Impact of Financial Incentives

Trial Title: Impact of Financial Incentives

NCT ID: NCT05744960

Condition: Human Papilloma Virus

Conditions: Official terms:
Papilloma

Conditions: Keywords:
financial incentives
pediatric medicine
vaccination
pay-for-performance

Study type: Interventional

Study phase: N/A

Overall status: Recruiting

Study design:

Allocation: Randomized

Intervention model: Parallel Assignment

Intervention model description: 1:1 ratio control and intervention arm randomized controlled trial

Primary purpose: Health Services Research

Masking: None (Open Label)

Intervention:

Intervention type: Behavioral
Intervention name: Communication training
Description: Clinics will host an Announcement Approach Training (AAT) workshop. A trained facilitator will use a standard script and slides to deliver workshop in-person or over Zoom; clinical staff who are unavailable will take the workshop later on their own.
Arm group label: HPV vaccine communication training and clinic-level financial incentive program
Arm group label: HPV vaccine communication training.

Intervention type: Behavioral
Intervention name: financial Incentive
Description: Clinics will host an AAT workshop, as in the other trial arm. Clinics in the intervention arm will then receive a 12-month clinic-level financial incentive program with predetermined targets for HPV vaccine initiation rates (5%, 10%, and 30% increases from baseline). Clinics will be notified of their HPV vaccination rates though a monthly, automated report. Clinic achievement will be assessed and incentives will be paid out to clinics monthly. Incentives will be tiered based on target and sized based on the number of clinic providers. For reaching the highest tier of 30%, clinics will receive an aggregate of $1000 per provider.
Arm group label: HPV vaccine communication training and clinic-level financial incentive program

Summary: 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.

Detailed 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.

Criteria for eligibility:
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

Gender: All

Minimum age: 9 Years

Maximum age: 12 Years

Healthy volunteers: Accepts Healthy Volunteers

Locations:

Facility:
Name: University of North Carolina at Chapel Hill

Address:
City: Chapel Hill
Zip: 27599-7590
Country: United States

Status: Recruiting

Contact:
Last name: Kathryn R Brignole, MSc

Phone: 919-966-3036
Email: brignolk@ad.unc.edu

Start date: February 28, 2023

Completion date: August 31, 2026

Lead sponsor:
Agency: UNC Lineberger Comprehensive Cancer Center
Agency class: Other

Collaborator:
Agency: National Cancer Institute (NCI)
Agency class: NIH

Source: UNC Lineberger Comprehensive Cancer Center

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT05744960