Vouchers to Increase Uptake of Already Free Eye Care

Johns Hopkins University

Status: Completed

Conditions: Glaucoma; Eye Diseases

Treatments: Behavioral: Voucher Without Value Information; Behavioral: Voucher With Value Information

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT04426331

IRB00054137

Details and patient eligibility

About

This study was intended to test if reframing an offer for a free follow-up eye examination could increase uptake within ongoing community-based screening program for low-income and minority populations in Baltimore City. This study evaluated the effect of offering participants a physical voucher they were told was redeemable for free follow-up, relative to simply telling participants that the follow-up appointment would be free of charge. The investigators assessed two forms of vouchers, one with estimated value information, and one without. The underlying hypothesis was that reframing these already free offers would increase uptake by increasing perceived offer value and increasing a sense of regret from not taking advantage of a "good deal."

Enrollment: 739 patients

Sex: All

Ages: 50+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Referred for follow-up at a Screening to Prevent Glaucoma (SToP) study screening event (overarching observational study from which trial sample was drawn). SToP participants were referred for follow-up for any of the following conditions: (1) VA worse than 20/40 in at least 1 eye despite autorefraction; (2) signs of retinal abnormalities on fundus photography; (3) uninterpretable fundus photography; (4) cup-to-disc ratio (CDR) greater than or equal to 0.9, and/or CDR between 0.7 and 0.9 with visual field defects or history of glaucoma; and (5) IOP of 23 mm Hg or greater.

Exclusion criteria

• SToP participants who were not referred at the time of screening but later contacted after review of fundus photography
• SToP participants who were referred for follow-up but stated at the time of counseling that they were already under the care of an eye doctor

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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739 participants in 3 patient groups

No Voucher

No Intervention group

Description:

Individuals being referred from screening events randomized to "no intervention" received the standard approach to offering free follow-up examinations (patient education, standard counseling, appointment information packet, reminder phone calls).

Voucher Without Value Information

Experimental group

Description:

In addition to receiving the standard approach above, individuals being referred from screening events randomized to "Voucher Without Value Information" received a personal voucher.

Treatment:

Behavioral: Voucher Without Value Information

Voucher With Value Information

Experimental group

Description:

In addition to receiving the standard approach above, individuals being referred from screening events randomized to "Voucher With Value Information" received a personal voucher, which differed from the voucher in the second arm since it included a statement of value.

Treatment:

Behavioral: Voucher With Value Information