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Randomized Controlled Trial
. 2015 Feb;34(2):160-71.
doi: 10.1037/hea0000088. Epub 2014 Aug 18.

Financial incentives for increasing uptake of HPV vaccinations: a randomized controlled trial

Eleni Mantzari  1 , Florian Vogt  2 , Theresa M Marteau  1
Affiliations
Free PMC article
Randomized Controlled Trial

Financial incentives for increasing uptake of HPV vaccinations: a randomized controlled trial

Eleni Mantzari et al. Health Psychol. 2015 Feb.
Free PMC article

Abstract

Objective: Uptake of human papillomavirus (HPV) vaccinations by 17- to 18-year-old girls in England is below (<35%) target (80%). This trial assesses (a) the impact of financial incentives on uptake and completion of an HPV vaccination program, and (b) whether impacts are moderated by participants' deprivation level. It also assesses the impact of incentives on decision quality to get vaccinated, as measured by attitudes toward the vaccination and knowledge of its consequences.

Method: One thousand 16- to 18-year-old girls were invited to participate in an HPV vaccination program: 500 previously uninvited, and 500 unresponsive to previous invitations. Girls randomly received either a standard invitation letter or a letter including the offer of vouchers worth £ 45 (€ 56; $73) for undergoing 3 vaccinations. Girls attending their first vaccination appointment completed a questionnaire assessing decision quality to be vaccinated. Outcomes were uptake of the first and third vaccinations and decision quality.

Results: The intervention increased uptake of the first (first-time invitees: 28.4% vs. 19.6%, odds ratio [OR] = 1.63, 95% confidence interval [CI; 1.08, 2.47]; previous nonattenders: 23.6% vs. 10.4%, OR = 2.65, 95% CI [1.61, 4.38]) and third (first-time invitees: 22.4% vs. 12%, OR = 2.15, 95% CI [1.32, 3.50]; previous nonattenders: 12.4% vs. 3%, OR = 4.28, 95% CI [1.92, 9.55]) vaccinations. Impacts were not moderated by deprivation level. Decision quality was unaffected by the intervention.

Conclusions: Although the intervention increased completion of HPV vaccinations, uptake remained lower than the national target, which, in addition to cost effectiveness and acceptability issues, necessitates consideration of other ways of achieving it.

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Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials (CONSORT) flow diagram.
Figure 2
Figure 2
Drop-off in uptake of HPV vaccinations over time for each of the trial groups. The color version of this figure appears in the online article only.
See this image and copyright information in PMC

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