The Impact of Alternative Social Assistance Disbursement on Drug-related Harm (TASA)

• ClinicalTrials.gov Identifier: NCT02457949
• Recruitment Status: Terminated
• First Posted: May 29, 2015
• Last Update Posted: November 17, 2020
• Sponsor: University of British Columbia
• Collaborator: BC Centre on Substance Use
• Information provided by (Responsible Party): Lindsey Richardson, University of British Columbia

Study Description

Brief Summary:

This study evaluates whether altering the timing and frequency of social assistance disbursement reduces drug related-harms that increase on the days surrounding monthly synchronized government social assistance cheque issue.

Condition or disease	Intervention/treatment	Phase
Drug Use	Other: Non-synchronized social assistance receipt; Other: cheque divided into two equal disbursements	Not Applicable

Detailed Description:

Coordinated monthly income assistance payments, while seeking to alleviate poverty, can also have negative and unintended impacts, particularly among people who use illicit drugs (PWUD). Observational research has identified escalations in drug-related harm coinciding with monthly assistance payments, such as overdose, treatment interruption, hospital admissions and public disorder. This project varies the timing and frequency of income assistance disbursement, and evaluates whether varying income assistance disbursement reduces drug-related harm coinciding with coordinated income assistance.

Conducted among 273 PWUD, participants will be allocated for 6 income assistance cycles to a control or one of two intervention arms. Participants in the control arm will receive payments according to the existing monthly government schedule. Participants in the intervention arm will receive their income assistance: (1) monthly on a day different from government cheque issue; or (2) semi-monthly on days different from government cheque issue. The intervention will be evaluated using qualitative and quantitative methods for its impact on drug use and related harms.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 194 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Single (Investigator)
• Primary Purpose: Other
• Official Title: The Impact of Alternative Social Assistance Disbursement on Drug-Related Harm: a Randomized Control Trial
• Actual Study Start Date: October 27, 2015
• Actual Primary Completion Date: January 2, 2019
• Actual Study Completion Date: September 30, 2019

Arms and Interventions

Arm	Intervention/treatment
No Intervention: Treatment As Usual (TAU); Receipt of social assistance on government cheque issue days for 6 income assistance cycles (approx 26 weeks).
Experimental: Staggered Arm; Receipt of social assistance once monthly on a randomly assigned day that does not fall during the week of government cheque issue (Non-synchronized social assistance receipt), for 6 income assistance cycles (approx 26 weeks).	Other: Non-synchronized social assistance receipt; Social assistance disbursement outside government cheque issue week; Other Name: Staggered
Experimental: Staggered and Split Arm; Receipt of social assistance twice monthly on equally spaced randomly assigned days that do not fall during the week of government cheque issue (Non-synchronized social assistance receipt, cheque divided into two equal disbursements), for 6 income assistance cycles (approx 26 weeks).	Other: Non-synchronized social assistance receipt; Social assistance disbursement outside government cheque issue week; Other Name: Staggered; Other: cheque divided into two equal disbursements; Social assistance disbursement divided into two equal payments; Other Name: Split

Outcome Measures

Primary Outcome Measures :

1. Illicit drug use on government cheque issue days [ Time Frame: 26 weeks ]
   Timeline Follow Back (TLFB) assessed increase of drug use defined as an increase in the frequency of drug use of at least 40% or an increase in the number of drugs used during the 3 days beginning with government cheque issue day, compared to non-cheque issue days.

Secondary Outcome Measures :

1. Illicit drug use on non-government cheque issue days [ Time Frame: 26 weeks ]
   Timeline Follow Back (TLFB) assessed increase of drug use defined as an increase in the frequency of drug use of at least 40% or an increase in the number of drugs used during the 3 days beginning with individual cheque issue day (among intervention participants), compared to non-cheque issue days.
2. Hospital admissions on government cheque issue days [ Time Frame: 26 weeks ]
   Emergency Department, Emergency Department Mental Health and substance use hospitalizations in the three days beginning with government cheque issue day compared to non-cheque issue days.
3. Overdose [ Time Frame: 26 weeks ]
   Self-reported non-fatal overdose and hospital record verified fatal overdose on the three days beginning with government cheque issue day compared to non-cheque issue days.
4. Police service utilization [ Time Frame: 26 weeks ]
   Self-reported and police record-verified interactions with police or use of police services on the three days beginning with government cheque issue day compared to non-cheque issue days.

Eligibility Criteria

• Ages Eligible for Study: 19 Years to 64 Years (Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• be ≥19 years of age or older
• reside in greater Vancouver, Canada
• report regular use of illicit drugs other than cannabis
• receive monthly provincial income assistance
• are not currently administered (where cheque issue/money is externally managed)
• be eligible and willing to be a client of the local credit union who will administer the intervention
• report intensified drug use around government cheque issue days
• provide written informed consent
• be willing to comply with study procedures

Exclusion Criteria:

• plan to relocate outside Vancouver
• have plans to discontinue income assistance

Contacts and Locations

Locations

Canada, British Columbia

British Columbia Centre on Substance Use

Vancouver, British Columbia, Canada, V6Z 2A9

Sponsors and Collaborators

University of British Columbia

BC Centre on Substance Use

Investigators

• Principal Investigator: Lindsey Richardson, DPhil; University of British Columbia

More Information

Additional Information:

British Columbia Centre on Substance Use 

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Richardson L, Laing A, Choi J, Nosova E, Milloy MJ, Marshall BD, Singer J, Wood E, Kerr T. Effect of alternative income assistance schedules on drug use and drug-related harm: a randomised controlled trial. Lancet Public Health. 2021 May;6(5):e324-e334. doi: 10.1016/S2468-2667(21)00023-2. Epub 2021 Apr 12.

Mendell J, Richardson L. Integrated knowledge translation to strengthen public policy research: a case study from experimental research on income assistance receipt among people who use drugs. BMC Public Health. 2021 Jan 18;21(1):153. doi: 10.1186/s12889-020-10121-9.

Richardson L, Laing A, Milloy MJ, Maynard R, Nosyk B, Marshall B, Grafstein E, Daly P, Wood E, Montaner J, Kerr T. 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. 2016 Jul 29;16:668. doi: 10.1186/s12889-016-3304-6.

• Responsible Party: Lindsey Richardson, Assistant Professor, University of British Columbia
• ClinicalTrials.gov Identifier: NCT02457949
• Other Study ID Numbers: H14-02401
• First Posted: May 29, 2015
• Last Update Posted: November 17, 2020
• Last Verified: November 2020

Keywords provided by Lindsey Richardson, University of British Columbia:

Social Assistance; Drug Use; Drug-Related harm