{"doi":"10.1371/journal.pone.0277312","title":"Effect of a one-time financial incentive on linkage to chronic hypertension care in Kenya and Uganda: A randomized controlled trial","abstract":"BACKGROUND: Fewer than 10% of people with hypertension in sub-Saharan Africa are diagnosed, linked to care, and achieve hypertension control. We hypothesized that a one-time financial incentive and phone call reminder for missed appointments would increase linkage to hypertension care following community-based screening in rural Uganda and Kenya. METHODS: In a randomized controlled trial, we conducted community-based hypertension screening and enrolled adults ≥25 years with blood pressure ≥140/90 mmHg on three measures; we excluded participants with known hypertension or hypertensive emergency. The intervention was transportation reimbursement upon linkage (~$5 USD) and up to three reminder phone calls for those not linking within seven days. Control participants received a clinic referral only. Outcomes were linkage to hypertension care within 30 days (primary) and hypertension control <140/90 mmHg measured in all participants at 90 days (secondary). We used targeted minimum loss-based estimation to compute adjusted risk ratios (aRR). RESULTS: We screened 1,998 participants, identifying 370 (18.5%) with uncontrolled hypertension and enrolling 199 (100 control, 99 intervention). Reasons for non-enrollment included prior hypertension diagnosis (n = 108) and hypertensive emergency (n = 32). Participants were 60% female, median age 56 (range 27-99); 10% were HIV-positive and 42% had baseline blood pressure ≥160/100 mmHg. Linkage to care within 30 days was 96% in intervention and 66% in control (aRR 1.45, 95%CI 1.25-1.68). Hypertension control at 90 days was 51% intervention and 41% control (aRR 1.22, 95%CI 0.92-1.66). CONCLUSION: A one-time financial incentive and reminder call for missed visits resulted in a 30% absolute increase in linkage to hypertension care following community-based screening. Financial incentives can improve the critical step of linkage to care for people newly diagnosed with hypertension in the community.","journal":"PLoS ONE","year":2022,"id":269820,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":15,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9523,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":255282,"name":"Asiphas Owaraganise","orcid":"0000-0002-5594-0310","position":1,"is_corresponding":false},{"id":255285,"name":"Norton Sang","orcid":"0000-0002-0092-7776","position":2,"is_corresponding":false},{"id":708134,"name":"Fredrick J. Opel","orcid":null,"position":3,"is_corresponding":false},{"id":933465,"name":"Erick Wafula Mugoma","orcid":null,"position":4,"is_corresponding":false},{"id":255275,"name":"James Ayieko","orcid":"0000-0002-0324-4006","position":5,"is_corresponding":false},{"id":255277,"name":"Jane Kabami","orcid":"0000-0002-0265-3174","position":6,"is_corresponding":false},{"id":255283,"name":"Gabriel Chamie","orcid":"0000-0002-5860-8081","position":7,"is_corresponding":false},{"id":379512,"name":"Elijah Kakande","orcid":"0000-0001-9532-5710","position":8,"is_corresponding":false},{"id":255295,"name":"Maya L. Petersen","orcid":"0000-0002-5505-153X","position":9,"is_corresponding":false},{"id":255278,"name":"Laura B. Balzer","orcid":"0000-0002-3730-410X","position":10,"is_corresponding":false},{"id":242453,"name":"Moses R. Kamya","orcid":"0000-0001-9106-4234","position":11,"is_corresponding":false},{"id":58746,"name":"Diane V. Havlir","orcid":"0000-0003-0761-3136","position":12,"is_corresponding":false},{"id":497710,"name":"Matthew D. Hickey","orcid":"0000-0001-8913-1602","position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":null,"created_at":"2026-07-19T00:27:22.602796Z","pmid":"36342940","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}