Despite innovative experiments and efforts aimed at prompting people towards healthier choices, these are not always successful, according to experts speaking at the 15th International Health Economics Association congress this week.
Worldwide, health insurers and public health experts are on a quest to understand how people make decisions, and nudge them to make better choices about their health – but their efforts occasionally fail, reports BusinessLIVE.
For example, Wits researchers had crafted specific text messages to people with HIV who had missed clinic appointments, encouraging them to make a fresh start on a key calendar date such as Youth Day or Mandela Day – but this was no more effective than a simple message without the time reference, they found.
With the world’s biggest HIV/Aids burden, SA also has the largest treatment programme. But despite free testing and medication, 18% to 30% of people who start antiretroviral treatment drop out, and by 2030 it is projected that only 78% of people with HIV will be on treatment. SA is therefore not on track to meet the 95-95-95 targets set by the UN Programme on HIV/Aids (UNAids).
Researchers from Wits’ Indlela behavioural economics “nudge unit” are trying to find novel ways to prompt people who have stopped taking their ARVs to resume treatment, and had teamed up with the Anova Health Institute to send text messages to people with HIV in Limpopo who had missed clinic visits.
Presenting their preliminary findings at the congress, Indlela researcher Caroline Govathson-Mandimika said prior research has found people are more likely to take action around a “temporal landmark”, as they see it as a new beginning.
But further research was needed to understand why the references to a fresh start on Youth Day or Mandela Day had no impact on participants, she said.
An experiment investigating whether providing calorie labels with online food menus would prompt people to choose lower-calorie items was equally surprising, with most appearing to ignore the information.
In April 2022, England introduced calorie labelling regulations for businesses providing “out-of-home” food, which required publication of the calorie content of food along with a statement that “adults need around 2 000 calories a day”.
Research had previously found that consumers often underestimate the calorie content of the meals they order in restaurants, and that the effort of counting calories may make them underestimate their consumption. So scientists designed an online takeaway menu with the calorie content of each item, and asked 1 040 participants to choose a takeaway meal for themselves.
However, the only people who appeared to be influenced by the calorie information were a small subgroup who described themselves as calorie-conscious to begin with, said Laura Cornelsen, associate professor in public health at the London School of Hygiene and Tropical Medicine.
BusinessLIVE article – Attempts to nudge healthier behaviour ‘may fall flat’ (Restricted access)
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