An economic incentive package to support the wellbeing of caregivers of adolescents living with HIV during the COVID-19 pandemic in South Africa: a feasibility study protocol for a pilot randomised trial

Pilot and Feasibility Studies

Study Protocol

Lovemore Sigwadhi¹  Jane Goudge²  Zibuyisile Mkhwanazi³  Stanley Carries³  Darshini Govindasamy³  Mosa Moshabela⁴  Makandwe Nyirenda⁵ 

[1] Biostatistics Unit, Stellenbosch University, Stellenbosch, South Africa;Centre for Health Policy, University of the Witwatersrand, Johannesburg, South Africa;Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa;School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa;School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa;Burden of Disease Unit, South African Medical Research Council, Cape Town, South Africa;

关键词: Caregivers;    Wellbeing;    HIV/AIDS;    Economic incentives;    Mental health;    COVID-19;    Sub-Saharan Africa;   

DOI  :  10.1186/s40814-023-01237-x

 received in 2022-03-31, accepted in 2023-01-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe mental and financial strain linked to unpaid caregiving has been amplified during the COVID-19 pandemic. In sub-Saharan Africa, carers of adolescents living with HIV (ALHIV) are critical for maintenance of optimum HIV treatment outcomes. However, the ability of caregivers to provide quality care to ALHIV is undermined by their ability to maintain their own wellbeing due to multiple factors (viz. poverty, stigma, lack of access to social support services) which have been exacerbated by the COVID-19 pandemic. Economic incentives, such as cash incentives combined with SMS reminders, have been shown to improve wellbeing. However, there is a lack of preliminary evidence on the potential of economic incentives to promote caregiver wellbeing in this setting, particularly in the context of a pandemic. This protocol outlines the design of a parallel-group pilot randomised trial comparing the feasibility and preliminary effectiveness of an economic incentive package versus a control for improving caregiver wellbeing.MethodsCaregivers of ALHIV will be recruited from public-sector HIV clinics in the south of the eThekwini municipality, KwaZulu-Natal, South Africa. Participants will be randomly assigned to one of the following groups: (i) the intervention group (n = 50) will receive three cash payments (of ZAR 350, approximately 23 USD), coupled with a positive wellbeing message over a 3-month period; (ii) the control group (n = 50) will receive a standard message encouraging linkage to health services. Participants will be interviewed at baseline and at endline (12 weeks) to collect socio-demographic, food insecurity, health status, mental health (stigma, depressive symptoms) and wellbeing data. The primary outcome measure, caregiver wellbeing, will be measured using the CarerQoL instrument. A qualitative study will be conducted alongside the main trial to understand participant views on participation in the trial and their feedback on study activities.DiscussionThis study will provide scientific direction for the design of a larger randomised controlled trial exploring the effects of an economic incentive for improving caregiver wellbeing. The feasibility of conducting study activities and delivering the intervention remotely in the context of a pandemic will also be provided.Trial registrationPACTR202203585402090. Registry name: Pan African Clinical Trials Registry (PACTR); URL: https://pactr.samrc.ac.za/; Registration. date: 24 March 2022 (retrospectively registered); Date first participant enrolled: 03 November 2021

【 授权许可】

CC BY   
© The Author(s) 2023

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