Smartphone-based incentives for promoting adherence to antiretroviral therapy: A randomized controlled trial

DeFulio, Anthony; Devoto, Amanda; Traxler, Haily K.; Cosottile, David W.; Fingerhood, Michael; Nuzzo, Paul A.; Dallery, Jesse

doi:10.1016/j.pmedr.2021.101318

Cited by 17 publications

(25 citation statements)

References 40 publications

(28 reference statements)

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“…In addition, patients' beliefs towards CM have not been widely investigated. Research has been limited to surveys examining acceptability of study procedures among patients in receipt of CM in the USA [15][16][17][18][19] and a small UK-based qualitative investigation [20]. These studies found that patients view CM as a motivating and positive tool to facilitate recovery and the monitoring of behaviours and financial incentives are strengths of the intervention [16].…”

Section: Introductionmentioning

confidence: 99%

“…Technology might optimise the application of reinforcement principles, monitoring and reinforcing the target behaviour more frequently than is otherwise possible [22,24]. A meta-analysis of mobile telephone-delivered CM [25] and more recent evaluation studies [19,[26][27][28][29][30] suggest these interventions are effective in generating positive behaviour change. However, the platforms upon which these interventions can be implemented might vary in their appropriateness or acceptability to the patient population.…”

Section: Introductionmentioning

confidence: 99%

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Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

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Weaver

Lynskey

et al. 2021

Drug and Alcohol Review

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Introduction. Contingency management interventions are among the most efficacious psychosocial interventions in promoting abstinence from smoking, alcohol and substance use. The aim of this study was to assess the beliefs and objections towards contingency management among patients in UK-based drug and alcohol services to help understand barriers to uptake and support the development and implementation of these interventions. Methods. The Service User Survey of Incentives was developed and implemented among patients (N = 181) at three UK-based drug and alcohol treatment services. Descriptive analyses were conducted to ascertain positive and negative beliefs about contingency management, acceptability of different target behaviours, incentives and delivery mechanisms including delivering incentives remotely using technology devices such as mobile telephones. Results. Overall, 81% of participants were in favour of incentive programs, with more than 70% of respondents agreeing with the majority of positive belief statements. With the exception of two survey items, less than a third of participants agreed with negative belief statements. The proportion of participants indicating a neutral response was higher for negative statements (27%) indicating greater levels of ambiguity towards objections and concerns regarding contingency management. Discussion and Conclusions. Positive beliefs towards contingency management interventions were found, including high levels of acceptability towards a range of target behaviours, incentives and the use of technology devices to remotely monitor behaviour and deliver incentives. These findings have implications for the development and implementation of remote contingency management interventions within the UK drug treatment services.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

Getty

Weaver

Lynskey

et al. 2021

Drug and Alcohol Review

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“…In one study, patients would receive congratulations for attending the clinic three consecutive on-time visits for HIV care, and they were given a sticker to proudly place on an interactive poster publicly displayed in the clinic to celebrate and acknowledge their achievement [143]. Another study involved a multi-component positive affect intervention for MSM who used drugs, eight core skills, and meditation exercises were delivered to them to increase positive affect among HIV management Use of non-explicit commitment devices in the form of financial incentives for ART adherence and viral load suppression goal in the future [108,144,147,154,[169][170][171][172][173][174][175][176][177][178][179][180][181] Use of non-explicit commitment devices in the form of financial incentives to meet HIV testing, linkage to HIV care and clinic attendance goal in the future [172,182,183] Use of non-explicit commitment devices in the form of non-financial incentives for ART adherence and viral load suppression goal in the future [74,147,155] Use of non-explicit commitment devices in the form of non-financial incentives to meet HIV testing, linkage to HIV care and clinic attendance goal in the future [117,143,146,[184][185][186] Ego HIV prevention HIV education sessions alongside financial education programmes to target ego and self-efficacy [18,31,99,[187][188][189] HIV education sessions and peer support to target ego and increase HIV risk perception ...…”

Section: Affectmentioning

confidence: 99%

Applying Behavioural Insights to HIV Prevention and Management: a Scoping Review

et al. 2022

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Purpose of Review This scoping review summarises the literature on HIV prevention and management interventions utilizing behavioural economic principles encapsulated in the MINDSPACE framework. Recent Findings MINDSPACE is an acronym developed by the UK’s behavioural insights team to summarise nine key influences on human behaviour: Messenger, Incentives, Norms, Default, Salience, Priming, Affect, Commitment, and Ego. These effects have been used in various settings to design interventions that encourage positive behaviours. Currently, over 200 institutionalised behavioural insight teams exist internationally, which may draw upon the MINDSPACE framework to inform policy and improve public services. To date, it is not clear how behavioural insights have been applied to HIV prevention and management interventions. Summary After screening 899 studies for eligibility, 124 were included in the final review. We identified examples of interventions that utilised all the MINDSPACE effects in a variety of settings and among various populations. Studies from high-income countries were most common (n = 54) and incentives were the most frequently applied effect (n = 100). The MINDSPACE framework is a useful tool to consider how behavioural science principles can be applied in future HIV prevention and management interventions. Creating nudges to enhance the design of HIV prevention and management interventions can help people make better choices as we strive to end the HIV/AIDS pandemic by 2030.

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“…In clinical studies it is common to provide these reinforcers in several ways. Examples include providing: 1) a fixed value reinforcer (e.g., DeFulio et al, 2021), where participants receive the same value incentive for each verified target behavior, 2) an escalating value of reinforcers across consecutive days in which participants meet treatment criteria (e.g., Dallery et al, 2013), or 3) an escalating value of reinforcers with a reset in value when patients lapse or relapse to drug use (e.g., Tidey et al, 2011). Several laboratory studies comparing these methods suggest that providing escalating reinforcers that reset in value upon a lapse or relapse (i.e., escalating and resetting schedule) is the most effective at reducing repeated drug choice; though a majority of these studies evaluated smoking cessation (Dallery & Raiff, 2007; Roll & Higgins, 2000; Roll & Shoptaw, 2006).…”

Section: Schedule Arrangementsmentioning

confidence: 99%

A preliminary investigation of schedule parameters on cocaine abstinence in contingency management

Regnier

Strickland²,

Stoops

2022

J Exper Analysis Behavior

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Contingency management (CM) interventions are the most effective psychosocial interventions for substance use disorders. However, further investigation is needed to create the most robust intervention possible. This study investigated the effects of 1) reinforcer magnitude; and 2) fixed and escalating and resetting incentives on cocaine abstinence in an outpatient trial. In this analysis, 34 treatment-seeking individuals with Cocaine Use Disorder received either high or low value incentives for providing a benzoylecgonine-negative urine sample or were in a control condition and received incentives for providing a urine sample regardless of the results. Participants received either escalating and resetting incentives, wherein the value of each incentive increased with consecutive negative samples and reset to the initial level upon a positive sample (Experiment 1), or fixed incentives, wherein they received the same value incentive for each negative urine sample they provided (Experiment 2). Large incentives produced more abstinence, although escalating and resetting reinforcer values did not have a differential effect. Large, fixed incentives promoted abstinence faster than other reinforcers, whereas smaller incentives resulted in poor abstinence and took many visits to achieve initial abstinence. Future research comparing different schedules on cocaine abstinence in a randomized control trial with a larger sample size is required.

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Smartphone-based incentives for promoting adherence to antiretroviral therapy: A randomized controlled trial

Cited by 17 publications

References 40 publications

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

Applying Behavioural Insights to HIV Prevention and Management: a Scoping Review

A preliminary investigation of schedule parameters on cocaine abstinence in contingency management

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