RT Journal Article
SR Electronic
T1 Increasing participation in a vector control campaign: a cluster randomised controlled evaluation of behavioural economic interventions in Peru
JF BMJ Global Health
FD BMJ Publishing Group Ltd
SP e000757
DO 10.1136/bmjgh-2018-000757
VO 3
IS 5
A1 Buttenheim, Alison M
A1 Paz-Soldán, Valerie A
A1 Castillo-Neyra, Ricardo
A1 Toledo Vizcarra, Amparo M
A1 Borrini-Mayori, Katty
A1 McGuire, Molly
A1 Arevalo-Nieto, Claudia
A1 Volpp, Kevin G
A1 Small, Dylan S
A1 Behrman, Jere R
A1 Naquira-Verlarde, Cesar
A1 Levy, Michael Z
YR 2018
UL http://gh.bmj.com/content/3/5/e000757.abstract
AB Objective To assess the efficacy of strategies informed by behavioural economics for increasing participation in a vector control campaign, compared with current practice.Design Pragmatic cluster randomised controlled trial.Setting Arequipa, Peru.Participants 4922 households.Interventions Households were randomised to one of four arms: advanced planning, leader recruitment, contingent group lotteries, or control.Main outcome measures Participation (allowing the house to be sprayed with insecticide) during the vector control campaign.Results In intent-to-treat analyses, none of the interventions increased participation compared with control (advanced planning adjusted OR (aOR) 1.07 (95% CI 0.87 to 1.32); leader recruitment aOR 0.95 (95% CI 0.78 to 1.15); group lotteries aOR 1.12 (95% CI 0.89 to 1.39)). The interventions did not improve the efficiency of the campaign (additional minutes needed to spray house from generalised estimating equation regressions: advanced planning 1.08 (95% CI −1.02 to 3.17); leader recruitment 3.91 (95% CI 1.85 to 5.97); group lotteries 3.51 (95% CI 1.38 to 5.64)) nor did it increase the odds that houses would be sprayed in an earlier versus a later stage of the campaign cycle (advanced planning aOR 0.94 (95% CI 0.76 to 1.25); leader recruitment aOR 0.68 (95% CI 0.55 to 0.83); group lotteries aOR 1.19 (95% CI 0.96 to 1.47)). A post hoc analysis suggested that advanced planning increased odds of participation compared with control among households who had declined to participate previously (aOR 2.50 (95% CI 1.41 to 4.43)).Conclusions Achieving high levels of household participation is crucial for many disease prevention efforts. Our trial was not successful in improving participation compared with the existing campaign. The trial highlights persistent challenges to field experiments as well as lessons about the intervention design process, particularly understanding barriers to participation through a behavioural lens.Trial registration number American Economic Association AEARCTR-0000620.