Evaluation of four interventions using behavioural economics insights to increase demand for voluntary medical male circumcision in South Africa through the MoyaApp: A quasi-experimental study.

medRxiv : the preprint server for health sciences Pub Date : 2024-01-19 DOI:10.1101/2024.01.18.24301032

Preethi Mistri, Silviu Tomescu, Simamkele Bokolo, Alexandra De Nooy, Pedro T Pisa, Skye Grove, Laura Schmucker, Candice Chetty-Makkan, Lawrence Long, Alison Buttenheim, Brendan Maughan-Brown

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Abstract

Background: While voluntary medical male circumcision (VMMC) reduces the risk of HIV transmission by 60%, circumcision coverage falls short of the UNAIDS 90% target. We investigated whether behaviourally informed message framing increased demand for VMMC.

Setting: Adult users of the MoyaApp, a data free application in South Africa, who viewed a form designed to generate interest in VMMC during August-November 2022.

Methods: A quasi-experimental study was conducted to evaluate four MoyaApp VMMC intervention forms against the Standard of Care (SOC) form. All forms enabled users to provide contact details for follow-up engagement by a call centre. The primary outcome was the proportion of forms submitted. Secondary outcomes included successful contact with the user, VMMC bookings/referrals and confirmed circumcision. Multivariable ordinary least-squares regression was used for the analysis.

Results: MoyaApp VMMC form viewers totalled 118,337 of which 6% submitted a form. Foot-in-the-Door form viewers were more likely (+1.3 percentage points, p<0.01) to submit a form compared to the SOC group (6.3%). Active Choice (-1.1 percentage points, p<0.01) and Reserved for You (-0.05 percentage points, p<0.05) form viewers were less likely to submit a form compared to SOC. Users submitting on Foot-in-the-Door were less likely to be booked/referred compared to SOC (-5 percentage points, p<0.05). There were no differences between the intervention and SOC forms for successful contact and circumcisions.

Conclusions: Message framing using behavioural insights was able to nudge men to engage with VMMC services. However, more work is needed to understand how to convert initial interest into bookings and circumcisions.

Trial registration: South African Clinical Trials Registry DOH-27-062022-7811Pan-African Clinical Trials Registry PACTR202112699416418.

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通过 MoyaApp，利用行为经济学观点评估四项干预措施，以增加南非对自愿包皮环切手术的需求：准实验研究。

背景：虽然自愿包皮环切术（VMMC）可将艾滋病病毒传播的风险降低 60%，但包皮环切术的覆盖率仍未达到联合国艾滋病规划署提出的 90% 的目标。我们调查了行为信息框架是否会增加对自愿包皮环切手术的需求：方法：一项准实验研究：方法：我们开展了一项准实验研究，对照 "护理标准"（SOC）表格，对四种 MoyaApp 虚拟医疗管理（VMMC）干预表格进行了评估。所有表格均可让用户提供联系方式，以便呼叫中心进行后续联系。主要结果是提交表格的比例。次要结果包括与用户的成功联系、虚拟医疗预约/转诊以及确认的包皮环切术。分析采用了多变量普通最小二乘回归法：MoyaApp虚拟医疗系统表格浏览者总数为118,337人，其中6%的人提交了表格。脚踏实地 "表单的浏览者更有可能提交表单（+1.3 个百分点，pConclusions）：利用行为洞察力设计信息框架能够促使男性参与到自愿医疗管理服务中来。然而，要了解如何将最初的兴趣转化为预约和包皮环切术，还需要做更多的工作：南非临床试验登记处 DOH-27-062022-7811泛非临床试验登记处 PACTR202112699416418。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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medRxiv : the preprint server for health sciences

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