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Interim analyses produced signal of intervention efficacy for primary outcomes and weaker signal of increased exposure to violence. Therefore, DSMC recommended stopping recruitment in May 2018. Enrolled participants completed intervention by Aug 2018
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| Name | Class |
|---|---|
| BC Centre on Substance Use | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment As Usual (TAU) | No Intervention | Receipt of social assistance on government cheque issue days for 6 income assistance cycles (approx 26 weeks). | |
| Staggered Arm | Experimental | 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). |
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| Staggered and Split Arm | Experimental | 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). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Non-synchronized social assistance receipt | Other | Social assistance disbursement outside government cheque issue week |
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| Measure | Description | Time Frame |
|---|---|---|
| Illicit drug use on government cheque issue days | 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. | 26 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Illicit drug use on non-government cheque issue days | 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. | 26 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lindsey Richardson, DPhil | University of British Columbia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| British Columbia Centre on Substance Use | Vancouver | British Columbia | V6Z 2A9 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40334114 | Derived | Klaire S, Choi J, Laing A, Richardson L. Impact of alternative income assistance disbursement on substance use disorder treatment adherence among people who use drugs. Am J Drug Alcohol Abuse. 2025;51(3):383-394. doi: 10.1080/00952990.2025.2494112. Epub 2025 May 7. | |
| 38183858 | Derived | Robinson K, Laing A, Choi J, Richardson L. Effect of modified income assistance payment schedules on substance use service access: Evidence from an experimental study. Int J Drug Policy. 2024 Feb;124:104293. doi: 10.1016/j.drugpo.2023.104293. Epub 2024 Jan 5. |
| Label | URL |
|---|---|
| British Columbia Centre on Substance Use | View source |
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| cheque divided into two equal disbursements | Other | Social assistance disbursement divided into two equal payments |
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| Hospital admissions on government cheque issue days | 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. | 26 weeks |
| Overdose | 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. | 26 weeks |
| Police service utilization | 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. | 26 weeks |
| 33857455 | Derived | 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. |
| 33461522 | Derived | 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. |
| 27473400 | Derived | 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. |