How a gift card could help speed up Alzheimer’s clinical research

Offering a modest gift card significantly increased enrollment of low-income individuals in a patient registry designed to accelerate Alzheimer’s disease clinical trials, a new USC study published in JAMA Health Forum finds.

Effective strategies are needed to improve representation of marginalized groups in Alzheimer’s clinical trials. Despite ongoing debate among researchers about the ethics of financial incentives for clinical trial enrollment, there has been little consensus on the appropriate use and size of incentives.

Nearly 50,000 adults 50 and older without a dementia diagnosis were invited over email or text message to enroll in the Alzheimer Prevention Trials (APT) Webstudy, which aims to accelerate clinical trials by identifying and tracking individuals who may be at higher risk of developing Alzheimer’s. The participants all received care through an integrated county health system that primarily serves Medicaid enrollees.

They were randomly assigned into three groups. An active control group received a simple invitation to register; a second group was offered a $25 Amazon gift card for enrolling; and a third group was offered, as a reward for enrolling, entry into a prize drawing for a $2,500 Amazon gift card with 1-in-100 odds of winning.

The small gift card offer increased enrollment by almost 40% compared to the message-only control group. Participants who were white, male or enrolled in Medicaid responded strongest to the incentive. The opportunity to win much larger prize money, however, did not increase enrollment.

Although the small gift card offer significantly increased enrollment, the message-only approach was a much cheaper and more cost-effective approach to registering low-income patients. Ultimately, investing in outreach to underrepresented communities may be a more effective use of patient registry resources, researchers concluded.

The lead authors of the study are Mireille Jacobson, co-director of the USC Schaeffer Center’s Aging and Cognition program and professor at the USC Leonard Davis School of Gerontology, and Doris Molina-Henry, a Schaeffer scholar and assistant professor of research neurology at the Alzheimer’s Therapeutic Research Institute (ATRI).

The study was conducted through the Alzheimer’s Trial Recruitment Innovation Lab (ATRIL), a collaboration of the Schaeffer Center, ATRI and Howard University that seeks to diversify clinical trial participant recruitment.