Effects of a prosocial intervention among sellers of HIV and reproductive health supplies on young women’s health

艾滋病毒和生殖健康用品销售者的亲社会干预对年轻女性健康的影响

• 批准号: 10509329
• 负责人: Jenny Xin Liu
• 金额: $ 8.08万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10509329
• 关键词: AIDS prevention; Africa South of the Sahara; Age; Area; Automobile Driving; Award; Baseline Surveys; Behavior; Businesses; Caring; Characteristics; Cluster randomized trial; Community Health; Community Services; Complement; Contraceptive Agents; Contraceptive Distributions; Contraceptive methods; Diagnostic Reagent Kits; Effectiveness; Enrollment; Ensure; Equipment and supply inventories; Face; Failure; Feedback; Female Adolescents; Future; Goals; Gold; HIV; Health; Health system; Heterogeneity; Human immunodeficiency virus test; Image; Intervention; Literature; Measures; Methods; Motivation; Outcome; Parents; Performance; Persons; Pharmaceutical Preparations; Phase; Population Dynamics; Positioning Attribute; Preventive; Preventive Health Services; Price; Private Sector; Privatization; Provider; Public Health; Randomized; Randomized Controlled Trials; Reporting; Reproductive Health; Reproductive Health Services; Research Infrastructure; Research Priority; Resources; Role; Sales; Sampling; Service provision; Services; Sexual Health; Side; Surveys; System; Tanzania; Testing; Time; Women' s Health; Work; arm; base; behavior change; behavioral economics; consumer demand; cost effective; design; experience; girls; innovation; insight; intervention program; novel; peer; pilot test; point of care; pregnancy prevention; prevention service; primary endpoint; primary outcome; programs; secondary endpoint; secondary outcome; self testing; service uptake; social; theories; trend; unintended pregnancy; uptake; willingness; young woman

SUMMARY In sub-Saharan Africa, adolescent girls and young women (AGYW; ages 15-24) face the dual threats of unintended pregnancy and HIV, but struggle to access critical preventive health services, such as HIV testing and contraception. As discreet and convenient access points, private sector drug shops have the potential to amplify access among AGYW, as demonstrated by our R34 pilot of our Malkia Klabu (“Queen Club”) intervention in Tanzania, a loyalty program that creates AGYW-friendly drug shops where AGYW can access contraception and HIV prevention services. While our pilot showed great potential for Malkia Kalbu to increase AGYW demand for such services at drug shops, shopkeepers were reluctant to continue service provision to AGYW beyond the study period. AGYW products were perceived to yield low profits, despite shopkeepers recognizing the benefit of increased AGYW patronage and expressing desires to support broader community health in their role as first point of care. Thus, private providers need additional motivation to independently support service provision to AGYW, even when consumer demand is high. Building on our planned cluster-randomized control trial (CRCT) our Malkia Klabu AGYW program in Tanzania (R01MH12451601), we proposed to pilot-test 2 strategies that bolster shopkeepers’ motivations to distribute AGYW SRH products: (1) privately giving AGYW customer feedback to shopkeepers to leverage prosocial motivation, and; (2) publicly giving AGYW customer feedback with peer comparisons to leverage social image motivations. Based on insights from behavioral economics (BE) and the mixed-methods results from our pilot, our novel interventions aim to harness shopkeepers’ intrinsic prosocial motivation towards AGYW and tendency to compare themselves with their peers. We hypothesize that providing customer feedback from AGYW to socially-motivated shopkeepers will encourage distribution of contraception and HIVST, especially when feedback is publicly displayed. To that end, we have designed a mixed-methods R03 study that leverages the research infrastructure and implementation from our parent R01 CRCT. Our proposed study will assess the effect of these strategies on shopkeepers’ distribution of HIVST and contraceptives to AGYW (Aim 1), and use mixed-methods to understand shopkeepers’ experiences and assess to what extent treatment mechanisms through prosocial motivation and social image theory drive behavior change (Aim 2). Specifically, we will cross-randomize the initial condition (i.e., No Feedback, Private Feedback, and Public Feedback) across the parent R01 CRCT’s 120 enrolled drug shops, with progressive phase-in of additional intervention conditions for each group over 18 months. If feasible and with preliminary evidence of effectiveness, we will develop our enhanced Malkia Klabu program for a future R01 sustainability study. Our study’s focus on increasing AGYW’s access to contraception matches the Population Dynamics Branch’s research priorities.

概括 在撒哈拉以南非洲，青春期女孩和年轻妇女（AGYW； 15-24岁）面临着双重威胁 意外怀孕和艾滋病毒，但努力获得关键的预防卫生服务，例如艾滋病毒测试 和避孕。作为谨慎和方便的访问点，私营部门药店有可能 如我们的Malkia Klabu（“ Queen Club”）的R34飞行员所展示的AGYW之间的访问 干预坦桑尼亚，这是一项忠诚计划，创建了AGYW友好的药店，AGYW可以访问 避孕和艾滋病毒预防服务。虽然我们的飞行员对马尔基亚·卡尔布（Malkia Kalbu）有很大的潜力增加 在药店对此类服务的AGYW需求，店主不愿继续提供服务 超越研究期。人们认为AGYW产品可产生低利润，Dospite店主 认识到增加AGYW赞助和表达支持广播公司社区的愿望的好处 健康的角色是第一点护理。那就是私人提供者需要额外的动力才能独立 即使消费者需求很高，也为AGYW提供支持。 在我们计划的集群随机控制试验（CRCT）的基础上，我们在坦桑尼亚的Malkia Klabu Agyw计划 （R01MH12451601），我们提出了提高店主分发动机的试点测试的2种策略 AGYW SRH产品：（1）私下向店主提供AGYW客户反馈以利用亲社会 动力，并且； （2）公开提供AGYW客户反馈，并进行同行比较以利用社交形象 动机。基于行为经济学（BE）的见解，以及我们的飞行员的混合方法， 我们的新颖干预措施旨在利用店主对Agyw和Agyw和 倾向于将自己与同龄人进行比较。我们假设从 与社会动机的店主一起，将鼓励分发避孕和HIVST，尤其是 公开显示反馈时。 为此，我们设计了一项混合方法R03研究，该研究利用了研究基础设施和 来自我们父母R01 CRCT的实现。我们提出的研究将评估这些策略对 店主将HIVST和避孕药分配给AGYW（AIM 1），并使用混合方法 了解店主的经验和评估在多大程度上通过亲社会的治疗机制 动机和社会形象理论推动行为改变（目标2）。具体来说，我们将交叉跨助手 母公司R01 CRCT的初始条件（即没有反馈，私人反馈和公共反馈） 120个注册的药店，每组有18个以上的额外干预条件的渐进阶段 月份。如果可行并有了有效性的初步证据，我们将开发增强的Malkia Klabu 未来R01可持续性研究的计划。我们的研究专注于增加AGYW的违规访问权限 与人口动态分支的研究重点相匹配。