Improving utilization of and retention in PMTCT services: can behavioral economics help?
Improving utilization of and retention in PMTCT services: can behavioral economics help?
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DOI：
10.1186/1472-6963-13-406
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发表时间：
2013-10-10
影响因子：
2.8
通讯作者：
Buttenheim AM
中科院分区：
文献类型：
--
作者：
Taylor NK;Buttenheim AM
世界卫生组织最近的战略行动呼吁将消除儿童艾滋病毒定为一项目标。虽然最近的努力集中在建设基础设施和确保获得高质量的治疗，但我们现在必须将重点转向消除垂直传播所需的行为改变。我们从行为经济学领域的概念，以预防母婴传播（PMTCT）计划，以更有效地解决需求方的吸收和保留的问题的应用情况。我们从行为经济学领域引入了五个概念，并讨论了它们在PMTCT项目中的应用：1）来自与PMTCT患者相似环境的指导母亲可以作为社会参考，他们提供了时间上显著的服务利用和治疗依从性模型。2)经济激励措施，如手机通话时间或食品券，奖励遵守PMTCT协议利用当前偏见，观察到人们通常偏向于眼前而不是未来的奖励。3)默认偏见，我们对默认选项的偏好，已经在许多国家以选择退出测试的形式使用，并可能扩展到所有预防母婴传播计划。4)我们天生就避免损失，而不是追求同等的收益。预防母婴传播方案可以利用损失规避，通过使用承诺合同，激励母亲返回诊所，以避免声誉和经济损失。消除艾滋病毒的垂直传播是一个雄心勃勃的目标。为了缩小剩余的差距，需要进行创新，以满足对防止母婴传播服务的需求。行为经济学提供了一套工具，可以设计成防止母婴传播方案，以增加吸收和改善保留最少的投资。
The most recent strategic call to action of the World Health Organization sets the elimination of pediatric HIV as a goal. While recent efforts have focused on building infrastructure and ensuring access to high-quality treatment, we must now turn our focus to the behavior change needed to eliminate vertical transmission. We make the case for the application of concepts from the field of behavioral economics to prevention of mother-to-child transmission (PMTCT) programs to more effectively address demand-side issues of uptake and retention. We introduce five concepts from the field of behavioral economics and discuss their application to PMTCT programs: 1) Mentor mothers who come from similar circumstances as PMTCT patients can serve as social references who provide temporally salient modeling of utilization of services and adherence to treatment. 2) Economic incentives, like cell phone minutes or food vouchers, that reward adherence to PMTCT protocols leverage present bias, the observation that people are generally biased toward immediate versus future awards. 3) Default bias, our preference for the default option, is already being used in many countries in the form of opt-out testing, and could be expanded to all PMTCT programs. 4) We are hardwired to avoid loss more than to pursue an equivalent gain. PMTCT programs can take advantage of loss aversion through the use of commitment contracts that incentivize mothers to return to the clinic in order to avoid both reputational and financial loss. Eliminating vertical transmission of HIV is an ambitious goal. To close the remaining gap, innovations are needed to address demand for PMTCT services. Behavioral economics offers a set of tools that can be engineered into PMTCT programs to increase uptake and improve retention with minimal investment.
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影响因子：
3
作者：
Ekirapa-Kiracho E;Waiswa P;Rahman MH;Makumbi F;Kiwanuka N;Okui O;Rutebemberwa E;Bua J;Mutebi A;Nalwadda G;Serwadda D;Pariyo GW;Peters DH
通讯作者：
Peters DH
对常规的艾滋病毒咨询和测试的态度，以及关于预防母亲在乌干达东部艾滋病毒传播的知识：产前参与者之间的横断面调查。
影响因子：
6
作者：
Byamugisha R;Tumwine JK;Ndeezi G;Karamagi CA;Tylleskär T
通讯作者：
Tylleskär T
影响因子：
3.7
作者：
Ekouevi, Didier K.;Stringer, Elizabeth;Dabis, Francois
通讯作者：
Dabis, Francois
影响因子：
3.5
作者：
Abadie, Alberto;Gay, Sebastien
通讯作者：
Gay, Sebastien
影响因子：
2.2
作者：
Bajunirwe, Francis;Muzoora, Michael
通讯作者：
Muzoora, Michael