Prize-linked Savings Initiatives for Promoting Better Health and Economic Outcomes in Kenya

HIV/AIDS Clinical Trial

Official title:

Prize-linked Savings Initiatives for Promoting Better Health and Economic Outcomes in Kenya

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04013295
• Other study ID #: 830084
• Status: Completed
• Phase: N/A
• Start date: September 3, 2018
• Est. completion date: December 18, 2018

Study information

• Verified date: April 2023
• Source: University of Pennsylvania
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Transactional sex is widely believed to be among the driving factors for the high HIV rates among adolescent girls and young women in Kenya. We will pilot a randomized trial among men in Kenya to assess whether prize-linked savings opportunities reduce spending on transactional sex. The project will randomize men to the savings intervention and assess changes in key economic and self-reported health outcomes over a 3-6 month period.

Description:

Despite a large decline in new adult HIV infections in eastern and southern Africa from 2005-2015, progress has slowed in recent years. In particular, HIV risk among adolescent girls and young women remains high. Transactional sex, or the exchange of material support in non-commercial sexual relationships, is widely believed to be among the main driving factors for the HIV risk in this population. There is a large gap when it comes to interventions targeting men who engage in transactional sex. The proposed pilot project seeks to fill this important gap by using behavioral economic principles to promote behavior change among men.

The project will assess a novel prize-linked savings intervention designed to shift men's income away from alcohol and transactional sex and towards saving for the future. Prize-linked savings accounts offer savers a random, lottery-like payout proportional to the amount participants save, instead of traditional interest income. A number of banks, employers, and policymakers have promoted this low-cost, scalable approach to increasing savings among low-income individuals. However, there have been no assessments of whether prize-linked savings interventions can induce changes in key health-related behaviors as well. We will conduct a pilot randomized trial among men in Kenya to assess whether offering prize-linked savings opportunities leads to reduced spending on alcohol and transactional sex. The project will enroll men who in communities with high HIV risk, randomize them to the savings intervention, and assess changes in key economic and self-reported health outcomes over a 3-month period with baseline and follow-up surveys. We hypothesize that men randomized to the prize-linked savings intervention will have higher savings, lower expenditure on transactional sex, alcohol, and gambling, and lower rates of participation in risk behaviors such as transactional sex, relative to men randomized to the standard bank account control group.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 300
• Est. completion date: December 18, 2018
• Est. primary completion date: December 18, 2018
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Male
• Age group: 21 Years and older

Eligibility

Inclusion Criteria:

• Resident in selected shoreline communities and their hinterlands in Siaya County, Kenya

• Male

• Age 21 years and above

• Primary or secondary occupation is fishing or transportation (i.e. motorbike taxi driver)

• Owns mobile phone

• Is willing to open savings account with a local bank and has, or is willing to obtain, the necessary documents (national identification card, Kenya Revenue authority PIN) to do so

Exclusion Criteria:

• Planning to relocate from study communities in the next 6 months

• Does not express willingness to open a savings account

Related Conditions & MeSH terms

• Acquired Immunodeficiency Syndrome
• HIV Infections
• HIV/AIDS

Intervention

Other:
• Prize-linked savings
Participants will be eligible for prizes based on the amount by which their account balance goes up in each period (e.g. for every 100 Ksh by which savings increases, participants get an entry into a lottery for monetary rewards where they have a small probability of winning a larger amount, or a larger probability of winning a smaller amount of money). This type of prize-linked savings intervention has been shown to promote savings in other settings. Other intervention components may include education materials to explain how the prize-linked savings incentives work and that emphasize the potential benefits of saving money. Participants in the intervention group will be encouraged to have more consideration for their future health and economic status, as this may motivate them to save more money. They will also be encouraged to consider the opportunity and health cost of their expenditures on alcohol and transactional sex and not miss the opportunity to win prizes by saving money.

Locations

Country	Name	City	State
United States	University of Pennsylvania	Philadelphia	Pennsylvania

Sponsors (4)

Lead Sponsor	Collaborator
University of Pennsylvania	Bill and Melinda Gates Foundation, Impact Research & Development Organization, Innovations for Poverty Action

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Increase in savings balance	This is a binary variable equal to 1 if the respondent's savings balance increased over the study period, and zero otherwise.	Measured throughout follow-up period (approx 3 months)
Primary	Savings balance	Total increase in savings balance over the study period (continuous measure)	Measured throughout follow-up period (approx 3 months)
Primary	Expenditures on alcohol	Total spending on alcohol in past 7 days	Recall period: past 7 days, measured in endline survey (approx 3 months after enrollment)
Primary	Participation in and expenditures on transactional sex	Total spending on transactional sex in past month, and binary indicator for any spending	Recall period: past month, measured in endline survey (approx 3 months after enrollment)
Secondary	Savings	Net increase in both the savings balance and in self-reported total savings from all sources, in each lottery period and over the entire study period	approx 3 month follow up period
Secondary	Expenditures on food	Money spent in past 7 days on food	Recall period: past 7 days, measured in endline survey
Secondary	Expenditures on non-food items	Money spent in past 7 days on all non-food items	Recall period: past 7 days, measured in endline survey