBT completion. In stage 2, we hypothesize that a lottery-based incentive and a raffle-based incentive will both lead to a statistically significant increase in the rate of FOBT completion compared to a fixed payment incentive with an equivalent dollar per patient value.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,549

participants targeted

Target at P75+ for phase_1 colorectal-cancer

Timeline
Completed

Started Feb 2012

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 19, 2012

Completed
6 days until next milestone

First Posted

Study publicly available on registry

January 25, 2012

Completed
7 days until next milestone

Study Start

First participant enrolled

February 1, 2012

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2013

Completed
1.7 years until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2015

Completed
Last Updated

October 26, 2015

Status Verified

October 1, 2015

Enrollment Period

1.7 years

First QC Date

January 19, 2012

Last Update Submit

October 23, 2015

Conditions

Keywords

screeningcolon cancerincentivesbehavioral economics

Outcome Measures

Primary Outcomes (1)

  • FOBT completion and return

    30 days

Secondary Outcomes (1)

  • FOBT completion rate among previously non-adherent patients and FOBT kit return time by arm

    30 days

Study Arms (8)

Stage 1 Control Group

NO INTERVENTION

In the FOBT kit, individuals will receive a card that asks them to complete and return their FOBT kit within 30 days.

$5 Incentive

EXPERIMENTAL

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $5 at PVAMC.

Behavioral: Stage 1

$10 Incentive

EXPERIMENTAL

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $10 at PVAMC.

Behavioral: Stage 1

$20 Incentive

EXPERIMENTAL

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $20 at PVAMC.

Behavioral: Stage 1

$5 Voucher-Based Incentive

EXPERIMENTAL

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $5 at PVAMC.

Behavioral: Stage 2

$50 Lottery-Based Incentive

EXPERIMENTAL

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will have a 1 in 10 chance of being mailed a voucher that can be exchanged for $50 at PVAMC.

Behavioral: Stage 2

$500 Raffle-Based Incentive

EXPERIMENTAL

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be entered into a raffle in which 1 randomly chosen patient (out of about 100 patients) will be mailed a check in the amount of $500.

Behavioral: Stage 2

Stage 2 Control Group

NO INTERVENTION

In the FOBT kit, individuals will receive a card that asks them to complete and return their FOBT kit within 30 days.

Interventions

Stage 1BEHAVIORAL

Patients who are prescribed an FOBT kit in one of the PVAMC Primary Care clinics (i.e., Module B or C) will be randomly assigned by day to one of 4 study arms. All FOBT kits will include a card with a description of the arm that the patient has been randomized to.

$10 Incentive$20 Incentive$5 Incentive
Stage 2BEHAVIORAL

Patients who are prescribed an FOBT kit in one of the PVAMC Primary Care clinics (i.e., Module B or C) will be randomly assigned by day to one of 4 study arms. All FOBT kits will include a card with a description of the arm that the patient has been randomized to. The exact dollar amounts for the Voucher-Based Incentive, Lottery-Based Incentive, and Raffle-Based Incentive arms will be based on the results of Stage 1.

$5 Voucher-Based Incentive$50 Lottery-Based Incentive$500 Raffle-Based Incentive

Eligibility Criteria

Sexmale
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • PVAMC outpatients who are prescribed an FOBT kit in Module B or C during the study period.

You may not qualify if:

  • None. All PVAMC outpatients who are prescribed an FOBT kit in Module B or C during the study period will be eligible.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Philadelphia Veterans Affairs Medical Center

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

  • Kullgren JT, Dicks TN, Fu X, Richardson D, Tzanis GL, Tobi M, Marcus SC. Financial incentives for completion of fecal occult blood tests among veterans: a 2-stage, pragmatic, cluster, randomized, controlled trial. Ann Intern Med. 2014 Nov 18;161(10 Suppl):S35-43. doi: 10.7326/M13-3015.

MeSH Terms

Conditions

Colorectal NeoplasmsColonic Neoplasms

Condition Hierarchy (Ancestors)

Intestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesRectal Diseases

Study Officials

  • Jeffrey T Kullgren, MD, MS, MPH

    Corporal Michael J. Crescenz VA Medical Center

    PRINCIPAL INVESTIGATOR
  • Steven C Marcus, PhD

    Corporal Michael J. Crescenz VA Medical Center

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
INVESTIGATOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

January 19, 2012

First Posted

January 25, 2012

Study Start

February 1, 2012

Primary Completion

October 1, 2013

Study Completion

June 1, 2015

Last Updated

October 26, 2015

Record last verified: 2015-10

Locations