Clinical trial NCT05010291: Behavioural Text Messages to Improve Retention in Care in South Africa
Official title: Behavioural Text Messaging to Improve Retention in Care for Patients on Antiretroviral Therapy in Ekurhuleni District, South Africa
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: HIV/AIDS
Keywords: Behavioral sciences
Retention in care
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
Collaborators: name: University of Witwatersrand, South Africa
name: Aurum Institute
First posted: 2021-08-18
Enrollment: 1541
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SCREENING

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.

Detailed 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Appointment reminders
timeFrame: Approximately 3-5 months
measure: Missed clinic appointments
timeFrame: Approximately 3-5 months
Secondary outcomes:
Other outcomes:
Locations:
city: Johannesburg
country: South Africa
facility: Aurum Institute
state: Gauteng
Study officials:
affiliation: Aurum Institute
name: Tonderai Mabuto, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Pennsylvania
name: Harsha Thirumurthy, PhD
role: PRINCIPAL_INVESTIGATOR
References: