Monetary versus nonmonetary incentives for TB skin test reading among drugusers

Background: In a prior study, we reported that monetary incentives were eff ective in increasing return for tuberculosis (TB) skin test reading. The pu rpose of this study was to compare the effects of monetary versus nonmoneta ry incentives and a theory-based educational intervention on return for TB skin test reading in a sample of newly recruited active injection and crack cocaine users, and to determine the prevalence of TB infection in this sam ple. Methods: Active injection drug and/or crack cocaine users (n = 1,078), recr uited using street outreach techniques, were skin tested for TB. They were randomly assigned to 1 of 5 experimental treatment conditions: $10 cash, gr ocery store coupons, bus tokens/fast-food coupons, motivational education, or usual encouragement to return, Nonmonetary incentives had a $10 value, a nd all incentives were provided at return for skin test leading. Results: Ninety-five percent of those who received $10 returned for. skin t est reading compared to 86% of those who received grocery store coupons and 83% of those who received either bus tokens or fast-food coupons. In contr ast, only 47% of those who received the educational session and only 49% of those who received usual encouragement returned for skin test reading. The prevalence of a positive tuberculin test was 21%, and was similar for crac k cocaine and injection drug users. Conclusions: Nonmonetary and monetary incentives dramatically increased the return rate for TB skin test reading among drug users who are at high risk of TB infection. Nonmonetary incentives were somewhat less effective than monetary incentives. (C) 1999 American Journal of Preventive Medicine.