Impact of family networks on uptake of health interventions: evidence from a community-randomized control trial aimed at increasing HIV testing in South Africa

INTRODUCTION: While it is widely acknowledged that family relationships can influence health outcomes, their impact on the uptake of individual health interventions is unclear. In this study, we quantified how the efficacy of a randomized health intervention is shaped by its pattern of distribution...

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Hauptverfasser: Makofane, Keletso (VerfasserIn) , Kim, Hae-Young (VerfasserIn) , Tchetgen Tchetgen, Eric (VerfasserIn) , Bassett, Mary T. (VerfasserIn) , Berkman, Lisa (VerfasserIn) , Adeagbo, Oluwafemi (VerfasserIn) , McGrath, Nuala (VerfasserIn) , Seeley, Janet (VerfasserIn) , Shahmanesh, Maryam (VerfasserIn) , Yapa, H. Manisha (VerfasserIn) , Herbst, Kobus (VerfasserIn) , Tanser, Frank (VerfasserIn) , Bärnighausen, Till (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 20 Aug 2023
In: Journal of the International AIDS Society
Year: 2023, Jahrgang: 26, Heft: 8, Pages: 1-9
ISSN:1758-2652
DOI:10.1002/jia2.26142
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/jia2.26142
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/jia2.26142
Volltext
Verfasserangaben:Keletso Makofane, Hae-Young Kim, Eric Tchetgen Tchetgen, Mary T. Bassett, Lisa Berkman, Oluwafemi Adeagbo, Nuala McGrath, Janet Seeley, Maryam Shahmanesh, H. Manisha Yapa, Kobus Herbst, Frank Tanser and Till Bärnighausen

MARC

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520 |a INTRODUCTION: While it is widely acknowledged that family relationships can influence health outcomes, their impact on the uptake of individual health interventions is unclear. In this study, we quantified how the efficacy of a randomized health intervention is shaped by its pattern of distribution in the family network. METHODS: The "Home-Based Intervention to Test and Start" (HITS) was a 2×2 factorial community-randomized controlled trial in Umkhanyakude, KwaZulu-Natal, South Africa, embedded in the Africa Health Research Institute's population-based demographic and HIV surveillance platform (ClinicalTrials.gov # NCT03757104). The study investigated the impact of two interventions: a financial micro-incentive and a male-targeted HIV-specific decision support programme. The surveillance area was divided into 45 community clusters. Individuals aged ≥15 years in 16 randomly selected communities were offered a micro-incentive (R50 [$3] food voucher) for rapid HIV testing (intervention arm). Those living in the remaining 29 communities were offered testing only (control arm). Study data were collected between February and November 2018. Using routinely collected data on parents, conjugal partners, and co-residents, a socio-centric family network was constructed among HITS-eligible individuals. Nodes in this network represent individuals and ties represent family relationships. We estimated the effect of offering the incentive to people with and without family members who also received the offer on the uptake of HIV testing. We fitted a linear probability model with robust standard errors, accounting for clustering at the community level. RESULTS: Overall, 15,675 people participated in the HITS trial. Among those with no family members who received the offer, the incentive's efficacy was a 6.5 percentage point increase (95% CI: 5.3-7.7). The efficacy was higher among those with at least one family member who received the offer (21.1 percentage point increase (95% CI: 19.9-22.3). The difference in efficacy was statistically significant (21.1-6.5 = 14.6%; 95% CI: 9.3-19.9). CONCLUSIONS: Micro-incentives appear to have synergistic effects when distributed within family networks. These effects support family network-based approaches for the design of health interventions. 
650 4 |a Adolescent 
650 4 |a Adult 
650 4 |a AHRI 
650 4 |a Epidemiological monitoring 
650 4 |a Family 
650 4 |a Female 
650 4 |a HIV epidemiology 
650 4 |a HIV infections 
650 4 |a HIV testing 
650 4 |a Humans 
650 4 |a Male 
650 4 |a Middle aged 
650 4 |a randomized controlled trial (RCT) 
650 4 |a Reimbursement, incentive 
650 4 |a social epidemiology 
650 4 |a Social networking 
650 4 |a social networks 
650 4 |a South Africa 
650 4 |a testing 
650 4 |a Young adult 
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