Improving participation in vector control campaigns

描述（由申请人提供）：说服家庭采用安全、有效和低成本的干预措施来改善健康是具有挑战性的。挨家挨户的健康宣传活动曾经是美国公共卫生实践的主要内容，但现在很少使用了。在发展中国家，挨家挨户的运动对于预防疾病和传播与健康有关的产品和服务仍然至关重要。不幸的是，这类运动的参与率往往很低，降低了低成本、经过验证的干预措施的有效性。例如，目前秘鲁阿雷基帕地区恰加斯病病媒控制项目的家庭参与率较低，威胁到该地区的恰加斯病控制工作。恰加斯病是一种影响800多万人的毁灭性虫媒疾病，是美洲发病率和死亡率的主要传染原因之一。先前的研究表明，恰加斯病在阿雷基帕的贫困社区悄然流行，那里有超过5%的儿童被感染。本研究的总体目标是制定和评估新的干预措施，以增加对大型公共卫生运动的参与，例如病媒控制运动，在这些运动中，要实现健康收益需要高参与率。这些干预措施是基于行为经济学的最新发现，即常见的认知偏见和心理捷径导致人们很少采取拯救生命的措施。干预措施包括提前承诺响应式调度；邻居招聘;还有随机分组彩票。预先承诺和抽签都能对抗当前的偏见——在做决定时，人们往往会把当前的成本和收益看得比未来的成本和收益更重。邻居招募利用社会规范的力量来改变行为。本研究的目的是：(1)确定在病媒控制运动中这三种行为经济干预措施的参与率；(2)衡量行为经济干预的比较成本效益；(3)评估每种行为经济干预对参与随后的公共卫生运动的影响。这项研究具有独特的优势，既可以加强美洲的南美锥虫病控制工作，又有助于对在家庭层面上至关重要的一系列健康主题（包括臭虫控制、消防安全和中毒预防）中的行为经济学干预措施有一个普遍的了解。

DESCRIPTION (provided by applicant): Persuading households to adopt safe, effective, and low-cost interventions to improve health is challenging. Door-to-door health campaigns, once a staple of public health practice in the US, are now rarely used. In developing country settings, door-to-door campaigns remain vital for disease prevention and dissemination of health-related products and services. Unfortunately, participation rates in such campaigns are often low, diminishing the effectiveness of low-cost, proven interventions. For example, current low household participation rates in the Chagas disease vector control program in Arequipa, Peru threaten Chagas control efforts in the region. Chagas, a devastating insect-borne disease affecting than 8 million people, is one of the principal infectious causes of morbidity and mortality in the Americas. Previous work has shown a quiet epidemic of Chagas in poorer communities in Arequipa, where more than 5% of children are infected. The overarching goal of this study is to develop and evaluate new interventions to increase participation in large-scale public health campaigns, such as vector control campaigns, where high rates of participation are required to achieve health gains. The interventions are based on recent discoveries from behavioral economics about the common cognitive biases and mental shortcuts that contribute to low uptake of life-saving measures. The interventions include responsive scheduling with advance commitment; neighbor recruitment; and contingent group lotteries. Advance commitments and lotteries both counter present bias-the common tendency to heavily weight immediate costs and benefits relative to future ones when making decisions. Neighbor recruitment leverages the power of social norms to change behavior. The aims of the study are to: (1) Determine the rate of participation under these three behavioral economic interventions in a vector control campaign; (2) Measure the comparative cost- effectiveness of the behavioral economic interventions; and (3) Assess the impact of each behavioral economic intervention on participation in subsequent public health campaigns. The study is uniquely positioned to both strengthen Chagas disease control efforts in the Americas, and to contribute to a general understanding of behavioral economics interventions across a wide range of health topics where uptake at the household level is critical, including bed bug control, fire safety and poisoning prevention.