Motivation, Syringe Exchange, and COVID-19

Study Overview
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Brief Summary
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People who inject drugs (PWIDs) are highly vulnerable to SARS-CoV-2 infection and to the disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19), however, rates of SARS-CoV-2 testing and vaccination uptake -vital to mitigating the spread of COVID-19 and achieving herd immunity - are lower among PWIDs compared to the general population. Building on our Phase I Rapid Acceleration of Diagnostics project, which found that contingency management (CM) increased testing utilization among PWIDs, the proposed project evaluates the comparative effectiveness of CM versus CM plus a brief motivational enhancement intervention on SARS-CoV-2 testing and vaccination uptake among PWIDs. This project has the potential to reduce COVID-19 health disparities among PWIDs and to decrease population level COVID-19 morbidity and mortality.

Detailed Description
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This study uses contingency management, specifically $10 financial incentives for participation in SARS-CoV-2 testing and $10 for participating in COVID-19 vaccination. It also uses a motivational enhancement intervention which is a brief conversation with clients to improve intrinsic motivation for testing and vaccination. Thus, the clinical trials portion of this study is a randomized control trial (N = 350) in which 175 participants will be assigned to contingency management plus the Connect2Test intervention and 175 will be assigned to the contingency management alone (i.e. services as usual). There will be a per site quota to ensure there are relatively equivalent numbers of participants per site to avoid site-specific biases. The data collection software (e.g., Qualtrics, PowerBI) will randomly assign individuals to condition in real time, after a participant consents to participate in the study.

Official Title
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Motivational Enhancement to Augment Contingency Management for SARS-CoV-2 Testing and Vaccination Utilization Among Syringe Exchange Clients

Conditions
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COVID-19 Pandemic

Intervention / Treatment
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* Behavioral: Connect2Test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 and older, understand English Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Connect2Test Intervention + Contingency Management<br>$10 financial incentive for vaccination and $10 financial incentive for testing plus a brief feedback-based motivational enhancement intervention. | Behavioral: Connect2Test<br>* Brief motivational enhancement intervention to improve the likelihood of testing and vaccination among syringe exchange clients<br>* Other names: Motivational Enhancement;|
| Active Comparator: Contingency Management Alone<br>$10 financial incentive for vaccination and $10 financial incentive for testing. | Behavioral: Connect2Test<br>* Brief motivational enhancement intervention to improve the likelihood of testing and vaccination among syringe exchange clients<br>* Other names: Motivational Enhancement;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SARS-CoV-2 Testing | Yes/no indicator of whether or not person was tested for SARS-CoV-2 testing at syringe exchange visit, data collected from testing intake data | One time point only ( 15 minute survey), when a participant engages in COVID-19 testing at a syringe exchange site, no longitudinal follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| COVID-19 Vaccination | Yes/no indicator of whether or not person was vaccinated for COVID-19 at syringe exchange visit, data collected from vaccine intake data | One time point only ( 15 minute survey), when a participant engages in COVID-19 vaccination at a syringe exchange site, no longitudinal follow-up |