The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial
The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial
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DOI：
10.1097/qai.0000000000001045
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发表时间：
2016-10-01
影响因子：
3.6
通讯作者：
Agot, Kawango
中科院分区：
文献类型：
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作者：
Thirumurthy, Harsha;Masters, Samuel H.;Agot, Kawango
背景资料：需要制定有效的创造需求战略，以增加东部和南部非洲男性包皮环切手术的接受率，减少艾滋病毒新感染。从行为经济学的见解的基础上，我们评估是否提供补偿的机会成本的时间或彩票为基础的奖励可以增加男性包皮环切术摄取在Kenya.Methods：年龄在21-39岁的未包皮环切男性随机在1：1：1的比例2干预组或对照组。一个干预小组获得了12.50美元的补偿，条件是接受包皮环切术。补偿以食品券的形式提供。第二个干预组有机会参加一个抽奖活动，有高价值的奖品接受割礼。主要结果是包皮环切摄取3 months.Results：在903名参与者中，获得12.50美元补偿的组包皮环切摄取率最高（8.4%，26/308），其次是基于彩票的奖励组（3.3%，10/302）和对照组（1.3%，4/299）。Logistic回归分析显示，与对照组相比，固定补偿组的包皮环切率显著较高[调整后比值比为7.1; 95%CI：2.4 - 20.8]。彩票为基础的奖励组并没有显着更高的包皮环切术摄取比对照组（调整后的比值比2.5; 95%CI：0.8至8.1）。结论：提供补偿是有效的，在短期内增加包皮环切术男性的摄取。这些结果与研究结果一致，这些研究表明，这些干预措施可以通过解决决策中的经济障碍和行为偏见来改变健康行为。与其他健康行为的研究结果相反，基于彩票的奖励并没有显着增加包皮环切术的吸收。
Background: Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery-based rewards can increase male circumcision uptake in Kenya.Methods: Uncircumcised men aged 21-39 years were randomized in 1: 1: 1 ratio to 2 intervention groups or a control group. One intervention group was offered compensation of US $12.50 conditional on circumcision uptake. Compensation was provided in the form of food vouchers. A second intervention group was offered the opportunity to participate in a lottery with high-value prizes on undergoing circumcision. The primary outcome was circumcision uptake within 3 months.Results: Among 903 participants enrolled, the group that received compensation of US $12.50 had the highest circumcision uptake (8.4%, 26/308), followed by the lottery-based rewards group (3.3%, 10/302), and the control group (1.3%, 4/299). Logistic regression analysis showed that compared with the control group, the fixed compensation group had significantly higher circumcision uptake [ adjusted odds ratio 7.1; 95% CI: 2.4 to 20.8]. The lottery-based rewards group did not have significantly higher circumcision uptake than the control group (adjusted odds ratio 2.5; 95% CI: 0.8 to 8.1).Conclusions: Providing compensation was effective in increasing circumcision uptake among men over a short period. The results are consistent with studies showing that such interventions can modify health behaviors by addressing economic barriers and behavioral biases in decision making. Contrary to findings from studies of other health behaviors, lottery-based rewards did not significantly increase circumcision uptake.