Arizona State University, 500 N 3rd Street, Phoenix, AZ 85004, United States.
Mildmay Uganda, Kampala, Uganda.
J Health Econ. 2021 May;77:102443. doi: 10.1016/j.jhealeco.2021.102443. Epub 2021 Mar 16.
Incentives are used to improve many health-related behaviors, but evidence is mixed for their effectiveness both during the incentivization period and, even more so, on the persistence of the behavior after incentives are withdrawn. In this paper, we present the results of a randomized controlled trial that successfully uses incentives to improve medication adherence among HIV-infected patients in Uganda over 20 months, and follows the sample for another 6 months to measure the persistence of these behavioral improvements. Our study contributes to the literature on habit formation by identifying a behavioral strategy that is associated with persistently high medication adherence after controlling for observable individual-level characteristics and the receipt of incentives. We find evidence supporting a psychological theory of habits as reflexive context-behavior associations, which suggests new ways of designing incentive-based interventions for better promoting persistent, healthier behaviors.
激励措施被用于改善许多与健康相关的行为，但它们在激励期间以及激励措施取消后对行为持续的有效性的证据存在分歧。在本文中，我们展示了一项随机对照试验的结果，该试验成功地使用激励措施来提高乌干达感染艾滋病毒的患者的药物依从性，并且在激励措施取消后又对该样本进行了 6 个月的随访，以衡量这些行为改善的持久性。我们的研究通过确定一种与可观察的个体特征和激励措施的获得无关的、与持续高药物依从性相关的行为策略，为习惯形成的文献做出了贡献。我们的研究结果支持习惯的心理理论，即反射性的情境-行为关联，这为基于激励的干预措施提供了新的设计思路，以更好地促进持续、更健康的行为。
