Browsing by Author "Maughan-Brown, Brendan"

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    The Empower Nudge lottery to increase dual protection use: a proof-of-concept randomised pilot trial in South Africa
    (Informa UK Limited, trading as Taylor & Francis Group, 2018) Galárraga, Omar; Harries, Jane; Maughan-Brown, Brendan; Cooper, Diane; Short, Susan E.; Lurie, Mark N.; Harrison, Abigail
    The objective of this study is to measure the preliminary efficacy of a pilot intervention, grounded in behavioural economics, increasing adherence of dual protection (simultaneous use of effective modern contraception and a barrier method, such as a condom) to protect against HIV, other sexually transmitted infections, and unintended pregnancy. Between 2015 and 2016, 100 women aged 18–40 years, seeking post-abortion care in Cape Town, South Africa were recruited to Empower Nudge, a randomised controlled trial to test a lottery incentive intervention designed to increase dual protection. At baseline, the mean age of participants was 27 years; 82% of them were from South Africa; 58% self-identified as Black African; average education completed was 11.7 years. At three months, assignment to the lottery intervention was associated with higher odds of returning for study visits (OR: 6.0; 95%CI: 2.45 to 14.7, p < 0.01), higher condom use (OR: 4.5; 95%CI: 1.43 to 14.1; p < 0.05), and higher use of dual protection (OR: 3.16; 95%CI: 1.01 to 9.9; p < 0.05). Only 60% of the study population returned after three months and only 38% returned after six months. Women who receive post-abortion care represent a neglected population with an urgent need for HIV and pregnancy prevention. Dual protection is a critically important strategy for this population. Lottery-based behavioural economics strategies may offer possible ways to increase dual protection use in this population. Further research with larger samples, longer exposure time, and more sites is needed to establish fully powered efficacy of lottery incentives for dual protection; using objective verification for monitoring.
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    Predictors of mask-wearing during the advent of the COVID-19 pandemic: Evidence from South Africa
    (Oxford University Press, 2022) Burger, Ronelle; English, Rene; Maughan-Brown, Brendan; Christian, Carmen
    Background: In the absence of a vaccine, the global spread of COVID-19 during 2020 has necessitated non-pharmaceutical interventions to curb the rise of cases. Purpose: The article uses the health belief model and a novel rapid mobile survey to examine correlates of reported mask-wearing as a nonpharmaceutical intervention in South Africa between May and August 2020. Methods: Two-way tabulations and multivariable analysis via logistic regression modeling describe correlations between reported mask-wearing and factors of interest among a sample of 7074 adults in a two-period national longitudinal survey, the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM). Results: In line with the health belief model, results showed that self-efficacy, the prevalence of others’ mask-wearing in the same district, and affluence were positively associated with reported mask-wearing. Those who reported staying at home were significantly less likely to report wearing a mask. There was little evidence that the expected severity of the disease if contracted, affects these decisions. Hypertension, obesity, or being overweight (measured three years earlier) did not have a significant association with maskwearing. The prevalence of mask-wearing increased significantly from May to August 2020 as COVID-19 cases increased and lockdown restrictions were eased. Contrary to the health belief model, we found that despite having a higher mortality risk, the elderly had significantly lower odds of mask-wearing. Conclusion: In South Africa, the mask-wearing adherence has increased rapidly. It is concerning that the elderly had lower odds of mask-wearing. This should be examined further in future research.