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: 10706507
• 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/10706507
• 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; Electronics; Enrollment; Ensure; Equipment and supply inventories; Exclusion; Face; Failure; Feedback; Female Adolescents; Friends; Future; Goals; Gold; HIV; Health; Health system; Heterogeneity; Human immunodeficiency virus test; Image; Intervention; Literature; Marketing; 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; 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; provider behavior; secondary endpoint; secondary outcome; self testing; service uptake; social; theories; trend; unintended pregnancy; uptake; willingness to pay; 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.

总结