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01.12.2012 | Study protocol | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Using financial incentives to increase initial uptake and completion of HPV vaccinations: protocol for a randomised controlled trial

BMC Health Services Research > Ausgabe 1/2012
Eleni Mantzari, Florian Vogt, Theresa M Marteau
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-301) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

TMM advised on the research design. EM drafted the protocol. All authors provided input on the protocol and read and approved the manuscript.



HPV vaccination reduces the risk of cervical cancer. Uptake however, of the ‘catch-up’ campaign in England for 17-18 year old girls is below the 80% NHS target. The aim of this randomized controlled trial is to assess the impact of financial incentives on (a) the uptake and completion of an HPV vaccination programme and (b) the quality of the decisions to undertake the vaccination.


One thousand (n = 1000) 16-18 year-old girls will be invited to participate in an HPV vaccination programme: Five-hundred (n = 500) will have received a previous invitation to get vaccinated but will have failed to do so (previous non-attenders) and 500 will not have previously received an invitation (first-time invitees). Girls will be randomly selected from eligible participants who are registered with a GP in areas covered by the Birmingham East and North (BEN) and Heart of Birmingham Primary Care Trusts. The two samples of girls will be randomised to receive either a standard vaccination invitation letter or an invitation letter including the offer of vouchers worth £45 for receiving three vaccinations. Girls will also complete a questionnaire to assess the quality of their decisions to be vaccinated. The primary outcome will be uptake of the 1st and 3rd vaccinations. The secondary outcome will be the quality of the decisions to undertake the vaccination, measured by assessing attitudes towards and knowledge of the HPV vaccination.


The key results will be: a) the effectiveness of financial incentives in increasing uptake of the 1st and 3rd vaccinations; b) the role of participants’ socio-economic status in the moderation of the impact of incentives on uptake; and c) the impact of incentives on the quality of decisions to undertake the HPV vaccinations.
Additional files 1: HPV Vaccination Invitation Letters.(PDF 255 KB)
Additional files 2: HPV Vaccination Survey Form.(PDF 173 KB)
Authors’ original file for figure 1
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