Article

A randomised controlled trial of financial incentives to increase hepatitis B vaccination completion among people who inject drugs in Australia

The Kirby Institute, University of New South Wales, NSW, 2052, Australia.
Preventive Medicine (Impact Factor: 2.93). 10/2013; 57(4):297-303. DOI: 10.1016/j.ypmed.2013.04.013

ABSTRACT Objective
This study aimed to investigate the efficacy of modest financial incentives in increasing completion of an accelerated 3-dose hepatitis B virus (HBV) vaccination schedule (0, 7, 21 days) among people who inject drugs (PWID).

Methods
Randomised controlled trial. Participants were randomly allocated to receive $30 Australian Dollars cash following receipt of vaccine doses two and three (‘incentive condition’), or standard care (‘control condition’). Serologically confirmed HBV-susceptible PWID. Two inner-city health services and a field study site in Sydney, Australia. The primary outcome was completion of the vaccination series. Additional assessments included self-reported demographic, drug use and treatment, and risk-taking histories.

Results
Compared to the control condition, significantly more participants in the incentive condition received all three vaccine doses, under intention-to-treat analyses (n = 139; 87% versus 66%; p = .004); and within the specified window periods under per protocol analyses (n = 107 received three vaccine doses; 92% versus 67%; p = .001). Multivariate analysis indicated that the incentive condition and longer injecting histories significantly increased the likelihood of series completion. Aboriginal/Torres Strait Islanders were significantly less likely to complete the series.

Conclusions
Modest financial incentives, per-dose, increased adherence to the accelerated HBV vaccination schedule among PWID. Results have implications for increasing HBV and, potentially, other vaccine-preventable infections, among PWID.

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Available from: Lisa Maher, Aug 14, 2014
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