Impact of Financial Incentives

UNC Lineberger Comprehensive Cancer Center

Status: Active, not recruiting

Conditions: Human Papilloma Virus

Treatments: Behavioral: Communication training; Behavioral: financial Incentive

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05744960

IMPACTP2FI

1P01CA250989-01A1 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This trial will look at the impact of clinic-level financial incentives to improve provider communication and increase HPV vaccine uptake. Some clinics will receive communication training. Other clinics will receive the same training and a clinic-level financial incentive program with a monthly data feedback report to increase HPV vaccine uptake.

Full description

The researchers will conduct a cluster randomized control trial. This trial will look at the impact of clinic-level financial incentives to improve provider communication and increase HPV vaccine uptake. The recruitment goal for the trial is 34 clinics in healthcare systems, including 9 rural-serving clinics. The researchers will randomize clinics using simple randomization (1:1). Some clinics will receive communication training. Other clinics will receive the same training and a clinic-level financial incentive program with a monthly data feedback report to increase HPV vaccine uptake. The researchers will use medical record data to compare changes in HPV vaccination among children ages 9-12. Clinics will be followed for 24 months. The study will engage clinical staff. Researchers will not have direct contact with children or their families.

Enrollment: 34 patients

Sex: All

Ages: 9 to 12 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

This trial will enroll clinics and intervene with clinical staff. We will use vaccination data from children to evaluate intervention effectiveness. We will not enroll children or interact with them directly.

Inclusion Criteria:

Clinics are eligible if they are a pediatric or family medicine clinic in North Carolina that in the past year had:

• less than 72% HPV vaccine initiation rate,
• greater than or equal to 50 patients ages 9-12
• greater than or equal to 2 HPV vaccine providers
• no clinic or provider-level financial incentive programs to increase system, clinic, or provider HPV vaccination rates among patients aged 9-12 in the past two years, and
• no HPV vaccine provider communication trainings in the past six months.

Children's medical records will be eligible to be included in the dataset if children:

• are between the ages of 9-12 years at baseline and
• are attributed to a participating clinic at 12- or 24-month follow-up.

Exclusion Criteria:

Clinics are excluded if they:

• do not provide HPV vaccine to children ages 9-12
• have a specialty other than pediatrics or family medicine
• had an HPV vaccine-specific financial incentive program in the past two years
• had a formal HPV vaccine communication training in the past 6 months
• had an HPV initiation rate greater than 72$
• had fewer than 49 patients aged 9-12
• had 1 or fewer HPV vaccine providers

Children's medical records will not be eligible to be included in the dataset if children:

• are not between the ages of 9-12 years at baseline
• are not attributed to a participating clinic at 12- or 24-month follow-up

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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34 participants in 2 patient groups

HPV vaccine communication training.

Experimental group

Description:

Staff in clinics randomized to this arm will receive an intervention called Announcement Approach Training (AAT). This training is designed to improve communication about HPV vaccination.

Treatment:

Behavioral: Communication training

HPV vaccine communication training and clinic-level financial incentive program

Experimental group

Description:

Staff in clinics randomized to this arm will receive the Announcement Approach Training and a clinic-level financial incentive program with a monthly data feedback report to increase HPV vaccine uptake.

Treatment:

Behavioral: financial Incentive

Behavioral: Communication training