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Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
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Plain English Summary

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

Trial website

Contact information



Primary contact

Prof Theresa Marteau


Contact details

Psychology Department (at Guy's)
Health Psychology Section
King's College London
5th Floor Bermondsey Wing
Guy's Campus
United Kingdom
+44 (0)20 7188 0192

Additional identifiers

EudraCT number number

Protocol/serial number

086031; Version 1

Study information

Scientific title

Financial incentives to increase uptake of human papillomavirus (HPV) vaccination: a randomised controlled trial


Study hypothesis

There are two questions being addressed by this project:
1. Does the offer of financial incentives increase the uptake of human papillomavirus (HPV) vaccination in girls aged 16 - 18 years?
2. Does the offer of financial incentives to undergo HPV vaccination reduce the quality of decision-making?

Ethics approval

Birmingham East, North and Solihull Research Ethics Committee, pending approval as of 18/02/2010

Study design

Randomised controlled single-centre trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please contact Narinder Kular at to request a patient information sheet


Human papillomavirus (HPV) vaccination / cervical cancer


Those allocated to the control group are invited to attend a local community centre on three occasions to undergo HPV vaccination. Those allocated to the intervention group receive the same invitation. In addition, the intervention group is being offered shopping vouchers for attending for each of three vaccinations (sum of £45; £20 for the first vaccination; £5 for the second; and £20 for the third).

Intervention type



Drug names

Primary outcome measure

Proportion of participants who have the HPV vaccine when a financial incentive is offered, measured when participants attend one of the three community clinics in the trial

Secondary outcome measures

Quality of decision, assessed using a short form of the Multidimensional Measure of Informed Choice, measured when participants attend one of the three community clinics in the trial

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Female, aged between 16 and 18 years
2. Living in Birmingham

Participant type


Age group




Target number of participants

In total 1000 participants will be recruited for the trial

Participant exclusion criteria

Feeling unwell at the time of presenting for vaccination

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

King's College London
United Kingdom

Sponsor information


NHS Birmingham East and North Primary Care Trust (UK)

Sponsor details

c/o Andrea Docherty
Richard House
B7 4AA
United Kingdom

Sponsor type

Hospital/treatment centre



Funder type


Funder name

Healthy Incentives (UK) - covered the costs of research activities at NHS Birmingham East and North Primary Care Trust

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

The Wellcome Trust (UK) (grant ref: 086031) - covered the cost of the evaluation at Kings College London

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2012 protocol in:
2015 results in:

Publication citations

  1. Protocol

    Mantzari E, Vogt F, Marteau TM, Using financial incentives to increase initial uptake and completion of HPV vaccinations: protocol for a randomised controlled trial., BMC Health Serv Res, 2012, 12, 301, doi: 10.1186/1472-6963-12-301.

  2. Results

    Mantzari E, Vogt F, Marteau TM, Financial incentives for increasing uptake of HPV vaccinations: a randomized controlled trial, Health Psychol, 2015 , 34, 2, 160-171, doi: 10.1037/hea0000088.

Additional files

Editorial Notes