Effectiveness of Financial Incentives and Text Messages to Improve Health Care in Population With Moderate and High Cardiovascular Risk
Effectiveness of Financial Incentives and Text Messages to Improve Health Care of Vulnerable Population With Moderate and High Cardiovascular Risk in Argentina: A Randomized Cluster Trial
Cardiovascular diseases are increasing throughout the developing world and are the cause of almost 16.7 million deaths each year, of which 80% occur in low and middle-income countries. As more than three fourth of the global burden of cardiometabolic diseases are related to risk factors connected with lifestyles or behaviors, such as smoking, unhealthy eating, low physical activity, and harmful consumption of alcohol. This burden could be dramatically reduced by changing individual behaviors. This study is focused on interventions that are aimed to improve the adherence to treatment in cardiovascular disease (hypertension), based on a Behavioral Economics approach. Most of public policies targeted to tackle NCDs utilize a rational economic model of behavior. Behavioral economics, by using insights from cognitive psychology and other social sciences, has drawn a lot of attention for its potential to increase healthy behaviors. Interventions informed by BE principles seek to rearrange the social or physical environment in such a way to 'nudge' people towards healthier choices and behaviors.
Main objective: to assess whether the implementation of two strategies based on behavioral economics, that include the use of a financial incentive scheme and specific framing to beneficiaries (i.e. mobile health interventions), increase the referral, evaluation and follow-up of people with moderate and high cardiovascular risk in the public health network, compared to the usual strategy.
Design: A cluster-randomized pragmatic clinical trial will be performed. The randomization unit will be the Community Health Centers (CHC) and the intervention groups (2 arms) or control will be assigned to 9 health centers in total (3 CHC per arm).
Population: This RCT is going to be conducted in selected CHC of Salta. Nine CHC will be selected, which will be randomized: 3 centers to the control, 3 centers to framing intervention with messages and 3 centers to the intervention with incentives.
A total of 900 patients ≥ 40 years, without health coverage and with a 10-year cardiovascular risk ≥ 10% will participate in this study.
Follow up: 3 month
調査の概要
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Salta
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Guemes、Salta、アルゼンチン、4400
- 1º DE MAYO
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Guemes、Salta、アルゼンチン、4400
- Barrio Cooperativa
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Guemes、Salta、アルゼンチン、4400
- Barrio La Tablada
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Guemes、Salta、アルゼンチン、4400
- Campo Santo
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Guemes、Salta、アルゼンチン、4400
- CIC
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Guemes、Salta、アルゼンチン、4400
- EL BORDO
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Guemes、Salta、アルゼンチン、4400
- El cruce
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Guemes、Salta、アルゼンチン、4400
- Villa Tranquila
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Güemes、Salta、アルゼンチン、4400
- Los Olivos
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Subjects that only have public health coverage.
- Residence in the area of influence of the health centers of the study.
- Have a mobile phone for personal use.
- 10 year cardiovascular risk ≥ 10%
Exclusion Criteria:
- Pregnant women.
- Immobilized people.
- Persons who do not give their informed consent.
- People planning to move in the next 3 months
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：防止
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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介入なし：普段のお手入れ
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|
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実験的：Financial incentives
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The study nurses will schedule an appointment with the doctor at the health center, within 4 weeks from the participant's inclusion in the study.
Participants who attend the first visit at the health center will receive a direct incentive consisting of the payment of a limited amount to be determined (approximately AR $ 150-200) through a shopping voucher for the amount mentioned.
Participants attending the follow-up visit at the health center within 3 months from their inclusion in the study will participate in a lottery.
The lottery will offer the possibility of winning a new voucher with a probability of 1 in 3. Participants who do not attend the health center will not receive any incentive.
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実験的：Framing (SMS)
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After inclusion, participants will receive weekly text messages (SMS) using a specific framing or formulation of the message, highlighting the potential benefits and positive aspects of health care.
These messages will promote follow-up visits, adherence to treatment, and benefits to be gained from a follow-up visit with the physician.
Messages will be sent with a frequency of two per week during the first 30 days and then 1 per week until the end of the follow-up.
These messages will have no cost to participants.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Attendance at the first medical visit
時間枠：4 weeks
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Proportion of patients who attended and completed the first clinical visit to the health center
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4 weeks
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Attendance at the second medical visit
時間枠：8 weeks after first medical visit
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Proportion of patients who attended and completed the second clinical visit to the health center
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8 weeks after first medical visit
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Attendance at least one clinical visit
時間枠：12 weeks
|
Proportion of patients who attended and completed at least one clinical visit to the health
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12 weeks
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- AR-T1087-P0001/2
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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Moderate and High Cardiovascular Riskの臨床試験
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Institute of Hematology & Blood Diseases Hospital...Hebei Taihe Chunyu Biotechnology Co., Ltd募集形質細胞白血病 | Ultra High Risk MM（UHR-MM）、18〜70歳、ASCTに適しています。次のUHR-MM定義のいずれかを満たします | 細胞遺伝学の超高リスク | 一次難治 | 早期進行 | 非麻痺性髄外浸潤 | R2-ISS-IV /MPSS-IV中国