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Compensation and Reimbursement of Research Participants

Compensation of research participants can present many ethical dilemmas: should all participants be compensated for their time? How much money/in kind compensation is adequate but will not present undue influence? Are commercial gift cards acceptable? Is tobacco an acceptable gift in Aboriginal research? When a study is unfunded, is it appropriate for the researcher to provide compensation from his/her own pocket? Should health professionals be compensated if participation means they will need to work overtime to make up for the time spent participating?

Definitions

Reimbursement: money given to the research participant that reflects out of pocket expenses associated with participating in a research study (e.g. transportation, or parking).

Compensation: money or item given to the research participant that acknowledges the time and effort they have provided in participating in the research.

General guidelines for reimbursement and compensation

a) reimbursement
Participants should be offered reimbursement for reasonable out of pocket expenses unless the researcher can justify why circumstances make this impossible. Participants should not be reimbursed to a set amount, recognizing that out of pocket expenses will vary according to personal factors. While it is understood that many studies are under- or unfunded, researchers should consider mechanisms by which reimbursement may be available and/or find ways to minimize expenses to participants (e.g. on-site child care, provide TTC tokens, use of technology (telephone, internet) already available).

Participants should be informed whether they will, or will not, be reimbursed for out of pocket expenses through the informed consent process. Participants may be asked to submit receipts for reimbursement, preferably without direct identifiers (participant code is acceptable). If official (point of purchase) receipts are not available, reimbursement should still apply, but other mechanisms (e.g. voucher) may be necessary.

b) compensation
Researchers should normally provide compensation to participants for their time. Where compensation will not be provided, researchers may explain why in the protocol – resources lacking, inappropriateness for the area of research or culture of research participants, etc.

Participants should either be informed that they shall be compensated and the amount, or that they shall not be compensated for their time. Note that compensation to research participants is not a benefit and should not be listed in the benefits section of the protocol or informed consent documentation.

In general, recruitment techniques (e.g., advertising) should not focus on compensation as a means of enticing potential participants. While it is appropriate (and required) to discuss
compensation with participants through the informed consent process, it is inappropriate to use compensation as the main reason for individuals to consider participation in research. However, it may be used as a means of encouraging participation. The REB should review all advertising materials – flyers, print ads and internet postings – to ensure that they are appropriately written and displayed.

Compensation may be provided as cash or in kind. Examples of the latter include gift cards/ gift certificates, gifts (toys, books), food or class marks. Researchers should consider the appropriateness of the compensation type with regard to the participant population. Cash should normally be used when payment is meant to realistically compensate the participant for time incurred due to study participation, not procedure type or level of risk. While it is understandable that incentives may be required to recruit and maintain participants in a study, such incentives cannot be set at levels that would unduly influence a participant to take part, or remain in a study. Conversely, compensation should not be set at a level that could be construed as disrespectful of participants’ value to the research. Where the budget is not available for true compensation, tokens of appreciation, such as gift cards or gifts, may be more appropriate. They should be referred to as such as tokens (or honorariums) and not as compensation.

Researchers should be cognizant of the amount of the gift card with respect to what could be purchased with it, as it is not appropriate to provide an amount that would require individuals to spend additional money to use the card. When possible, gift cards should be purchased from establishments that participants would typically frequent – locally accessible and non-controversial. Gifts should be appropriate to the participant group and, for research involving children, to caretakers as well. Food and/or drinks should be provided, when possible, for research procedures involving 3 or more consecutive hours or taking place during meal times.

The use of credits as compensation for research is a common practice in some undergraduate courses at the University of Toronto.

Payment structures

Because compensation is tied to research participants’ time, payment should normally be incremental (i.e. pro-rated), not based on completion of the study. However, it may also be acceptable to provide a slightly higher final payment to participants upon completion of their study responsibilities. Participants should be informed of when they will receive each installment of payment and how much in the informed consent process.

When token gifts are provided in lieu of compensation, they should be provided to all participants, regardless of continuation in the study. It may be appropriate to provide a token gift at each visit/stage of the research.

Professionals as participants

The majority of research reviewed at the University of Toronto involves participant groups representative of the local community; however, on occasion, research may focus on specific professions or will involve professionals in some way. In such situations, researchers may request compensation for these individuals at a higher level than normally provided, the rationale being that professionals in that field cannot or will not participate without pay for work-time lost. In some situations the compensation received by the professional is returned to his/her department for time lost. Research involving differing professional groups or professionals and local community members may consider offering differing amounts of compensation per participant group. This may also require justification under some circumstances. The REB shall consider compensation amounts in light of practicable recruitment in its deliberations.

International research

Compensation can present an ethical challenge when it comes to international research, particularly in developing countries, where poverty may be a major issue for participant populations. Compensation at Canadian rates may pose an undue influence to communities to participate, while compensation at rates typical to the host country’s hourly wage may give the appearance of “outsourcing” for lower costs.

To mitigate the latter (and to conduct oneself as an ethical researcher overall), international research in developing countries should only be conducted for the benefit of that country/population. If the research can take place locally without changing the focus or research question, this should be done. To ensure that compensation does not pose undue influence, the researcher should compensate participants in a culturally sensitive manner, taking into account the standard wage (for monetary compensation) or forms of gifts typical for the country and population. The researcher must ensure that individuals not feel coerced or unduly influenced to participate in research because of the compensation offered. Discussion of the issue of compensation with community leaders and/or experts during the consultation/planning phase of the research is highly advised.

Vulnerable populations

Within the local context, researchers may conduct research with financially- and socially-vulnerable groups (e.g. homeless youth, intravenous drug users, gambling addicts). Determining appropriate compensation for these populations raises difficult issues, as REBs try to balance ethical principles including respect for participants’ autonomy, prevention of undue influence and providing protection for vulnerable persons. It is essential that when determining acceptable amounts and kinds of compensation for vulnerable groups, researchers and the REB not confuse protection with paternalism. Research participants who are competent to consent to research should be considered to be autonomous in how they utilize compensation. It is not within the purview of researchers or REBs to set restrictions (directly or indirectly) on compensation beyond those that would normally be set for non-vulnerable populations.

Use of draws and incentive-based compensation

Draws in lieu of compensation are sometimes used when research is un- or under-funded. In these instances, participants’ names or codes are collected and one or a few individuals are picked to “win” a prize. All participants have an equal chance of winning, but the majority will not receive anything for participating in the research study.

Draws are not a preferred method of compensation, but may be ethically acceptable provided that the prize, irrespective of the odds of winning, is not significant enough to unduly influence participation in the study. For research involving draws, information on the prize(s) and its/their value, the probability of winning and the number of participants in the study, should all be provided through the informed consent process. If personal information (name, phone number) must be collected for the draw, the researcher should maintain security of this information throughout the duration of the study, and should destroy the information once prizes have been awarded. Draws are not usually appropriate for anonymous research, as they would require identification where otherwise none would be needed, and present an unfair advantage to those willing to identify themselves, versus those who do not.

Incentive-based compensation is a technique used in management and gambling research. In these research studies, compensation is based on the participant’s willingness to “take a chance” with the result either increasing the compensation, or decreasing it. This structure is not inherently unethical; however, the researcher should explain to participants how compensation is tied to the research method through the informed consent process.

Use of tobacco in Aboriginal research

In some Aboriginal populations, the sharing of tobacco is considered a sign of respect and can be considered as an appropriate form of compensation. As with all Aboriginal research, researchers are encouraged to consult with community leaders and experts.

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