Does the use of financial incentives increase the take up rate of the human papillomavirus (HPV) vaccination in 16 - 18 year old females?

Plain English summary of protocol

Background and study aims
The Human Papillomavirus (HPV) is a common sexually transmitted virus responsible for most cases of cervical cancer. Immunisation against HPV requires completion of three vaccinations. Since 2008, a routine HPV vaccination programme aimed at 12-13 year-old girls has been rolled out in England and Wales, generating good uptake rates. Uptake of a catch-up HPV vaccination programme aimed at girls aged 17-18 years, however, has been significantly below the 80% target set by the NHS. One way of improving this is to offer girls money for getting vaccinated. The offer of money however, could potentially have a negative effect on the quality of girls' decisions to get vaccinated. Specifically, it is possible that the offer of money might tempt girls with negative attitudes towards the HPV vaccination and/or insufficient knowledge of the vaccination to get vaccinated. The study's aim is to find out whether offering teenage girls money for getting vaccinated against HPV could improve vaccination uptake rates. It also aims to find out whether the offer of money has a negative effect on the quality of girls' decisions to get vaccinated, as assessed by their attitudes towards the HPV vaccination and their knowledge of the HPV vaccination.

Who can participate?
One thousand girls aged 16 to 18 were invited to participate in the HPV vaccination programme: Five-hundred had received a previous invitation to get vaccinated but had failed to attend their first vaccination appointment (previous non-attenders) and 500 had never previously received a vaccination invitation (first-time invitees). Girls were randomly selected from eligible participants who i) who were registered with a GP within areas covered by the administration of the Birmingham East and North (BEN) and Heart of Birmingham Primary Care Trusts, ii) had not been previously vaccinated against HPV and iii) were eligible to receive the vaccinations through clinics. Girls were excluded from the study if they were feeling unwell at the time of presenting for the vaccinations.

What does the study involve?
The two groups of girls were randomly allocated to receive either a standard letter inviting them to attend the first HPV vaccination session or a modified invitation letter including the offer of vouchers worth £45 for receiving the three vaccinations: £20 for receiving the first vaccination; £5 for receiving the second vaccination; and £20 for receiving the third vaccination. Girls who were sent the modified invitation letters were also sent text messages reminding them of their second and third vaccination appointments. When attending their first vaccination session, all girls were also requested to complete a questionnaire to assess the quality of their decisions to undertake the HPV vaccinations.

What are the possible benefits and risks of participating?
By participating in the study girls became immunised against HPV, thus lowering their chances of developing cervical cancer. There are no risks associated with participating in the study

Where is the study run from?
The study is run by the Birmingham East and North Primary Care Trust (BEN PCT) in association with the Young Foundation as part of the Healthy Incentives partnership between these two organisations.

When is the study starting and how long is it expected to run for?
Recruitment for the study began in February 2010 and was completed in September 2010. Evaluation of the trial began in April 2011.

Who is funding the study?
The trial is funded by the Birmingham East and North Primary Care Trust. The evaluation is funded by the Wellcome Trust, as part of a Strategic Award in Biomedical Ethics; programme title: 'The Centre for the Study of Incentives in Health'; grant number: 086031/Z/08/Z.

Who is the main contact?
Professor Theresa Marteau
theresa.marteau@kcl.ac.uk

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• England
• United Kingdom

Study participating centre

Sponsor information

Funders

Funder type

Charity

Results and Publications

Study outputs