Participant perspectives on incentives for TB preventative therapy adherence and reduced alcohol use

A qualitative study

Bibliographic Data

ID19592460
AuthorsAyesha Appa (0000-0002-4602-5954, University of California, San Francisco, corresponding author), Amanda P Miller (0000-0002-2252-6973, San Diego State University, corresponding author), Robin Fatch (0000-0002-8423-3471, University of California, San Francisco, corresponding author), Allen Kekibiina (0000-0002-2835-8528, Mbarara University of Science and Technology, corresponding author), Brian Beesiga (0000-0001-5927-8857, Infectious Diseases Research Collaboration, corresponding author), Julian Adong (0000-0001-9314-5257, Mbarara University of Science and Technology, corresponding author), Nneka Emenyonu (0000-0003-4376-7810, University of California, San Francisco, corresponding author), Kara Marson (0000-0001-9534-0371, University of California, San Francisco, corresponding author), Monica Getahun (0000-0002-2116-2637, University of California, San Francisco, corresponding author), Moses R Kamya (0000-0001-9106-4234, Infectious Diseases Research Collaboration, corresponding author), Moses Kamya, Winnie Muyindike (0000-0002-6694-2645, Mbarara University of Science and Technology, corresponding author), Michael G Mcdonell (0000-0002-8372-6469, Washington State University Spokane, corresponding author), Michael Mcdonell, Harsha Thirumurthy (0000-0002-3308-7603, University of Pennsylvania, corresponding author), Judith A Hahn (0000-0002-2697-8264, University of California, San Francisco, corresponding author), Gabriel Chamie (0000-0002-5860-8081, University of California, San Francisco, corresponding author), Carol S Camlin (0000-0001-5615-1164, University of California, San Francisco, corresponding author)
EditorsTara Carney (0000-0001-5400-0565)
Year2024
Volume4
Issue4
Pagese0002472
Publication date2024-04-24
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002472
PMID38656992
OpenAlexW4395069731
LanguageEN
Citations received1
References cited27

Economic incentives to promote health behavior change are highly efficacious for substance use disorders as well as increased medication adherence. Knowledge about participants’ experiences with and perceptions of incentives is needed to understand their mechanisms of action and optimize future incentive-based interventions. The Drinkers’ Intervention to Prevent Tuberculosis (DIPT) trial enrolled people with HIV (PWH) in Uganda with latent tuberculosis and unhealthy alcohol use in a 2x2 factorial trial that incentivized recent alcohol abstinence and isoniazid (INH) adherence on monthly urine testing while on INH preventive therapy. We interviewed 32 DIPT study participants across trial arms to explore their perspectives on this intervention. Participants described 1) satisfaction with incentives of sufficient size that allowed them to purchase items that improved their quality of life, 2) multiple ways in which incentives were motivating, from gamification of “winning” through support of pre-existing desire to improve health to suggesting variable effects of extrinsic and intrinsic motivation, and 3) finding value in learning results of increased clinical monitoring. To build effective incentive programs to support both reduced substance use and increased antimicrobial adherence, we recommend carefully selecting incentive magnitude as well as harnessing both intrinsic motivation to improve health and extrinsic reward of target behavior. In addition to these participant-described strengths, incorporating results of clinical monitoring related to the incentive program that provide participants more information about their health may also contribute to health-related empowerment

Contingency management · Incentive · Psychiatry · Psychological intervention · Clinical Psychology · Gambling Behavior and Treatments · HIV/AIDS Research and Interventions · Medicine · Microfinance and Financial Inclusion · Psychology