Compensating control participants when the intervention is of significant value: experience in Guatemala, India, Peru and Rwanda

• Type of Material: Article
• Authors: Ashlinn K. Quinn, National Institutes of Health; Kendra Williams, Johns Hopkins University; Lisa Thompson, Emory University; Ghislaine Rosa, London School of Hygiene & Tropical Medicine; Anaite Diaz-Artiga, Univ Valle Guatemala; Gurusamy Thangavel, Sri Ramachandra Insitute; Kalpana Balakrishnan, Sri Ramachandra Insitute; J. Jaime Miranda, Universidad Peruana Cayetano Heredia; Joshua P. Rosenthal, National Institutes of Health; Thomas Clasen, Emory University; Steven A. Harvey, Johns Hopkins University; Dana Boyd Barr, Emory University; Howard H. Chang, Emory University; Ajay Pillarisetti, Emory University; Usha Ramakrishnan, Emory University; P. Barry Ryan, Emory University; Jeremy Sarnat, Emory University; Lance A. Waller, Emory University
• Language: English
• Date: 2019-07-01
• Publisher: BMJ Publishing Group: Open Access
• Publication Version: Final Published Version
• Copyright Statement: © 2019 Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjgh-2019-001567
• Title of Journal or Parent Work: BMJ Global Health
• ISSN: 2059-7908
• Volume: 4
• Issue: 4
• Start Page: e001567
• End Page: e001567
• Grant/Funding Information: The HAPIN trial is funded by the U.S. National Institutes of Health (cooperative agreement 1UM1HL134590) in collaboration with the Bill & Melinda Gates Foundation [OPP1131279].
• Keywords: multi-country trial; Life Sciences & Biomedicine; compensation; ethics; randomised controlled trial; CASH; Science & Technology; Public, Environmental & Occupational Health; PAYMENT
• Research Categories: Health Sciences, Public Health

Abstract

The Household Air Pollution Intervention Network (HAPIN) trial is a randomised controlled trial in Guatemala, India, Peru and Rwanda to assess the health impact of a clean cooking intervention in households using solid biomass for cooking. The HAPIN intervention-a liquefied petroleum gas (LPG) stove and 18-month supply of LPG-has significant value in these communities, irrespective of potential health benefits. For control households, it was necessary to develop a compensation strategy that would be comparable across four settings and would address concerns about differential loss to follow-up, fairness and potential effects on household economics. Each site developed slightly different, contextually appropriate compensation packages by combining a set of uniform principles with local community input. In Guatemala, control compensation consists of coupons equivalent to the LPG stove's value that can be redeemed for the participant's choice of household items, which could include an LPG stove. In Peru, control households receive several small items during the trial, plus the intervention stove and 1 month of fuel at the trial's conclusion. Rwandan participants are given small items during the trial and a choice of a solar kit, LPG stove and four fuel refills, or cash equivalent at the end. India is the only setting in which control participants receive the intervention (LPG stove and 18 months of fuel) at the trial's end while also being compensated for their time during the trial, in accordance with local ethics committee requirements. The approaches presented here could inform compensation strategy development in future multi-country trials.