Behavioural Text Messages to Improve Retention in Care in South Africa

HIV/AIDS Clinical Trial

Official title:

Behavioural Text Messaging to Improve Retention in Care for Patients on Antiretroviral Therapy in Ekurhuleni District, South Africa

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05010291
• Other study ID #: 210308
• Status: Completed
• Phase: N/A
• Start date: August 5, 2021
• Est. completion date: December 7, 2021

Study information

• Verified date: July 2022
• Source: University of Pennsylvania
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Description:

The objective of this study is to rapidly determine whether text messages framed according to behavioural economics principles increase the likelihood that recipients of care attend their clinic appointment and return to clinic within 28 days of a missed appointment. The study will be nested in a routine HIV program, in approximately 5 selected Aurum Institute clinics based in Ekurhuleni district, Gauteng province, South Africa.

Intervention arms will include voice call attempts and one-way text messages sent by clinic staff to recipients of care in two scenarios: 1) Approximately 3-7 days in advance of a clinic appointment for collecting antiretroviral medication supplies or collection of a specimen for viral load testing and 2) Approximately 24 hours after a missed clinic appointment.

This individually randomised trial will have four arms. Each time there is an upcoming or missed clinic visit clinic staff will randomly assign recipients of care to one of the following study arms: 1) Standard of Care 2) Loss aversion framed messaging 3) Social norms framed messaging or 4) Altruism framed messaging.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1541
• Est. completion date: December 7, 2021
• Est. primary completion date: December 7, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• 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.

Exclusion Criteria:

• 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.

Related Conditions & MeSH terms

• Acquired Immunodeficiency Syndrome
• HIV Infections
• HIV/AIDS

Intervention

Behavioral:
• Standard of Care (SOC) text message reminder to attend clinic appointment
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.
• Loss aversion framed text message reminder to attend clinic appointment
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.
• Social norms framed text message reminder to attend clinic appointment
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.
• Altruism framed text message reminder to attend clinic appointment
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.

Locations

Country	Name	City	State
South Africa	Aurum Institute	Johannesburg	Gauteng

Sponsors (3)

Lead Sponsor	Collaborator
University of Pennsylvania	Aurum Institute, University of Witwatersrand, South Africa

Country where clinical trial is conducted

South Africa, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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
Primary	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