Ethics of Participant Payment in Drug Abuse Research

描述(由申请人提供)：应急管理文献中的研究证据是明确的：较大的支付激励比较低的支付激励对客户的行为更有影响力，更受客户的青睐(例如，Kirby等人，1998；Lamb等人，1995；Silverman等人，1999)。这似乎为在研究和临床环境中使用更高级别的薪酬激励提供了理由。由于这些反对意见，研究人员经常被迫向研究参与者提供规模较小的非现金激励，研究证据有力地表明，这很可能是对人类行为的较不有效的修饰(例如，Cottler等人，1995；Lamb等人，1995；Stitzer等人，1983)。然而，在我们自己的研究项目之前，没有直接证据表明大规模的激励措施是否会影响复发率或客户对胁迫的看法。这是对#R01-DA-13408的竞争延续申请的第一次修订，题为《药物滥用研究中参与者付费的道德规范》。这项为期两年的研究的目的是通过实验检验不同激励安排对以下方面的影响：(1)使用新药物的可能性，(2)感知到的强迫程度，(3)随访率和(4)对研究研究的满意度。在二乘三的实验设计中，我们随机分配同意的药物滥用门诊患者获得10美元、40美元或70美元的现金或礼券，用于参加为期6个月的随访研究预约。重要的是，我们的发现显示，支付方式和金额对GCMS定量分析所衡量的新药物使用率或参与者对胁迫的感知都没有显著影响。我们的研究结果还显示，金额越大的现金支付与更高的随访率、对研究研究的更高满意度以及未来参与研究研究的意愿越高，这一点并不令人惊讶。这一竞争性延续应用程序的目标是通过将支付金额增加到包括100美元、130美元和160美元的增量来扩展这一创新的研究计划。我们的目的是确定这些规模更大的激励措施是否能够以道德和安全的方式使用，而不会催生新的毒品使用或增加吸毒人群对胁迫的看法。有必要测试这些较高数额的激励措施，以便作出决定，为较大的研究负担(例如，较长的后续行动、更具侵入性的程序)提供更高的补偿，开始收集关于经常在其他情况下使用的付款水平的数据(例如，应急管理协议；就业、公共援助)，并确定较高数额的报酬是否有助于较高的随访率。

DESCRIPTION (provided by applicant): The research evidence from contingency management literature is unambiguous: larger-magnitude payment incentives are more influential to clients' behavior and more favored by clients than are lower-magnitude incentives (e.g., Kirby et al., 1998; Lamb et al., 1995; Silverman et al., 1999). This would seem to argue for the use of higher-magnitude payment incentives in research and clinical settings. As a result of these objections, researchers have often been forced to provide lower-magnitude, non-cash incentives to research participants, which the research evidence strongly suggests is likely to be a less effective modifier of human behavior (e.g., Cottler et al., 1995; Lamb et al., 1995; Stitzer et al., 1983). Prior to our own program of research, however, there was no direct evidence regarding whether large-magnitude incentives affect relapse rates or client perceptions of coercion. This is the first revision of the competing-continuation application for #R01-DA-13408, entitled Ethics of Participant Payment in Drug Abuse Research. The aims of that two-year study were to experimentally examine the effects of different incentive arrangements on: (1) likelihood of new drug use, (2) levels of perceived coercion, (3) rates of follow-up attendance and (4) satisfaction with the research study. In a two-by-three experimental design, we randomly assigned consenting drug abuse outpatient clients to receive $10, $40, or $70 in either cash or in a gift certificate for attending a 6-month follow-up research appointment. Importantly, our findings revealed that neither the mode nor magnitude of payment had a significant effect on rates of new drug use as measured by GCMS quantitative analyses, or on participants' perceptions of coercion. Our findings also revealed, not surprisingly, that higher-magnitude cash payments were associated with higher follow-up rates, as well as greater satisfaction with the research study and a greater willingness to participate in research studies in the future. The goal of this competing continuation application is to extend this innovative program of research by increasing the payment magnitudes to include $100, $130, and $160 increments. Our intent is to determine whether these higher magnitude incentives can be used in an ethical and safe manner, without precipitating new drug use or increasing perceptions of coercion among a drug using population. Testing these higher magnitudes of incentives is necessary to inform decisions about providing higher compensation for greater research burden (e.g., longer follow-ups, more invasive procedures), to begin to gather data on levels of payment that are often used in other contexts (e.g., contingency management protocols; employment, public assistance), and to determine whether higher magnitudes of payments contribute to higher follow-up rates.