Motivational Enhancement to Augment Contingency Management for SARS-CoV-2 Testing and Vaccination Utilization Among Syringe Exchange Clients

Background: The purpose of this study was to reduce COVID-19 morbidity and mortality among people who inject drugs (PWIDs), a population highly vulnerable to SARS-CoV-2 infection due to underlying medical conditions, unstable housing, stigmatization, discrimination, and exposure to misinformation that limited access to healthcare services. In collaboration with the HIV Alliance (HIVA), this study sought to sustain and enhance COVID-19 efforts through targeted behavioral interventions.

Materials/Methods: This study evaluated the sustained effectiveness of a contingency management (CM) intervention to address high vaccine hesitancy within the PWID population. A randomized controlled trial was conducted to determine whether a brief motivational enhancement (ME) intervention, Connect2Test, could augment CM’s effects on SARS-CoV-2 testing and vaccination uptake. The study also included an implementation analysis with a cost-effectiveness comparison of CM alone versus CM combined with Connect2Test to assess long-term sustainability of these strategies.

Outcome/Impact: The study demonstrated that CM significantly improved testing uptake and the combination of CM and Connect2Test would likely yield greater and longer-lasting increases in SARS-CoV-2 testing and vaccination rates among PWIDs. The expected impact was to establish scalable, cost-effective intervention models to sustain testing and vaccination efforts and mitigate the spread of COVID-19 in this high-risk population.