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

基本信息

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
项目类别：
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&apos 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

项目摘要

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地区，少女和年轻女性（AGYW；15-24 岁）面临着双重威胁意外怀孕和艾滋病毒，但难以获得重要的预防性卫生服务，例如艾滋病毒检测作为谨慎和方便的获取点，私营药店有潜力提供服务。扩大 AGYW 之间的访问，正如我们的 Malkia Klabu（“女王俱乐部”）的 R34 飞行员所证明的那样在坦桑尼亚进行干预，这是一项忠诚度计划，旨在创建 AGYW 友好的药店，AGYW 可以进入这些药店我们的试点显示 Malkia Kalbu 具有增加避孕和艾滋病毒预防服务的巨大潜力。 AGYW 要求药店提供此类服务，但店主不愿意继续向尽管店主认为 AGYW 产品的利润较低，但研究期过后。认识到增加 AGYW 赞助的好处并表达支持更广泛社区的愿望因此，私人医疗服务提供者需要额外的动力来独立进行。即使消费者需求很高，也支持向 AGYW 提供服务。基于我们计划的整群随机对照试验 (CRCT)，我们在坦桑尼亚开展了 Malkia Klabu AGYW 项目（R01MH12451601），我们建议试点2种增强店主分销动机的策略 AGYW SRH 产品：(1) 私下向店主提供 AGYW 客户反馈，以利用亲社会动机；(2) 公开提供 AGYW 客户反馈并进行同行比较，以利用社会形象基于行为经济学 (BE) 的见解和我们试点的混合方法结果，我们新颖的干预措施旨在利用店主对 AGYW 的内在亲社会动机我们倾向于将自己与同行进行比较，但我们很难提供客户反馈。 AGYW 面向具有社会动机的店主，将鼓励分发避孕药具和 HIVST，特别是当公开显示反馈时。为此，我们设计了一项混合方法 R03 研究，利用研究基础设施和我们提议的研究将评估这些策略对我们母公司 R01 CRCT 的实施。店主向 AGYW 分发 HIVST 和避孕药具（目标 1），并使用混合方法店主的经验并评估在多大程度上通过亲社会治疗机制具体来说，动机和社会形象理论驱动行为改变（目标 2）。父 R01 CRCT 的初始条件（即无反馈、私人反馈和公共反馈） 120 家药店参与其中，并逐步为 18 岁以上的每组提供额外的干预条件如果可行并且有初步的有效性证据，我们将开发增强型 Malkia Klabu。未来 R01 可持续性研究计划的重点是增加 AGYW 获得避孕措施的机会。符合人口动态分支的研究重点。