Speaker
Mireille Jacobson, PhD
Professor, University of Southern California Davis
School of Gerontology and Schaeffer Institute
Keywords
Incentives; Financial incentives; Alzheimer’s Disease; Participation; Dementia
Key Points
- There are nearly 6 million people living with Alzheimer’s Disease and related dementias (AD/ADRD) in the United States, a number projected to double by 2060. Despite the feact that the highest rates of AD/ADRD are found in Black and Hispanic populations, diversity in Alzheimer’s Trials is limited; between 2000 and 2019, 90% of completed trials had 75% – 100% non-Hispanic White participants.
- The Alzehimer’s Prevention Webstudy (APT Webstudy) is a remote registry in which participants, aged 50 and older, take quarterly memory assessments. The research team sought to assess whether financial incentives could increase diversity in the APT webstudy. 45,000 patients were invited to enroll; the first ~15,000 (Arm 1) were invited via message only, Arm 2 was offered a $25 incentive, and Arm 3 was offered the chance to win $2,500.
- The study team found that the $25 guaranteed incentives increased enrollment the most, but messages alone were the most cost-effective. 29% of new enrollees were Black or Hispanic patients, an improvement over the APT Webstudy baseline of 5.4%. However, the study team concluded, more needs to be done to enroll people of diverse backgrounds specifically.
Discussion Themes
Attendees considered the ethical implications of the $25 and whether it qualified as coercive when offered to low-income communities. Dr. Jacobson believed that $25 was not enough to be coercive in the context of a low-risk registry study, but that the ethics might differ in a clinical trial involving medication risks.
While higher amounts might increase participation, Dr. Jacobson suggested that messaging frequency may be a more critical factor than increasing the dollar amount.
