规划提示以促进乌干达农村地区男性接受艾滋病毒服务:一项随机试验。

Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda.

机构信息

Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Data Science to Patient Value, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

BMJ Glob Health. 2020 Nov;5(11). doi: 10.1136/bmjgh-2020-003390.

Abstract

INTRODUCTION

Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.

METHODS

We randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.

RESULTS

Among 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI -1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI -2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8 percentage-point increase; 95% CI -2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.

CONCLUSION

These findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.

摘要

引言

受行为经济学启发的干预措施,如计划提示,有可能以最小或无成本增加艾滋病毒检测。 此前尚未对计划提示进行过艾滋病毒检测的评估。 我们进行了一项随机临床试验,以评估低成本计划提示在促进男性艾滋病毒检测方面的有效性。

方法

我们将乌干达农村教区的成年男性随机分为两组,一组收到日历计划提示,使他们有机会在社区卫生运动中计划进行艾滋病毒检测;另一组则收到显示社区卫生运动日期的日历(对照组)或显示日期并提示他们选择参加时间的日历(计划提示组)。参与者无需选择日期和时间,也无需与研究人员分享他们的选择。主要结局是在社区卫生运动中进行艾滋病毒检测的人数。

结果

在 2362 名参与者中,有 1796 名(76%)接受了艾滋病毒检测。与对照组相比,接受计划提示的男性接受检测的可能性高 2.2 个百分点,但差异无统计学意义(77.1%对 74.9%;95%CI-1.2 至 5.7 个百分点,p=0.20)。该计划提示在活动前 40 天内登记的男性中效果更显著(检测率增加 3.6 个百分点;95%CI-2.9 至 10.1,p=0.27),而在活动前 40 天以上登记的男性中效果不明显(检测率增加 1.8 个百分点;95%CI-2.3 至 5.8,p=0.39),但亚组内的效果并不显著。

结论

这些发现表明,计划提示可能是一种以最小或无成本促进艾滋病毒检测的有效行为干预措施。大规模研究应进一步评估此类干预措施的影响和成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2788/7705572/c30118da3424/bmjgh-2020-003390f01.jpg

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