Behavioral Nudges, Information and Incentives for HIV Testing: A Field Experiment in Ecuador
Last registered on June 09, 2017

Pre-Trial

Trial Information
General Information
Title
Behavioral Nudges, Information and Incentives for HIV Testing: A Field Experiment in Ecuador
RCT ID
AEARCTR-0002263
Initial registration date
June 08, 2017
Last updated
June 09, 2017 12:35 PM EDT
Location(s)

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Primary Investigator
Affiliation
Johns Hopkins University
Other Primary Investigator(s)
PI Affiliation
University of South Florida
PI Affiliation
Universidad de San Francisco de Quito
PI Affiliation
Universidad de San Francisco de Quito
PI Affiliation
Johns Hopkins University
PI Affiliation
University of South Florida
Additional Trial Information
Status
In development
Start date
2017-06-12
End date
2018-05-31
Secondary IDs
Abstract
We will conduct a randomized controlled field experiment in the city of Esmeraldas, Ecuador, a province that shares a disproportionate burden of HIV/AIDS, to compare the effects of information, a behavioral nudge (“active choice”), and financial incentives in inducing individuals to get tested. The CDC and other health agencies recommend that all individuals should be routinely tested for HIV/AIDS. In our study, we will test these various strategies both on “at risk” individuals (men who have sex with men, and sex workers) and on a broader population.
External Link(s)
Registration Citation
Citation
Grunauer, Michelle et al. 2017. "Behavioral Nudges, Information and Incentives for HIV Testing: A Field Experiment in Ecuador." AEA RCT Registry. June 09. https://www.socialscienceregistry.org/trials/2263/history/18461
Experimental Details
Interventions
Intervention(s)
This proposed study has three specific aims.
Specific Aim 1: To estimate the effect of behavioral nudges, information, and financial incentives in inducing individuals to be tested for HIV. By comparing the number of subjects who agree to be tested in the control group and under our experimental conditions, we will be able to estimate the effect of our proposed treatments on (a) the share of new subjects tested and (b) the share of new subjects tested who have the disease.

Specific Aim 2: To compare the demographic, socioeconomic, cultural, and health characteristics of the individuals induced to get tested by our interventions with those of individuals who are being tested according to current practices in Ecuador. We are particularly interested in determining whether participants under the different strategies are more or less likely to reveal risk factors.
Specific Aim 3: To estimate the cost of detection under the different types of schemes, and compare it to the cost of detection using existing strategies. We can thus determine which type of strategy is most cost-effective, and therefore most useful from a policy perspective.
Intervention Start Date
2017-06-12
Intervention End Date
2018-05-31
Primary Outcomes
Primary Outcomes (end points)
The main outcomes of interest will be the following: (a) the share of patients who agree to be tested in each experimental condition (b) the results of the test
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
We propose to conduct a randomized controlled trial in collaboration with the Fundacion Raices, an NGO with strong ties to the local community of Esmeraldas, Ecuador. A total of about 3,000 subjects will be involved in the full-scale study over the course of 2 years. In partnership with the Fundacion Raices, the research team will set up stands at four public places in the city of Esmeraldas: the “malecon” (esplanade on the town’s waterfront), the “Centro Comercial Multiplaza” (Esmeraldas’ large shopping mall), the municipal market (a popular destination for groceries, etc.), and a public park located in the city center. Each stand will feature a sign inviting people to stop and “get their health checked”, and will provide free refreshments (juice boxes and water). A monitor will approach individuals at the malecon/shopping center/municipal market/public park and ask whether they are interested to learn about a health initiative by the Fundacion Raices and a group of public health researchers. If the person is interested, the monitor will begin the three steps of the experiment:
(1) The subject fills out a brief, anonymous survey with demographics, socio- economic characteristics, and whether they have been tested for HIV/AIDS in the past.
(2) The subject receives the script and actions associated with the experimental condition she/he is assigned to according to the randomization.
There are three experimental conditions:
T1 = “Information”.
T2 = “Active Choice”.
T3 = “Monetary incentive”.
Experimental Design Details
Not available
Randomization Method
Randomization done in the office using a random number generator in Excel.
Randomization Unit
Randomization: The randomization will be by week. That is, all participants who present on the same week will be assigned to the same experimental condition. This is done to minimize spillover effects due to possible communication between participants assigned to different experimental conditions, and to avoid confusion among the staff. The implementation schedule will be designed to guarantee balance of treatment conditions across locations and days of the week.
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
48 weeks
Sample size: planned number of observations
3,000
Sample size (or number of clusters) by treatment arms
4 locations
48 weeks in total
12 weeks in each location
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
The Institutional Review Board of USFQ
IRB Approval Date
2016-10-18
IRB Approval Number
2016-138IN
IRB Name
Johns Hopkins University Homewood Institutional Review Board
IRB Approval Date
2016-12-12
IRB Approval Number
HIRB00004772