Financial incentives to increase stool collection rates for microbiome studies in adult bone marrow transplant patients

• Published in: PloS one Vol. 17; no. 5; p. e0267974
• Main Authors: Thompson, Jillian C., Ren, Yi, Romero, Kristi, Lew, Meagan, Bush, Amy T., Messina, Julia A., Jung, Sin-Ho, Siamakpour-Reihani, Sharareh, Miller, Julie, Jenq, Robert R., Peled, Jonathan U., van den Brink, Marcel R. M., Chao, Nelson J., Shrime, Mark G., Sung, Anthony D.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 04.05.2022; Public Library of Science (PLoS)
• Subjects: Adult; Autografts; Biology and Life Sciences; Bone marrow; Bone marrow transplantation; Bone Marrow Transplantation - methods; Cancer; Collection; Economic incentives; Evaluation; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Humans; Incentives; Influence; Medical research; Medical screening; Medicine and Health Sciences; Medicine, Experimental; Microbiomes; Microbiota; Monetary incentives; Motivation; Patients; Prospective Studies; Social Sciences; Stem cell transplantation; Stem cells; Transplantation; Transplantation Conditioning - methods; Transplantation, Autologous; Transplantation, Homologous; Transplants & implants; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0267974

In order to study the role of the microbiome in hematopoietic stem cell transplantation (HCT), researchers collect stool samples from patients at various time points throughout HCT. However, stool collection requires active subject participation and may be limited by patient reluctance to handling stool. We performed a prospective study on the impact of financial incentives on stool collection rates. The intervention group consisted of allogeneic HCT patients from 05/2017-05/2018 who were compensated with a $10 gas gift card for each stool sample. The intervention group was compared to a historical control group of allogeneic HCT patients from 11/2016-05/2017 who provided stool samples before the incentive was implemented. To control for possible changes in collections over time, we also compared a contemporaneous control group of autologous HCT patients from 05/2017-05/2018 with a historical control group of autologous HCT patients from 11/2016-05/2017; neither autologous HCT group was compensated. The collection rate was defined as the number of samples provided divided by the number of time points we attempted to obtain stool. There were 35 allogeneic HCT patients in the intervention group, 19 allogeneic HCT patients in the historical control group, 142 autologous HCT patients in the contemporaneous control group (that did not receive a financial incentive), and 75 autologous HCT patients in the historical control group. Allogeneic HCT patients in the intervention group had significantly higher average overall collection rates when compared to the historical control group allogeneic HCT patients (80% vs 37%, p<0.0001). There were no significant differences in overall average collection rates between the autologous HCT patients in the contemporaneous control and historical control groups (36% vs 32%, p = 0.2760). Our results demonstrate that a modest incentive can significantly increase collection rates. These results may help to inform the design of future studies involving stool collection.