Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs
Abstract Background Government social assistance payments seek to alleviate poverty and address survival needs, but their monthly disbursement may cue increases in illicit drug use. This cue may be magnified when assistance is disbursed simultaneously across the population. Synchronized payments hav...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2016-07-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-016-3304-6 |
| _version_ | 1830144709322866688 |
|---|---|
| author | Lindsey Richardson Allison Laing M-J Milloy Russ Maynard Bohdan Nosyk Brandon Marshall Eric Grafstein Patricia Daly Evan Wood Julio Montaner Thomas Kerr |
| author_facet | Lindsey Richardson Allison Laing M-J Milloy Russ Maynard Bohdan Nosyk Brandon Marshall Eric Grafstein Patricia Daly Evan Wood Julio Montaner Thomas Kerr |
| author_sort | Lindsey Richardson |
| collection | DOAJ |
| description | Abstract Background Government social assistance payments seek to alleviate poverty and address survival needs, but their monthly disbursement may cue increases in illicit drug use. This cue may be magnified when assistance is disbursed simultaneously across the population. Synchronized payments have been linked to escalations in drug use and unintended but severe drug-related harms, including overdose, as well as spikes in demand for health, social, financial and police services. Methods/design The TASA study examines whether changing payment timing and frequency can mitigate drug-related harm associated with synchronized social assistance disbursement. The study is a parallel arm multi-group randomized controlled trial in which 273 participants are randomly allocated for six assistance cycles to a control or one of two intervention arms on a 1:1:1 basis. Intervention arm participants receive their payments: (1) monthly; or (2) semi-monthly, in each case on days that are not during the week when cheques are normally issued. The study partners with a community-based credit union that has developed a system to vary social assistance payment timing. The primary outcome is a 40 % increase in drug use during the 3 days beginning with cheque issue day compared to other days of the month. Bi-weekly follow-up interviews collect participant information on this and secondary outcomes of interest, including drug-related harm (e.g. non-fatal overdose), exposure to violence and health service utilization. Self-reported data will be supplemented with participant information from health, financial, police and government administrative databases. A longitudinal, nested, qualitative parallel process evaluation explores participant experiences, and a cost-effectiveness evaluation of different disbursement scenarios will be undertaken. Outcomes will be compared between control and intervention arms to identify the impacts of alternative disbursement schedules on drug-related harm resulting from synchronized income assistance. Discussion This structural RCT benefits from strong community partnerships, highly detailed outcome measurement, robust methods of randomization and data triangulation with third party administrative databases. The study will provide evidence regarding the potential importance of social assistance program design as a lever to support population health outcomes and service provision for populations with a high prevalence of substance use. Trial registration NCT02457949 Registered 13 May 2015. |
| first_indexed | 2024-12-17T10:10:29Z |
| format | Article |
| id | doaj.art-7b60815e30474e12ac7c452935362c5f |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-17T10:10:29Z |
| publishDate | 2016-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-7b60815e30474e12ac7c452935362c5f2022-12-21T21:53:02ZengBMCBMC Public Health1471-24582016-07-0116111610.1186/s12889-016-3304-6Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugsLindsey Richardson0Allison Laing1M-J Milloy2Russ Maynard3Bohdan Nosyk4Brandon Marshall5Eric Grafstein6Patricia Daly7Evan Wood8Julio Montaner9Thomas Kerr10British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalDepartment of Epidemiology, School of Public Health, Brown UniversityDepartment of Emergency Medicine, Faculty of Medicine, University of British ColumbiaVancouver Coastal HealthBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalBritish Columbia Centre for Excellence in HIV/AIDS, St. Paul’s HospitalAbstract Background Government social assistance payments seek to alleviate poverty and address survival needs, but their monthly disbursement may cue increases in illicit drug use. This cue may be magnified when assistance is disbursed simultaneously across the population. Synchronized payments have been linked to escalations in drug use and unintended but severe drug-related harms, including overdose, as well as spikes in demand for health, social, financial and police services. Methods/design The TASA study examines whether changing payment timing and frequency can mitigate drug-related harm associated with synchronized social assistance disbursement. The study is a parallel arm multi-group randomized controlled trial in which 273 participants are randomly allocated for six assistance cycles to a control or one of two intervention arms on a 1:1:1 basis. Intervention arm participants receive their payments: (1) monthly; or (2) semi-monthly, in each case on days that are not during the week when cheques are normally issued. The study partners with a community-based credit union that has developed a system to vary social assistance payment timing. The primary outcome is a 40 % increase in drug use during the 3 days beginning with cheque issue day compared to other days of the month. Bi-weekly follow-up interviews collect participant information on this and secondary outcomes of interest, including drug-related harm (e.g. non-fatal overdose), exposure to violence and health service utilization. Self-reported data will be supplemented with participant information from health, financial, police and government administrative databases. A longitudinal, nested, qualitative parallel process evaluation explores participant experiences, and a cost-effectiveness evaluation of different disbursement scenarios will be undertaken. Outcomes will be compared between control and intervention arms to identify the impacts of alternative disbursement schedules on drug-related harm resulting from synchronized income assistance. Discussion This structural RCT benefits from strong community partnerships, highly detailed outcome measurement, robust methods of randomization and data triangulation with third party administrative databases. The study will provide evidence regarding the potential importance of social assistance program design as a lever to support population health outcomes and service provision for populations with a high prevalence of substance use. Trial registration NCT02457949 Registered 13 May 2015.http://link.springer.com/article/10.1186/s12889-016-3304-6Social assistanceDrug useDrug-related harmStructural intervention |
| spellingShingle | Lindsey Richardson Allison Laing M-J Milloy Russ Maynard Bohdan Nosyk Brandon Marshall Eric Grafstein Patricia Daly Evan Wood Julio Montaner Thomas Kerr Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs BMC Public Health Social assistance Drug use Drug-related harm Structural intervention |
| title | Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs |
| title_full | Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs |
| title_fullStr | Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs |
| title_full_unstemmed | Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs |
| title_short | Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs |
| title_sort | protocol of the impact of alternative social assistance disbursement on drug related harm tasa study a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs |
| topic | Social assistance Drug use Drug-related harm Structural intervention |
| url | http://link.springer.com/article/10.1186/s12889-016-3304-6 |
| work_keys_str_mv | AT lindseyrichardson protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT allisonlaing protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT mjmilloy protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT russmaynard protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT bohdannosyk protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT brandonmarshall protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT ericgrafstein protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT patriciadaly protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT evanwood protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT juliomontaner protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs AT thomaskerr protocoloftheimpactofalternativesocialassistancedisbursementondrugrelatedharmtasastudyarandomizedcontrolledtrialtoevaluatechangestopaymenttimingandfrequencyamongpeoplewhouseillicitdrugs |