Clinical trial NCT04013295: Prize-linked Savings Initiatives for Promoting Better Health and Economic Outcomes in Kenya
Official title: Prize-linked Savings Initiatives for Promoting Better Health and Economic Outcomes in Kenya
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: HIV/AIDS
Keywords: HIV
transactional sex
prize-linked savings
savings
Lead sponsor: University of Pennsylvania
Sponsor class: OTHER
Collaborators: name: Impact Research & Development Organization
name: Innovations for Poverty Action
name: Bill and Melinda Gates Foundation
First posted: 2019-07-09
Enrollment: 300
Sex: MALE
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief 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.

Detailed 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.

Eligibility criteria: 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

Primary outcomes:
measure: Increase in savings balance
timeFrame: Measured throughout follow-up period (approx 3 months)
measure: Savings balance
timeFrame: Measured throughout follow-up period (approx 3 months)
measure: Expenditures on alcohol
timeFrame: Recall period: past 7 days, measured in endline survey (approx 3 months after enrollment)
measure: Participation in and expenditures on transactional sex
timeFrame: Recall period: past month, measured in endline survey (approx 3 months after enrollment)
Secondary outcomes:
measure: Savings
timeFrame: approx 3 month follow up period
measure: Expenditures on food
timeFrame: Recall period: past 7 days, measured in endline survey
measure: Expenditures on non-food items
timeFrame: Recall period: past 7 days, measured in endline survey
Other outcomes:
Locations:
city: Philadelphia
country: United States
facility: University of Pennsylvania
state: Pennsylvania
Study officials:
affiliation: University of Pennsylvania
name: Harsha Thirumurthy
role: PRINCIPAL_INVESTIGATOR
References:
citation: Moscoe E, Agot K, Thirumurthy H. Effect of a Prize-Linked Savings Intervention on Savings and Healthy Behaviors Among Men in Kenya: A Randomized Clinical Trial. JAMA Netw Open. 2019 Sep 4;2(9):e1911162. doi: 10.1001/jamanetworkopen.2019.11162.