Greetings everyone,
I am the PI of an investigator-initiated trial in Cameroon. We are using text messages to improve adherence to HIV medication(http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01247181). We have been recruiting for the past 3 weeks. I have a few experiences I'd like to share. What do you think is the best option for compensation interviewers?

1. Monthly salary: they get paid even during the periods when there is no data collection. They get a monthly salary till the trial ends.

2. Pay per data collection period: A lump some for baseline data, interim data and final data collection.

3. Pay per questionnaire filled: A payment for each case record form filled. This would mean they will have to wait till the end of the study when all the data has been collected to get paid.

Awaiting your insights and experiences.

Lawrence.

Reply

  • jhagarwal jhagarwal 14 Dec 2010

    Greetings Lawerence what a great study, I read this with much interest. Patient compensation is a hard issue that ethics committees always pick up on. It should not be an incentive yet should compensate them for the time they miss from work or jobs in the home.

  • lawrens Lawrence Mbuagbaw 16 Dec 2010

    Hi Jhagarwal. I spoke of interviewer compensation above, but in line with what you are saying we compensated time for time: after using up their time for interviews, we reduced their time spent in the waitng room by taking them straight to see the doctor.

  • mlopenza mlopenza 17 Dec 2010

    I think the important matter is to not be an incentive but pay for time as I thinks you saying? I am not sure those 3 options fit. They should be paid at each visit and this payment match their costs and missed income. Good study, very interesting. thank you for sharing with us

  • atashili Julius Atashili 17 Dec 2010

    Hello Lawrence,
    Nice to meet you here. Interesting study (and acronym, of course). Here are my thoughts on interviewer compensation based on experience with the study area:
    a) Unless I am missing a piece, since the study has started, I expect that you had budgeted a certain amount for interviewers in which case I would pay them as budgeted.
    b) Now if not budgeted or if seeking a budget amendment, then the payment should depend on the type of interviewers you are using- full time employed by the study or employed only part-time. In my experience full-time employees are preferable, if you can afford them. In this case a monthly salary is also preferable. A monthly salary is preferable from an interviewer's perspective because they are left with less uncertainty and can focus on the study (and data) quality.
    If part-time interviewers, then I will suggest you use either option 2 or a modification of option 3 (ie number of questionnaires filled at the end of the month, NOT the end of the study-most people can't wait that long, unless it is a really short study).
    We are using a combination of option 1 and modified option 3 in a study we are implementing in Cameroon and, in my opinion, that has worked well.

  • lawrens Lawrence Mbuagbaw 18 Dec 2010

    Hi,
    Thanks for your helpful insights. I am using part-time interviewers. They are getting exactly what was in the budget. I also used interviewer contracts to define our responsibility towards them and the number of questionnaires they are expected to fill over a given time. Does anyone have experience with interviewer contracts? We reached our enrollment target this week, much earlier than anticipated.

  • lawrens Lawrence Mbuagbaw 18 Dec 2010

    Hi,
    Thanks for your helpful insights. I am using part-time interviewers. They are getting exactly what was in the budget. I also used interviewer contracts to define our responsibility towards them and the number of questionnaires they are expected to fill over a given time. Does anyone have experience with interviewer contracts? We reached our enrollment target this week, much earlier than anticipated.

  • dralinn ALI Innocent 5 Jan 2011

    Hi Lawrence, Nice trial going on here! I feel interviewer contract doesnt take a different form from the usual work based contract arrangements. what is the endpoint of your study may I ask.

  • lawrens Lawrence Mbuagbaw 7 Jan 2011

    Hi Innocent,
    Our primary endpoints are adherence, measured using the visual analogue scale, self report and pharmacy refill data. We are also looking at clinical and biological changes, mortality, quality of life and retention.

  • lawrens Lawrence Mbuagbaw 7 Feb 2011

    Dear all,
    Do you have any experience with insuring participants in a clinical trial. I approached some insurance companies in Cameroon and they had no idea what I was talking about!! How does this work on you end? Thanks.

  • Graham Graham Waite 17 Feb 2011

    Dear Lawrence,
    Information concerning the legal requirements, and availability of insurance cover for Research Subjects participating in trials in Cameroon appears to be very limited. However, Cameroon is a member of the Conference Interafricaine des Marches d'Assurances (CIMA) , which has established a supranational regulatory and supervisory region. I'd suggest an approach to CIMA [ in the first instance through any insurance brokers or insurers your organisation might routinely use in Cameroon ] to make your enquiry:-

    Orig Treaty Doc.
    http://info.worldbank.org/etools/docs/library/157491/contractual2003/pdf/day2/ses1_moutassi.pdf

    www:-

    http://www.cima-afrique.org/

    Hope this is of some help,

    Graham

  • lawrens Lawrence Mbuagbaw 17 Feb 2011

    Thanks Graham,
    This is quite helpful. I will widen my search for insurance brokers and also contact other researchers in Cameroon to see what they have done.

  • lawrens Lawrence Mbuagbaw 17 Feb 2011

    BTW the study protocol is available at: http://www.trialsjournal.com/content/12/1/5/abstract

  • Jantina Jantina de Vries 13 Mar 2011

    Hi all, great discussion here, and very helpful for Lawrence I hope. I just wanted to add - I think that it is necessary to pay field staff (interviewers or other data or sample collectors) a set salary, and not per person recruited into the study. In my experience, if fieldworkers (or interviewers, in this case) are paid per person recruited, then their focus in recruitment may shift from 'explaining the study well' to 'getting more people in the trial'. I think what that does, is create unnecessary challenges for consent. I think that excludes option 3.

  • lawrens Lawrence Mbuagbaw 13 Mar 2011

    I agree entirely. We are paying a fixed salary, but per study phase ie baseline, interim and end of study. It seems to be working fine. At least all the options were put on the table and the most appropriate for the study and the interviewers was chosen. I think if all these are explained to them they will be able to make the choices that produce the best quality of data.

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