A behavioral design approach to improving a Chagas disease vector control campaign in Peru.

Autor: Buttenheim AM; Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Boulevard, 416 Fagin Hall, Philadelphia, PA, 19104, USA. abutt@nursing.upenn.edu., Levy MZ; Department of Biostatistics, Epidemiology, and Informatics, Perleman School of Medicine of the University of Pennsylvana, Philadelphia, PA, USA., Castillo-Neyra R; Department of Biostatistics, Epidemiology, and Informatics, Perleman School of Medicine of the University of Pennsylvana, Philadelphia, PA, USA., McGuire M; Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.; Chagas Disease Working Group, Arequipa, Peru., Toledo Vizcarra AM; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru., Mollesaca Riveros LM; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru., Meza J; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru., Borrini-Mayori K; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru., Naquira C; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru., Behrman J; Department of Economics, University of Pennsylvania, Philadelphia, PA, USA., Paz-Soldan VA; Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2019 Sep 18; Vol. 19 (1), pp. 1272. Date of Electronic Publication: 2019 Sep 18.
DOI: 10.1186/s12889-019-7525-3
Abstrakt: Background: Individual behavior change is a critical ingredient in efforts to improve global health. Central to the focus on behavior has been a growing understanding of how the human brain makes decisions, from motivations and mindsets to unconscious biases and cognitive shortcuts. Recent work in the field of behavioral economics and related fields has contributed to a rich menu of insights and principles that can be engineered into global health programs to increase impact and reach. However, there is little research on the process of designing and testing interventions informed by behavioral insights.
Methods: In a study focused on increasing household participation in a Chagas disease vector control campaign in Arequipa, Peru, we applied Datta and Mullainathan's "behavioral design" approach to formulate and test specific interventions. In this Technical Advance article we describe the behavioral design approach in detail, including the Define, Diagnosis, Design, and Test phases. We also show how the interventions designed through the behavioral design process were adapted for a pragmatic randomized controlled field trial.
Results: The behavioral design framework provided a systematic methodology for defining the behavior of interest, diagnosing reasons for household reluctance or refusal to participate, designing interventions to address actionable bottlenecks, and then testing those interventions in a rigorous counterfactual context. Behavioral design offered us a broader range of strategies and approaches than are typically used in vector control campaigns.
Conclusions: Careful attention to how behavioral design may affect internal and external validity of evaluations and the scalability of interventions is needed going forward. We recommend behavioral design as a useful complement to other intervention design and evaluation approaches in global health programs.
Databáze: MEDLINE
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