The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial
BACKGROUND:Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2016-10, Vol.72 Suppl 4 (4), p.S299-S305 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
| container_volume | 72 Suppl 4 |
| creator | Thirumurthy, Harsha Masters, Samuel H Rao, Samwel Murray, Kate Prasad, Ram Zivin, Joshua G Omanga, Eunice Agot, Kawango |
| description | BACKGROUND:Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery-based rewards can increase male circumcision uptake in Kenya.
METHODS:Uncircumcised men aged 21–39 years were randomized in 1:1:1 ratio to 2 intervention groups or a control group. One intervention group was offered compensation of US $12.50 conditional on circumcision uptake. Compensation was provided in the form of food vouchers. A second intervention group was offered the opportunity to participate in a lottery with high-value prizes on undergoing circumcision. The primary outcome was circumcision uptake within 3 months.
RESULTS:Among 903 participants enrolled, the group that received compensation of US $12.50 had the highest circumcision uptake (8.4%, 26/308), followed by the lottery-based rewards group (3.3%, 10/302), and the control group (1.3%, 4/299). Logistic regression analysis showed that compared with the control group, the fixed compensation group had significantly higher circumcision uptake [adjusted odds ratio 7.1; 95% CI2.4 to 20.8]. The lottery-based rewards group did not have significantly higher circumcision uptake than the control group (adjusted odds ratio 2.5; 95% CI0.8 to 8.1).
CONCLUSIONS:Providing compensation was effective in increasing circumcision uptake among men over a short period. The results are consistent with studies showing that such interventions can modify health behaviors by addressing economic barriers and behavioral biases in decision making. Contrary to findings from studies of other health behaviors, lottery-based rewards did not significantly increase circumcision uptake.
TRIAL REGISTRATION:Registry for International Development Impact EvaluationsRIDIE-STUDY-ID-530e60df56107. |
| doi_str_mv | 10.1097/QAI.0000000000001045 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5054965</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4229511101</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5187-bad9a73bfbfd03a202157eff3696fe26cd3e473557916c41646168b650b87be63</originalsourceid><addsrcrecordid>eNpdkt9OFDEUhydGI4i-gTFNvB7s_854YbJuQIlLVLJcN52ZU7Yw0y7tDOvyBry13YCI9qZNzu98Pc3XonhL8CHBtfrwc3ZyiJ8sgrl4VuyTmvNSVRV_ns-CipITJvaKVyld5ozkvH5Z7FHFMceE7hd3yxWgI2uhHRMKFv2I4cZ1zl-gY_cLOjQPwxp8MqMLHhnfoUUYR4jb8rNJuXwGGxO73OnR-Xo0V7BjnELnWtOjU9MDmrvYTkPr0g7gPPoGfms-ohk6y7QwuNtMWUZn-tfFC2v6BG8e9oPi_PhoOf9aLr5_OZnPFmUrSKXKxnS1Uayxje0wMxRTIhRYy2QtLVDZdgy4YkKomsiW5xdLIqtGCtxUqgHJDopP99z11AzQteDHaHq9jm4wcauDcfrfincrfRFutMCC11JkwPsHQAzXE6RRX4Yp-jyzJhWjFeEC45zi96k2hpQi2McbCNY7gToL1P8LzG3vnk732PTH2F_uJvRZRLrqpw1EvQLTj6vMI1QyxkuaXeMqf4Byh1bsN-wqprg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1832814500</pqid></control><display><type>article</type><title>The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial</title><source>MEDLINE</source><source>Journals@Ovid LWW Legacy Archive</source><source>Journals@Ovid Complete</source><source>Free E- Journals</source><creator>Thirumurthy, Harsha ; Masters, Samuel H ; Rao, Samwel ; Murray, Kate ; Prasad, Ram ; Zivin, Joshua G ; Omanga, Eunice ; Agot, Kawango</creator><creatorcontrib>Thirumurthy, Harsha ; Masters, Samuel H ; Rao, Samwel ; Murray, Kate ; Prasad, Ram ; Zivin, Joshua G ; Omanga, Eunice ; Agot, Kawango</creatorcontrib><description>BACKGROUND:Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery-based rewards can increase male circumcision uptake in Kenya.
METHODS:Uncircumcised men aged 21–39 years were randomized in 1:1:1 ratio to 2 intervention groups or a control group. One intervention group was offered compensation of US $12.50 conditional on circumcision uptake. Compensation was provided in the form of food vouchers. A second intervention group was offered the opportunity to participate in a lottery with high-value prizes on undergoing circumcision. The primary outcome was circumcision uptake within 3 months.
RESULTS:Among 903 participants enrolled, the group that received compensation of US $12.50 had the highest circumcision uptake (8.4%, 26/308), followed by the lottery-based rewards group (3.3%, 10/302), and the control group (1.3%, 4/299). Logistic regression analysis showed that compared with the control group, the fixed compensation group had significantly higher circumcision uptake [adjusted odds ratio 7.1; 95% CI2.4 to 20.8]. The lottery-based rewards group did not have significantly higher circumcision uptake than the control group (adjusted odds ratio 2.5; 95% CI0.8 to 8.1).
CONCLUSIONS:Providing compensation was effective in increasing circumcision uptake among men over a short period. The results are consistent with studies showing that such interventions can modify health behaviors by addressing economic barriers and behavioral biases in decision making. Contrary to findings from studies of other health behaviors, lottery-based rewards did not significantly increase circumcision uptake.
TRIAL REGISTRATION:Registry for International Development Impact EvaluationsRIDIE-STUDY-ID-530e60df56107.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0000000000001045</identifier><identifier>PMID: 27404012</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Circumcision ; Circumcision, Male - statistics & numerical data ; Clinical trials ; Compensation ; Compensation and Redress ; Effects ; Humans ; Kenya ; Lotteries ; Male ; Reward ; Rewards ; Supplement ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2016-10, Vol.72 Suppl 4 (4), p.S299-S305</ispartof><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Oct 1, 2016</rights><rights>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5187-bad9a73bfbfd03a202157eff3696fe26cd3e473557916c41646168b650b87be63</citedby><cites>FETCH-LOGICAL-c5187-bad9a73bfbfd03a202157eff3696fe26cd3e473557916c41646168b650b87be63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-201608152-00007$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>230,314,777,781,882,4595,27905,27906,65212</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27404012$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thirumurthy, Harsha</creatorcontrib><creatorcontrib>Masters, Samuel H</creatorcontrib><creatorcontrib>Rao, Samwel</creatorcontrib><creatorcontrib>Murray, Kate</creatorcontrib><creatorcontrib>Prasad, Ram</creatorcontrib><creatorcontrib>Zivin, Joshua G</creatorcontrib><creatorcontrib>Omanga, Eunice</creatorcontrib><creatorcontrib>Agot, Kawango</creatorcontrib><title>The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>BACKGROUND:Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery-based rewards can increase male circumcision uptake in Kenya.
METHODS:Uncircumcised men aged 21–39 years were randomized in 1:1:1 ratio to 2 intervention groups or a control group. One intervention group was offered compensation of US $12.50 conditional on circumcision uptake. Compensation was provided in the form of food vouchers. A second intervention group was offered the opportunity to participate in a lottery with high-value prizes on undergoing circumcision. The primary outcome was circumcision uptake within 3 months.
RESULTS:Among 903 participants enrolled, the group that received compensation of US $12.50 had the highest circumcision uptake (8.4%, 26/308), followed by the lottery-based rewards group (3.3%, 10/302), and the control group (1.3%, 4/299). Logistic regression analysis showed that compared with the control group, the fixed compensation group had significantly higher circumcision uptake [adjusted odds ratio 7.1; 95% CI2.4 to 20.8]. The lottery-based rewards group did not have significantly higher circumcision uptake than the control group (adjusted odds ratio 2.5; 95% CI0.8 to 8.1).
CONCLUSIONS:Providing compensation was effective in increasing circumcision uptake among men over a short period. The results are consistent with studies showing that such interventions can modify health behaviors by addressing economic barriers and behavioral biases in decision making. Contrary to findings from studies of other health behaviors, lottery-based rewards did not significantly increase circumcision uptake.
TRIAL REGISTRATION:Registry for International Development Impact EvaluationsRIDIE-STUDY-ID-530e60df56107.</description><subject>Adult</subject><subject>Circumcision</subject><subject>Circumcision, Male - statistics & numerical data</subject><subject>Clinical trials</subject><subject>Compensation</subject><subject>Compensation and Redress</subject><subject>Effects</subject><subject>Humans</subject><subject>Kenya</subject><subject>Lotteries</subject><subject>Male</subject><subject>Reward</subject><subject>Rewards</subject><subject>Supplement</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkt9OFDEUhydGI4i-gTFNvB7s_854YbJuQIlLVLJcN52ZU7Yw0y7tDOvyBry13YCI9qZNzu98Pc3XonhL8CHBtfrwc3ZyiJ8sgrl4VuyTmvNSVRV_ns-CipITJvaKVyld5ozkvH5Z7FHFMceE7hd3yxWgI2uhHRMKFv2I4cZ1zl-gY_cLOjQPwxp8MqMLHhnfoUUYR4jb8rNJuXwGGxO73OnR-Xo0V7BjnELnWtOjU9MDmrvYTkPr0g7gPPoGfms-ohk6y7QwuNtMWUZn-tfFC2v6BG8e9oPi_PhoOf9aLr5_OZnPFmUrSKXKxnS1Uayxje0wMxRTIhRYy2QtLVDZdgy4YkKomsiW5xdLIqtGCtxUqgHJDopP99z11AzQteDHaHq9jm4wcauDcfrfincrfRFutMCC11JkwPsHQAzXE6RRX4Yp-jyzJhWjFeEC45zi96k2hpQi2McbCNY7gToL1P8LzG3vnk732PTH2F_uJvRZRLrqpw1EvQLTj6vMI1QyxkuaXeMqf4Byh1bsN-wqprg</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Thirumurthy, Harsha</creator><creator>Masters, Samuel H</creator><creator>Rao, Samwel</creator><creator>Murray, Kate</creator><creator>Prasad, Ram</creator><creator>Zivin, Joshua G</creator><creator>Omanga, Eunice</creator><creator>Agot, Kawango</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><general>JAIDS Journal of Acquired Immune Deficiency Syndromes</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>5PM</scope></search><sort><creationdate>20161001</creationdate><title>The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial</title><author>Thirumurthy, Harsha ; Masters, Samuel H ; Rao, Samwel ; Murray, Kate ; Prasad, Ram ; Zivin, Joshua G ; Omanga, Eunice ; Agot, Kawango</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5187-bad9a73bfbfd03a202157eff3696fe26cd3e473557916c41646168b650b87be63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Circumcision</topic><topic>Circumcision, Male - statistics & numerical data</topic><topic>Clinical trials</topic><topic>Compensation</topic><topic>Compensation and Redress</topic><topic>Effects</topic><topic>Humans</topic><topic>Kenya</topic><topic>Lotteries</topic><topic>Male</topic><topic>Reward</topic><topic>Rewards</topic><topic>Supplement</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thirumurthy, Harsha</creatorcontrib><creatorcontrib>Masters, Samuel H</creatorcontrib><creatorcontrib>Rao, Samwel</creatorcontrib><creatorcontrib>Murray, Kate</creatorcontrib><creatorcontrib>Prasad, Ram</creatorcontrib><creatorcontrib>Zivin, Joshua G</creatorcontrib><creatorcontrib>Omanga, Eunice</creatorcontrib><creatorcontrib>Agot, Kawango</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thirumurthy, Harsha</au><au>Masters, Samuel H</au><au>Rao, Samwel</au><au>Murray, Kate</au><au>Prasad, Ram</au><au>Zivin, Joshua G</au><au>Omanga, Eunice</au><au>Agot, Kawango</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>72 Suppl 4</volume><issue>4</issue><spage>S299</spage><epage>S305</epage><pages>S299-S305</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>BACKGROUND:Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery-based rewards can increase male circumcision uptake in Kenya.
METHODS:Uncircumcised men aged 21–39 years were randomized in 1:1:1 ratio to 2 intervention groups or a control group. One intervention group was offered compensation of US $12.50 conditional on circumcision uptake. Compensation was provided in the form of food vouchers. A second intervention group was offered the opportunity to participate in a lottery with high-value prizes on undergoing circumcision. The primary outcome was circumcision uptake within 3 months.
RESULTS:Among 903 participants enrolled, the group that received compensation of US $12.50 had the highest circumcision uptake (8.4%, 26/308), followed by the lottery-based rewards group (3.3%, 10/302), and the control group (1.3%, 4/299). Logistic regression analysis showed that compared with the control group, the fixed compensation group had significantly higher circumcision uptake [adjusted odds ratio 7.1; 95% CI2.4 to 20.8]. The lottery-based rewards group did not have significantly higher circumcision uptake than the control group (adjusted odds ratio 2.5; 95% CI0.8 to 8.1).
CONCLUSIONS:Providing compensation was effective in increasing circumcision uptake among men over a short period. The results are consistent with studies showing that such interventions can modify health behaviors by addressing economic barriers and behavioral biases in decision making. Contrary to findings from studies of other health behaviors, lottery-based rewards did not significantly increase circumcision uptake.
TRIAL REGISTRATION:Registry for International Development Impact EvaluationsRIDIE-STUDY-ID-530e60df56107.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>27404012</pmid><doi>10.1097/QAI.0000000000001045</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Circumcision Circumcision, Male - statistics & numerical data Clinical trials Compensation Compensation and Redress Effects Humans Kenya Lotteries Male Reward Rewards Supplement Young Adult |
| title | The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial |
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