Motivation, Syringe Exchange, and COVID-19

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

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.

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.

$10 financial incentive for vaccination and $10 financial incentive for testing plus a brief feedback-based motivational enhancement intervention.

Brief motivational enhancement intervention to improve the likelihood of testing and vaccination among syringe exchange clients

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

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

In line with funding requirements, we will share data with our data coordination center and the national institutes of health