What's the Price of a Research Subject? Approaches to Payment for Research Participation

Dickert, Neal W.; Grady, Christine

doi:10.1056/nejm199907153410312

Cited by 346 publications

(329 citation statements)

References 9 publications

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“…Some authors have raised concerns that payments to underserved populations represents coercion, while others have suggested that payments may bias study results obtained or population recruited. [73][74][75][76][77][78][79] Accordingly, payments could potentially have a negative impact on trust, especially in vulnerable populations that might already be distrustful of research.…”

Section: Discussionmentioning

confidence: 99%

Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions

2007

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BACKGROUND: Members of vulnerable populations are underrepresented in research studies.OBJECTIVE: To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies.DATA SOURCES: Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study.RESULTS: African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35-45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms. CONCLUSIONS:Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies.

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Section: Discussionmentioning

confidence: 99%

Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions

2007

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“…How does one determine whether subjects are being underpaid and, therefore, exploited? There are several different approaches to the question: the market model, the wage model, and the reimbursement model (Dickert and Grady 1999). According to the market-based approach, the value of the labor is whatever the companies will pay.…”

Section: Exploitationmentioning

confidence: 99%

“…According to this approach, subjects should be paid a wage equivalent to the wage paid to unskilled laborers. The rate of payment for this work would be about $10.00 per hour, with a higher payment for tasks or procedures that are particularly demanding or uncomfortable (Dickert and Grady 1999). The wage payment model can avoid the problem of undue influence by ensuring that subjects are paid only as much as other people working in unskilled jobs.…”

Section: Exploitationmentioning

confidence: 99%

Strategies to Minimize Risks and Exploitation in Phase One Trials on Healthy Subjects*

Shamoo

Resnik

2006

The American Journal of Bioethics

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Most of the literature on phase one trials has focused on ethical and safety issues in research on patients with advanced cancer, but this article focuses on healthy, adult subjects. The article makes six specific recommendations for protecting the rights and welfare of healthy subjects in phase one trials: 1) because phase one trials are short in duaration (usually 1 to 3 months), researchers should gather more data on the short-term and long-term risks of participation in phase one studies by healthy subjects; 2) researchers should develop strict inclusion/exclusion criteria that exclude unhealthy or vulnerable subjects, such as decisionally impaired people, in phase one studies; 3) subjects should not participate in more than one phase one study at the same time and should wait at least 30 days between participating in different studies; 4) researchers should develop a database to keep track of phase one participants; 5) subjects should be guaranteed a minimum wage equivalent to the equivalent type of unskilled labor, but there should be no upper limits on wages; and 6) subjects should be allowed to engage in collective bargaining with research sponsors.

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“…However, a number of serious, yet untested, ethical objections have been raised against the practice of using high-magnitude incentives for research participation. Among these objections are that (1) large incentives, particularly if they are provided in the form of cash, could trigger a relapse to drug use (Fry and Dwyer, 2001;Koocher, 1991;Rosenheck, 1997;Shaner et al, 1995); and (2) large incentives may be coercive (Dickert and Grady, 1999;Macklin, 1981;McGee, 1997), meaning they could compromise participants' normal decisional processes and unduly entice them to participate even if they ordinarily would hold preferences against participation. 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.…”

Section: Introductionmentioning

confidence: 99%

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

Festinger

Marlowe

Dugosh

et al. 2008

Drug and Alcohol Dependence

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In 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. The present study extended those findings to higher payment magnitudes. Participants from an urban outpatient substance abuse treatment program were randomly assigned to receive $70, $100, $130, or $160 in either cash or a gift card for completing a follow-up assessment at 6 months post-admission (n ≅ 50 per cell). Apart from the payment incentives, all participants received a standardized, minimal platform of follow-up efforts. Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion. Consistent with our previous findings, higher payments and cash payments resulted in significantly higher follow-up rates and fewer tracking calls. In addition participants receiving cash vs. gift cards were more likely to use their payments for essential, non-luxury purchases. Follow-up rates for participants receiving cash payments of $100, $130, and $160 approached or exceeded the FDA required minimum of 70% for studies to be considered in evaluations of new medications. This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up samples without increasing new drug use or perceptions of coercion.

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What's the Price of a Research Subject? Approaches to Payment for Research Participation

Cited by 346 publications

References 9 publications

Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions

Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions

Strategies to Minimize Risks and Exploitation in Phase One Trials on Healthy Subjects*

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

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