Behaviourally informed messaging increases medication adherence

Genesis Analytics was commissioned by PPO Serve to help improve medication adherence among HIV-positive patients enrolled on the GP Care Cell (GPCC) programme. The programme offers free HIV treatment through a network of private GPs.

We developed behaviourally informed messaging for its new low-cost messaging platform - GP Connect – that is being rolled out to all new patients on GPCC.

Why is this project important?

The second and third ‘90s’ of the UNAIDS global HIV treatment target aim for 90% of all HIV-positive people to be on antiretroviral treatment (ART) and 90% of them to be virally suppressed. However, adhering to daily medication for life can be difficult, particularly for people dealing with the shock of being recently diagnosed, and having to form an entirely new habit, often with little support.

The messaging provided through the GP Connect aims to address this problem by providing ongoing psycho-social support through sending regular behaviourally informed WhatsApp messages to people on the GPCC programme. Similar programmes have had great success in increasing ART adherence rates at low cost. In rural Kenya, the introduction of messaging increased adherence rates by 13 percentage points.

What did the team do?

The Genesis team created a full year’s supportive messaging for patients - from the day of their diagnosis to their last appointment at GPCC.

We put a name and face to GP Connect – Sindiwe, a digital avatar, who simulates peer messaging. The message is informed by the latest research in behavioural science. It is sequenced to support habit formation and then moves on to more complex health-living behaviours. Sindiwe’s messages includes basic HIV information, tips for taking ART, support in establishing new habits, commitment devices, treatment pick-up reminders, and gamification to reinforce ART adherence behaviours.

What is happening now?

Sindiwe and her messages were positively received in user testing of GP Connect. Workshop participants view her as a buddy who is likeable and easily trusted.

GP Connect is currently being finalised and will go live soon for new GPCC patients. The programme expects to increase the number of patients initiated on ART and retained in care by 3-10 percentage points.

This project demonstrates how simple, low-cost applications of behavioural science to existing health programmes can complement and step-change their ability to affect sustainable behaviour-change.