Period: 2017

Researchers: Vilma Irazola, Rosana Poggio, Marilina Santero

Goal

Determine if the use of two strategies based on Behavioral Economics (framing effects) are effective to improve the initial evaluation and follow-up of the population with moderate and high cardiovascular risk that is referred to the health centers of the public primary care network.

Summary

This study is a pragmatic cluster-randomized clinical trial that will determine whether the use of two strategies based on Behavioral Economics, which include the use of an incentive scheme and sending text messages (framing effects), They are effective in improving the initial evaluation and follow-up of the population with moderate and high cardiovascular risk that is referred to health centers in the public primary care network. 9 health centers will be selected, which will be randomized to the following arms: 3 to the control arm, 3 to the intervention arm with messages and 3 to the intervention arm with incentives. 900 participants ≥ 40 years of age will be included (300 participants per arm), without health coverage and with a 10-year cardiovascular risk ≥ 10%. All participants will be assigned a first scheduled shift for evaluation and follow-up with a medical professional from the health center. Subsequent follow-up appointments will be granted by the health center according to medical criteria. Participants assigned to the incentive arm will be offered a direct incentive (purchase voucher) if they attend the initial scheduled consultation at the health center and participation in a lottery system if they attend the follow-up visit. Participants assigned to the messaging arm will receive weekly text messages using message framing or formulation based on behavioral economics principles to promote attendance at scheduled health center visits. Participants assigned to the control arm will only receive one scheduled appointment for the initial consultation. The primary outcomes that will be measured are: the proportion of subjects with a 10-year risk of cardiovascular disease ≥ 10% who attended and completed the first and second clinical visits to the health center.

Financing

IDB – Inter-American Development Bank

Type of study

Pragmatic Cluster Randomized Clinical Trial