A behavioral design approach to improving a Chagas disease vector control campaign in Peru
A behavioral design approach to improving a Chagas disease vector control campaign in Peru
复制标题
DOI：
10.1186/s12889-019-7525-3
复制
发表时间：
2019-09-18
影响因子：
4.5
通讯作者：
Paz-Soldan, Valerie A.
中科院分区：
文献类型：
--
作者：
Buttenheim, Alison M.;Levy, Michael Z.;Paz-Soldan, Valerie A.
背景：个人行为改变是改善全球健康的一个关键因素。对行为的关注的核心是对人类大脑如何做出决定的理解，从动机和心态到无意识的偏见和认知捷径。最近在行为经济学和相关领域的研究为我们提供了丰富的见解和原则，这些见解和原则可以用于全球卫生项目，以增加影响和覆盖面。然而，关于设计和测试干预措施的过程的研究很少。方法：在秘鲁阿雷基帕开展的一项旨在提高家庭参与南美锥虫病病媒控制运动的研究中，我们应用Datta和Mullainathan的“行为设计”方法来制定和测试具体干预措施。在这篇Technical Advance文章中，我们详细描述了行为设计方法，包括定义、诊断、设计和测试阶段。我们还展示了通过行为设计过程设计的干预措施如何适用于实用的随机对照现场试验。结果：行为设计框架提供了一个系统的方法来定义利益行为，诊断家庭不愿意或拒绝参与的原因，设计干预措施来解决可操作的瓶颈，然后在严格的反事实背景下测试这些干预措施。行为设计为我们提供了比通常用于病媒控制活动的更广泛的策略和方法。结论：未来需要仔细关注行为设计如何影响评估的内部和外部有效性以及干预措施的可扩展性。我们推荐行为设计作为全球健康计划中其他干预设计和评估方法的有益补充。
Background: Individual behavior change is a critical ingredient in efforts to improve global health. Central to the focus on behavior has been a growing understanding of how the human brain makes decisions, from motivations and mindsets to unconscious biases and cognitive shortcuts. Recent work in the field of behavioral economics and related fields has contributed to a rich menu of insights and principles that can be engineered into global health programs to increase impact and reach. However, there is little research on the process of designing and testing interventions informed by behavioral insights.Methods: In a study focused on increasing household participation in a Chagas disease vector control campaign in Arequipa, Peru, we applied Datta and Mullainathan's "behavioral design" approach to formulate and test specific interventions. In this Technical Advance article we describe the behavioral design approach in detail, including the Define, Diagnosis, Design, and Test phases. We also show how the interventions designed through the behavioral design process were adapted for a pragmatic randomized controlled field trial.Results: The behavioral design framework provided a systematic methodology for defining the behavior of interest, diagnosing reasons for household reluctance or refusal to participate, designing interventions to address actionable bottlenecks, and then testing those interventions in a rigorous counterfactual context. Behavioral design offered us a broader range of strategies and approaches than are typically used in vector control campaigns.Conclusions: Careful attention to how behavioral design may affect internal and external validity of evaluations and the scalability of interventions is needed going forward. We recommend behavioral design as a useful complement to other intervention design and evaluation approaches in global health programs.