Behavioural Text Messages to Improve Retention in Care in South Africa

NCT05010291 | Completed

• 1 other identifier: 210308
• Study Type: interventional
• Target: 1,541
• Locations: 1 country
• Sites: 1

Brief Summary

The proportion of South Africans aware of their HIV status and on treatment remains lower than optimal. The goal of this study is to rapidly determine whether text messages framed according to behavioural economics principles increase clinic attendance among recipients of care on antiretroviral therapy in South Africa. We hypothesize that messages incorporating behavioural economics principles will increase the likelihood of recipients of care attending clinic appointments and returning within 28 days of a missed appointment.

Conditions

HIV/AIDS

Keywords

Behavioral sciences; Retention in care

Outcome Measures

Primary Outcomes (2)

• Appointment reminders

  Proportion of clients with schedule clinic visit attendance, defined as the number of patients with a verified clinic on the scheduled appointment day/the total number of clients that were sent appointment reminders (stratified by study arm).

  Approximately 3-5 months

• Missed clinic appointments

  Proportion of patients with a verified clinic visit within 28 days of missing a scheduled clinic appointment defined as the number of patients with a verified clinic within 28 days of missing a scheduled clinic appointment/the total number of clients that Tracers sent text messages following a missed clinic appointment.

  Approximately 3-5 months

Study Arms (4)

Standard of Care (SOC) messaging

EXPERIMENTAL

Participants randomized into this arm will receive standard voice call reminders + the Standard of Care (SOC) text message reminders. The study team will send these one-way text messages to recipients of care as a reminder 1) approximately 3-7 days in advance of a clinic appointment, or 2) to follow-up approximately 24 hours after a missed clinic appointment. These text messages will include the SOC text

Behavioral: Standard of Care (SOC) text message reminder to attend clinic appointment

Loss aversion messaging

EXPERIMENTAL

Participants randomized into this arm will receive standard voice call reminders + loss aversion text message reminders. The study team will send these one-way text messages to recipients of care as a reminder 1) approximately 3-7 days in advance of a clinic appointment, or 2) to follow-up approximately 24 hours after a missed clinic appointment. These text messages will include loss aversion framing.

Behavioral: Loss aversion framed text message reminder to attend clinic appointment

Social norms messaging

EXPERIMENTAL

Participants randomized into this arm will receive standard voice call reminders + social norms text message reminders. The study team will send these one-way text messages to recipients of care as a reminder 1) approximately 3-7 days in advance of a clinic appointment, or 2) to follow-up approximately 24 hours after a missed clinic appointment. These text messages will include social norms framing.

Behavioral: Social norms framed text message reminder to attend clinic appointment

Altruism messaging

EXPERIMENTAL

Participants randomized into this arm will receive standard voice call reminders + altruism text message reminders. The study team will send these one-way text messages to recipients of care as a reminder 1) approximately 3-7 days in advance of a clinic appointment, or 2) to follow-up approximately 24 hours after a missed clinic appointment. These text messages will include altruism framing.

Behavioral: Altruism framed text message reminder to attend clinic appointment

Interventions

Standard of Care (SOC) text message reminder to attend clinic appointment BEHAVIORAL

SOC one-way text message reminding recipient of care to either 1) attend a scheduled clinic appointment or 2) visit the clinic after a missed appointment.

Standard of Care (SOC) messaging

Loss aversion framed text message reminder to attend clinic appointment BEHAVIORAL

Loss aversion framed one-way text message reminding recipient of care to either 1) attend a scheduled clinic appointment or 2) visit the clinic after a missed appointment.

Loss aversion messaging

Social norms framed text message reminder to attend clinic appointment BEHAVIORAL

Social norms framed one-way text message reminding recipient of care to either 1) attend a scheduled clinic appointment or 2) visit the clinic after a missed appointment.

Social norms messaging

Altruism framed text message reminder to attend clinic appointment BEHAVIORAL

Altruism framed one-way text message reminding recipient of care to either 1) attend a scheduled clinic appointment or 2) visit the clinic after a missed appointment.

Altruism messaging

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Registered to receive ART (this includes patients receiving ART through multi-month scripting) at selected study sites.
• Aged ≥18 years.
• Have a documented cell phone number in their clinic records
• Are eligible to receive appointment reminders as part of routine care OR eligible to receive follow-up text messages as part of routine care for missed clinic appointments.

You may not qualify if:

• Do not have contact details in their clinic records.
• Have contact details on record that are established to belong to someone else upon follow-up (i.e., wrong number).
• Have contact details that are deactivated/non-functional (i.e., voice notification that the number does not exist).
• Are documented to have self-transferred out of the clinic.
• Are known to have been deceased.

Sponsors & Collaborators

• University of Pennsylvania: lead
• University of Witwatersrand, South Africa: collaborator
• Aurum Institute: collaborator

Study Sites (1)

Aurum Institute

Johannesburg, Gauteng, 2194, South Africa

Location

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

HIV Infections; Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Slow Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Officials

• Tonderai Mabuto, PhD

  Aurum Institute

  PRINCIPAL INVESTIGATOR

• Harsha Thirumurthy, PhD

  University of Pennsylvania

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 10, 2021
• First Posted: August 18, 2021
• Study Start: August 5, 2021
• Primary Completion: December 7, 2021
• Study Completion: December 7, 2021
• Last Updated: July 20, 2022

Record last verified: 2022-07

Locations

ZA (1)