Mistri Preethi, Tomescu Silviu, Bokolo Simamkele, De Nooy Alexandra, Pisa Pedro T, Grove Skye, Schmucker Laura, Chetty-Makkan Candice, Long Lawrence, Buttenheim Alison, Maughan-Brown Brendan
Faculty of Health Sciences, Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa.
Right to Care, Department of Strategic Information, Centurion, South Africa.
J Acquir Immune Defic Syndr. 2024 Dec 1;97(4):371-378. doi: 10.1097/QAI.0000000000003504.
While voluntary medical male circumcision (VMMC) reduces the risk of HIV transmission by 60%, circumcision coverage falls short of the UNAIDS 90% VMMC target. We investigated whether behaviorally informed message framing increased demand for VMMC.
Adult users of the MoyaApp, a data-free application in South Africa, who viewed a form designed to generate interest in VMMC from August 2022 to November 2022.
A quasi-experimental study was conducted to evaluate 4 MoyaApp VMMC intervention forms against the standard-of-care (SOC) form. All forms enabled users to provide contact details for follow-up engagement by a call center. The primary outcome was the proportion of forms submitted. Secondary outcomes included successful contact with the user, VMMC bookings/referrals, and confirmed circumcision. Multivariable ordinary least-squares regression was used for the analysis.
Of 118,337 MoyaApp VMMC form viewers, 6% submitted a form. foot-in-the-door form viewers were more likely (+1.3 percentage points, P < 0.01) to submit a form compared with the SOC group (6.3%). Active Choice (-1.1 percentage points, P < 0.01) and Reserved for You (-0.05 percentage points, P < 0.05) form viewers were less likely to submit a form compared with SOC form. Users submitting the foot-in-the-door form were less likely to be booked/referred compared with those using the SOC form (-5 percentage points, P < 0.05). There were no differences between the intervention and SOC forms for successful contact and circumcisions.
Message framing using behavioral insights was able to nudge men to engage with VMMC services. However, more work is needed to understand how to convert initial interest into bookings and circumcisions.
虽然自愿男性医学包皮环切术（VMMC）可将艾滋病毒传播风险降低60%，但包皮环切术的覆盖率未达到联合国艾滋病规划署90%的VMMC目标。我们调查了基于行为学的信息框架是否能增加对VMMC的需求。
MoyaApp的成年用户，这是一款在南非的免数据应用程序，他们在2022年8月至2022年11月期间查看了一份旨在激发对VMMC兴趣的表格。
进行了一项准实验研究，以评估4种MoyaApp VMMC干预表格与标准护理（SOC）表格的效果。所有表格都允许用户提供联系方式，以便呼叫中心进行后续跟进。主要结果是提交表格的比例。次要结果包括与用户的成功联系、VMMC预约/转诊以及确认的包皮环切术。分析采用多变量普通最小二乘法回归。
在118337名MoyaApp VMMC表格查看者中，6%的人提交了表格。与SOC组（6.3%）相比，“登门槛”表格查看者提交表格的可能性更高（增加1.3个百分点，P<0.01）。与SOC表格相比，“主动选择”（减少1.1个百分点，P<0.01）和“为您保留”（减少0.05个百分点，P<0.05）表格查看者提交表格的可能性更低。与使用SOC表格的用户相比，提交“登门槛”表格的用户被预约/转诊的可能性更低（减少5个百分点，P<0.05）。在成功联系和包皮环切术方面，干预表格和SOC表格之间没有差异。
利用行为洞察的信息框架能够促使男性参与VMMC服务。然而，需要开展更多工作来了解如何将最初的兴趣转化为预约和包皮环切术。
