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


Authors: Thompson, J. C.; Ren, Y.; Romero, K.; Lew, M.; Bush, A. T.; Messina, J. A.; Jung, S. H.; Siamakpour-Reihani, S.; Miller, J.; Jenq, R. R.; Peled, J. U.; van den Brink, M. R. M.; Chao, N. J.; Shrime, M. G.; Sung, A. D.
Article Title: Financial incentives to increase stool collection rates for microbiome studies in adult bone marrow transplant patients
Abstract: Introduction 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. Methods 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. Results 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). Conclusion 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. © 2022 Thompson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: adult; controlled study; human tissue; transplantation, homologous; major clinical study; nonhuman; prospective study; prospective studies; motivation; hematopoietic stem cell transplantation; transplantation conditioning; allogeneic hematopoietic stem cell transplantation; bone marrow transplantation; transplantation, autologous; feces; autologous hematopoietic stem cell transplantation; allotransplantation; autotransplantation; microflora; procedures; microbiota; microbiome; humans; human; male; female; article; economic incentive
Journal Title: PLoS ONE
Volume: 17
Issue: 5
ISSN: 1932-6203
Publisher: Public Library of Science  
Date Published: 2022-05-04
Start Page: e0267974
Language: English
DOI: 10.1371/journal.pone.0267974
PUBMED: 35507633
PROVIDER: scopus
PMCID: PMC9067695
DOI/URL:
Notes: Article -- Export Date: 1 June 2022 -- Source: Scopus
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  1. Jonathan U Peled
    143 Peled