‘Show me the money’: financial incentives increase chlamydia screening rates among tertiary students: a pilot study
Marian J. Currie A E , Matthias Schmidt B , Belinda K. Davis A , Anne M. Baynes A , Elissa J. O’Keefe C , Tim P. Bavinton B , Michelle McNiven D , Sarah J. Martin A C and Francis J. Bowden A CA Academic Unit of Internal Medicine, Australian National University Medical School, Canberra Clinical School, Canberra Hospital, PO Box 11, Woden, ACT 2605, Australia.
B Sexual Health and Family Planning ACT, Level 1, 28 University Avenue, Canberra, ACT 2601, Australia.
C Canberra Sexual Health Centre, Building 5, Canberra Hospital, PO Box 11, Woden, ACT 2606, Australia.
D ACT Pathology, Building 10, Canberra Hospital, PO Box 11, Woden, ACT 2605, Australia.
E Corresponding author. Email: marian.currie@act.gov.au
Sexual Health 7(1) 60-65 https://doi.org/10.1071/SH08091
Submitted: 8 December 2008 Accepted: 3 December 2009 Published: 15 February 2010
Abstract
Background: We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. Methods: A cross-sectional study was conducted over two phases on eight tertiary campuses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. Results: 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. Conclusions: Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-campus chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.
Additional keywords: direct costs, peer-recruitment, specimen pooling.
Acknowledgements
The authors gratefully acknowledge the support of the Students’ Associations at the various institutions and the staff and the students who participated in the project.
[1]
[2]
[3] McEvoy M, Coupey SM. Sexually transmitted infection. A challenge for nurses working with adolescents. Nurs Clin North Am 2002; 37 461–74.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[4] Goldenberg S, Shoveller J, Koehoorn M, Ostry A. Barriers to STI testing among youth in a Canadian oil and gas community. Health Place 2007; 14 718–29.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[5] Bowden FJ, O’Keefe EJ, Primrose R, Currie MJ. Sexually transmitted infections, blood-borne viruses and risk behaviour in an Australian senior high school population – the SHLiRP study. Sex Health 2005; 2 229–36.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[6] Seal KH, Kral AH, Lorvick J, McNees A, Gee L, Edlin BR. A randomized controlled trial of monetary incentives vs. outreach to enhance adherence to the hepatitis B vaccine series among injection drug users. Drug Alcohol Depend 2003; 71 127–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[7] Lorvick J, Thompson S, Edlin BR, Kral AH, Lifson AR, Watters JK. Incentives and accessibility: a pilot study to promote adherence to TB prophylaxis in a high-risk community. J Urban Health 1999; 76 461–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[8] Finkelstein EA, Brown DS, Brown DR, Buchner DM. A randomized study of financial incentives to increase physical activity among sedentary older adults. Prev Med 2008; 47 182–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Malotte CK, Rhodes F, Mais KE. Tuberculosis screening and compliance with return for skin test reading among active drug users. Am J Public Health 1998; 88 792–6.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[10] Carey MP, Vanable PA, Senn TE, Coury-Doniger P, Urban MA. Recruiting patients from a sexually transmitted disease clinic to sexual risk reduction workshops: are monetary incentives necessary? J Public Health Manag Pract 2005; 11 516–21.
| PubMed |
[11] Wing RR, Jeffery RW. Food provision as a strategy to promote weight loss. Obes Res 2001; 9(Suppl. 4): 271S–5S.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[12] Diclemente R, Wingood GM. Monetary incentives: a useful strategy for enhancing enrollment and promoting participation in HIV/STD risk reduction interventions. Sex Transm Infect 1998; 74 239–40.
| CAS | PubMed |
[13] Martinson BC, Lazovich D, Lando HA, Perry CL, McGovern PG, Boyle RG. Effectiveness of monetary incentives for recruiting adolescents to an intervention trial to reduce smoking. Prev Med 2000; 31 706–13.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[14] Hey KP, Perera R. Competitions and incentives for smoking cessation. Cochrane Database Syst Rev 2005; Apr 18(2): CD004307.
[15] Volpp KG, Gurmankin Levy A, Asch DA, Berlin JA, Murphy JM, Gomez A, et al. A randomized controlled trial of financial incentives for smoking cessation. Cancer Epidemiol Biomarkers Prev 2006; 15 12–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[16]
[17] Kamb ML, Rhodes F, Hoxworth T, Rogers J, Lentz A, Kent C, et al. What about money? Effect of small monetary incentives on enrollment, retention, and motivation to change behaviour in an HIV/STD prevention counselling intervention. The Project RESPECT Study Group. Sex Transm Infect 1998; 74 253–5.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[18] Talbot M. Monetary incentives in research and participation in HIV/STD risk reduction programmes. Sex Transm Infect 1999; 75 1–2.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[19] Russell ML, Moralejo DG, Burgess ED. Paying research subjects: participants’ perspectives. J Med Ethics 2000; 26 126–30.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[20] Borzekowski DL, Rickert VI, Ipp L, Fortenberry JD. At what price? The current state of subject payment in adolescent research. J Adolesc Health 2003; 33 378–84.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[21] Fry CL, Ritter A, Baldwin S, Bowen KJ, Gardiner P, Holt T, et al. Paying research participants: a study of current practices in Australia. J Med Ethics 2005; 31 542–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[22] Pentz RD. Spreading it around: money for researcher and research participants. Mt Sinai J Med 2004; 71 266–70.
| PubMed |
[23]
[24]
[25]
[26] Kacena KA, Quinn SB, Howell MR, Madico GE, Quinn TC, Gaydos CA. Pooling urine samples for ligase chain reaction screening for genital Chlamydia trachomatis infection in asymptomatic women. J Clin Microbiol 1998; 36 481–5.
| CAS | PubMed |
[27]
