Financial Incentives for Living Kidney Donors

Not currently recruiting at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins University

Disqualifiers: International donors, Non-English speakers

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if small financial incentives can encourage living kidney donors to complete necessary follow-up care, which includes filling out a short questionnaire and undergoing lab tests. Half of the participants will receive gift cards as an incentive, while the other half will follow the usual care process without additional rewards. The study seeks adults who have donated a kidney at specific hospitals in Maryland. As an unphased trial, it offers participants the chance to contribute to improving follow-up care for future kidney donors.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that financial incentives for living kidney donors are safe?

Research has shown that financial rewards, such as gift cards, can encourage attendance at follow-up appointments after kidney donation. In this study, some participants will receive gift cards as a thank you for completing these follow-up tasks. This method is considered safe because it involves no medical procedures or drugs; it simply encourages participation.

Although specific studies on negative effects of financial rewards in this context are lacking, the main goal is to determine if they help maintain donor involvement in health check-ups. Thus, it offers a low-risk way to enhance donor follow-up without introducing physical risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores the impact of financial incentives on living kidney donors. Traditionally, follow-up care for donors relies on standard protocols without additional incentives. This trial is unique because it tests whether providing gift cards for timely and complete follow-up data submissions can improve donor engagement and adherence to post-donation care. By potentially enhancing donor participation and follow-up, this approach could lead to better health outcomes for donors and more comprehensive data collection.

What evidence suggests that financial incentives could be effective for increasing compliance with living kidney donor follow-up?

Research has shown that financial incentives, which participants in this trial may receive, can help living kidney donors maintain their follow-up care. In similar studies, payments increased the likelihood of participants attending necessary medical check-ins. This method leverages the idea that small rewards, such as gift cards, encourage people to complete important tasks. Studies have found that even small incentives can improve participation in healthcare activities. Overall, financial incentives appear to be a promising way to help donors stay on track with their follow-up appointments. ^{2 3 4 6 7}

Who Is on the Research Team?

Daniel Warren, PhD

Principal Investigator

Johns Hopkins University

Are You a Good Fit for This Trial?

This trial is for adults over 18 who have donated a kidney at Johns Hopkins or University of Maryland Medical Centers, speak English, and live in the U.S. It's not for those who don't speak English or international donors.

Inclusion Criteria

I had a kidney removal surgery from a living donor at Johns Hopkins or University of Maryland Medical Center.

Exclusion Criteria

Non-English speaking live kidney donors

International live kidney donors

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Follow-up

Participants complete follow-up activities at 6-months, 1-year, and 2-years post-donation, including a brief questionnaire and lab draw

2 years

3 visits (in-person or virtual) at 6-months, 1-year, and 2-years

Incentive Evaluation

Evaluation of the effectiveness of financial incentives on compliance with follow-up activities

2 years

What Are the Treatments Tested in This Trial?

Interventions

• Financial Incentive

Trial Overview

The study tests if giving small financial rewards (gift cards) helps kidney donors follow up better after surgery. Participants are split into two groups: one gets gift cards after completing check-ups; the other does not.

How Is the Trial Designed?

Group I: Financial Incentive Experimental Treatment 1 Intervention

Up to three gift cards to a major online retailer will be mailed to participants assigned to the intervention arm after complete (i.e. all components addressed) and timely (i.e. within the policy-defined follow-up period) submission of follow-up data at each 6-month, 1-year, and 2-year follow-up visit.

Group II: Standard of Care Active Control 1 Intervention

Participants in the control arm will be instructed to attend required follow-up as is standard of care, but will not receive a financial incentive.

Who Is Running the Clinical Trial?

Johns Hopkins University

Lead Sponsor

Trials

2,366

Recruited

15,160,000+

University of Maryland, Baltimore

Collaborator

Trials

729

Recruited

540,000+

The Living Legacy Foundation

Collaborator

Trials

1

Recruited

320+

University of Maryland School of Medicine

Collaborator

Trials

5

Recruited

790+

Published Research Related to This Trial

A systematic review of 23 randomized controlled trials involving 6074 participants found that financial incentives significantly increased physical activity (PA), with most studies reporting positive effects during the intervention period.

Even after the removal of incentives, participants maintained higher daily step counts, suggesting that short-term financial incentives can lead to sustained increases in physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Financial incentives for physical activity in adults: systematic review and meta-analysis. Mitchell, MS., Orstad, SL., Biswas, A., et al.[2022]

Health care systems can enhance value for money by implementing both financial and non-financial incentive structures to improve performance and reduce financial barriers for providers.

There is no one-size-fits-all approach to incentives in health care; their effectiveness varies based on specific circumstances, and careful design involving stakeholders is crucial for success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing performance of health care services within economic constraints: working towards improved incentive structures. Custers, T., Klazinga, NS., Brown, AD.[2019]

This review aims to evaluate the effectiveness of financial incentives provided by employers to encourage physical activity among employees in high-income countries, focusing on adherence to programs and related health outcomes like sick leave.

The study will include randomized controlled trials and assess various factors such as age, gender, and implementation quality, with plans for meta-analysis if sufficient data is available, ensuring a comprehensive understanding of the impact of financial incentives on physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using financial incentives to increase physical activity among employees as a strategy of workplace health promotion: protocol for a systematic review. Heise, TL., Frense, J., Christianson, L., et al.[2021]

A systematic analysis of 394 online comments from New York Times readers revealed that most people have negative perceptions of financial incentives for health improvement, viewing them as absurd or a reward for irresponsibility.

While some individuals supported financial incentives as a cost-effective way to prevent chronic diseases, the overall sentiment emphasized a desire for greater personal responsibility in health management, which may hinder the acceptance of such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The New York Times readers' opinions about paying people to take their medicine. Park, JD., Metlay, J., Asch, JM., et al.[2015]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC3848409/

Financial Incentives for Living Kidney Donation: Ethics and ...

Across the income spectrum, the offer of payment increased baseline willingness of participants to donate a kidney. In conjoint analysis, ...

2.

sciencedirect.com

sciencedirect.com/science/article/pii/S1600613522035766

Incentive Models to Increase Living Kidney Donation ...

We describe four models of incentives to improve rates of living kidney donation: the market compensation model, the fixed compensation model, nocompensation ...

3.

clinicaltrials.gov

clinicaltrials.gov/study/NCT03090646

Use of Financial Incentives to Increase Live Kidney Donor ...

This study evaluates whether using small financial incentives increases patient compliance with nationally-mandated living kidney donor follow-up at ...

4.

withpower.com

withpower.com/trial/phase-2-2017-23a6b

Financial Incentives for Living Kidney Donors

This study evaluates whether using small financial incentives increases patient compliance with nationally-mandated living kidney donor follow-up at ...

5.

frontierspartnerships.org

frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12483/full

Public Opinions on Removing Disincentives and Introducing ...

On average, 57% of respondents supported a paid-donor system with no kidney supply gains, and about 70% supported a paid-donor system when the ...

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC5989678/

Identifying Outcomes that Are Important to Living Kidney Donors

We identified the outcomes most important to living kidney donors and described the reasons for their choices.

7.

optn.transplant.hrsa.gov

optn.transplant.hrsa.gov/media/2084/ethics_pcproposal_financial_incentives_201701.pdf

A White Paper Addressing Financial Incentives for Organ ...

This white paper provides an ethical analysis of financial incentives for organ donation, addressing four key ethical considerations, and is a resource for the ...