Ethics of Participant Payment in Drug Abuse Research

描述（由申请人提供）：来自应急管理文献的研究证据是明确的：较大幅度的支付激励对客户的行为更具影响力，并且比较低幅度的激励更受客户青睐（例如，Kirby等人，1998; Lamb等人，1995; Silverman等人，1999年）。这似乎是在研究和临床环境中使用更高幅度的支付激励的理由。由于这些反对意见，研究人员经常被迫向研究参与者提供较低幅度的非现金激励，研究证据强烈表明这可能是对人类行为的不太有效的调节（例如，Cottler等人，1995; Lamb等人，1995; Stitzer等人，1983年）。然而，在我们自己的研究计划之前，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#R01-DA-13408的竞争延续申请的第一次修订，标题为药物滥用研究参与者支付的伦理学。这项为期两年的研究的目的是实验性地检查不同的激励安排对以下方面的影响：（1）使用新药物的可能性，（2）感觉到的胁迫程度，（3）后续出勤率和（4）对研究的满意度。在一个2 × 3的实验设计中，我们随机分配同意药物滥用的门诊客户接受10美元，40美元或70美元的现金或礼券，以参加6个月的随访研究预约。重要的是，我们的研究结果显示，无论是支付方式还是支付幅度，都不会对GCMS定量分析测量的新药使用率或参与者对胁迫的看法产生重大影响。我们的研究结果还显示，毫不奇怪，更高的现金支付与更高的随访率，以及对研究的更高满意度和未来参与研究的更大意愿相关。这种竞争延续应用程序的目标是通过增加支付幅度，包括100美元，130美元和160美元的增量来扩展这种创新的研究计划。我们的目的是确定这些更高幅度的激励措施是否可以以道德和安全的方式使用，而不会促使新的药物使用或增加吸毒人群中的胁迫感。测试这些更高的激励措施是必要的，以告知有关为更大的研究负担提供更高补偿的决策（例如，更长的随访，更具侵入性的程序），以开始收集关于在其他情况下经常使用的支付水平的数据（例如，应急管理协议;就业、公共援助），并确定较高的付款额是否有助于较高的后续率。

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.