Do research payments precipitate drug use or coerce participation?

Higher magnitude cash payments improve research follow-up rates without increasing drug use or perceived coercion

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AbstractIn a prior study (Festinger et al, 2005) we found that neither the mode (cash vs. gift card) nor magnitude ($10, $40, or $70) of research follow-up payments increased rates of new drug use or perceptions of coercion. However, higher payments and payments in cash were associated with better follow-up attendance, reduced tracking efforts, and improved participant satisfaction with the study.

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“…As a result, researchers are often forced to use lower magnitude cash incentives or payments in the form of gift certificates or vouchers that must subsequently be exchanged for goods or services. This is unfortunate because research clearly demonstrates that higher magnitude incentives increase rates of responding on a range of behaviors including drug abstinence, treatment attendance, and compliance with follow-up assessments (e.g., Dallery et al, 2001;Festinger et al, 2005;Silverman et al, 1999). Moreover, evidence suggests clients greatly prefer cash to vouchers and other non-monetary incentives (e.g., Amass et al, 1996;Festinger et al, 2005;Reilly et al, 2000;Schmitz et al, 1994;Stitzer et al, 1983).…”

“…In a prior study (Festinger et al, 2005), we randomly assigned 350 outpatient drug abuse treatment clients to receive $10, $40, or $70 in either cash or gift cards for attending a 6-month follow-up research appointment. We implemented highly standardized, yet relatively minimal, follow-up procedures to ensure participants were otherwise treated equivalently across the research conditions.…”

Barriers and Opportunities for Recruitment for Nonintervention Studies on HIV Risk: Perspectives of Street Drug Users

“…The central features of ethical debate regarding the use of monetary incentives as a recruitment technique have focused on (1) whether or not it is ethical for researchers to provide cash payments when they may be used to support drug use (Buchanan et al, 2002; Fisher, 2004) and (2) whether or not monetary incentives distort the ability of members of addicted and impoverished populations to give voluntary and uncoerced consent (Dickert and Grady, 1999; Emmanuel, 2005; Festinger et al, 2005; Fry, Madden, Brogan, and Loff, 2006; Klitzman, 2005). Concerns about participants using monetary incentives to purchase drugs may be even more heightened in contemporary Western societies that place a moral imperative on health-promoting activities and condemn actions destructive to one’s health (Katz, 1997).…”

“…Empirical examination of these concerns have found that while drug users often cite monetary incentives as a primary reason for participation in research studies on drug use and HIV (Grady et al, 2008; Jenkins et al, 2000; Slomka, McCurdy, Ratliff, Timpson, and Willams, 2007), they also cite opportunity to gain personal and health-related knowledge, material goods for family members, or to contribute to scientific knowledge and policy (Barratt et al, 2007; Fry and Dwyer, 2001; Sherman and Latkin, 1999; Wright, Klee, and Reid, 1998). Recently, Festinger and fellow researchers (2005) found that while increasing amounts of monetary incentives were effective in preventing study attrition among drug using participants, they neither led to increased drug use nor higher rates of self-reported coercion.…”