The Indlela Behavioural Hub (B-Hub): Leveraging community voices to better understand behaviour and design more effective interventions

Why create a B-Hub?

We believe that creating interventions to help boost healthy behaviours in the HIV service delivery space should also incorporate views of “consumers”, or in our case community members. Incorporating these valuable perspectives throughout the design process can help ensure these ideas are most likely to be effective.

 

Indlela provides technical support during the co-creation of interventions for our Behavioural Insights Test (BIT) projects. Together with our partner organisations, we brainstorm potential behavioural insights and nudges. In some cases, we have not been sure if we should test all of our ideas or try to select only the best options. We wished there was a quick and easy way to prototype the wording or the framing to assure us that we were focusing on the options with the highest potential for impact. These queries led to us creating an Indlela B-Hub. This group of community members would include recipients of care, health providers, and others who would agree to participate in regular surveys and interviews with the Indlela team. 

 

 

 

What is a consumer panel?

A consumer panel is a group of individuals selected by a business or organisation to provide feedback and input on products and services. Leveraging consumer perspectives through market research has historically offered an advantage to companies trying to create products relevant to their target audience.

 

 

 

Learning from market research strategies 

Various companies have been successful in conducting market research in Sub-Saharan Africa. We can learn from these examples on how to effectively motivate participation and efficiently collect information. 

 

Consumer Panel Africa has launched various consumer panels across the continent and is led by Africa Business Communities and a US-based market research firm. They create an appeal to young people to participate in their online surveys by framing participation as a way to influence trends and share opinions about brands they care about, as well as win prizes. After the successful launch of consumer panels in 13 other African countries, UAE-based Kantar launched the largest consumer panel in South Africa with approximately 6,500 members across all 9 provinces. The size of their panel allows for a representative sample, and their automated system for collecting purchasing data makes it quick and easy to consistently participate. TGM Research conducts market research globally, and created an online panel of nearly 15,000 members in Kenya, focused both on consumers and B2B (business to business). Their retention is high because of their generous reward schemes and their online engagement that allows them to push out surveys to thousands of users in a matter of days. 

 

 

 

Panel surveys 

Within the research community, panel surveys are used to collect data over time within the same group of individuals.We highlight three examples below and how we can learn from the important aspects of this model to understand how to prevent attrition over time and ensure support for participants. 

 

The Performance Monitoring for Action (PMA) DataLab implements longitudinal surveys across 9 countries among the same women over time to understand reproductive health and drive programs and policy-making. The recruitment framing emphasizes empowerment and community engagement and encourages participation by offering women a platform to talk about reproductive health and the challenges they face. The Kenya Life Panel Survey is a long-term survey collecting various health and socioeconomic outcomes among thousands of Kenyans. This team had high rates of retention due to collecting rigorous personal and residential information at the point of recruitment and introducing strategies for tracking transient individuals. Another example is the CVACS, or COVID-19 Vaccine Survey, co-led by Indlela Faculty Brendan Maughn-Brown including two survey rounds within the same sample in South Africa. Their team was able to complete the surveys very quickly recruiting from an existing database and implementing a brief survey. 

 

 

 

An example of a successful B-Hub in Kenya 

One of the groups that influenced the idea for the Indlela B-Hub is the Busara Center for Behavioral Economics based in Nairobi, Kenya. Busara operates three state-of-the-art decision labs and a mobile lab unit with the capacity to collect data from up to 530 respondents in a day. They can study respondents in a controlled environment and run a large number of studies across multiple locations in a short amount of time. The participants have been recruited from within and around Nairobi and their team has built a large data management system and in-person meeting space with capacity to manage this work. Their methods set the stage to collect precise measures and complex information, and better understand behaviour and estimate influence of interventions. The Indlela B-Hub can learn from Busara in how to create an infrastructure that supports the longevity of the panel and can quickly conduct a range of tests.

 

 

 

Launching a B-Hub in South Africa 

The panel will seek to to determine the feasibility, useability and relevance of potential BIT projects prior to scaling and evaluating these in a larger population. Prototyping the interventions with this panel could offer us insights into refining the interventions and ensure that they will be appropriate to the context without the need for resources and large surveys. The panel also aims to explore knowledge, attitudes and beliefs that our BIT projects are built upon. We build BIT projects that directly address challenges experienced in HIV cascade, but we want to ensure that we are not missing the mark and that these interventions address the key concerns and barriers being addressed. Understanding perceptions of community members is key in this process. Read more about the Indlela B-Hub here.

 

 

 

Considerations in managing a B-Hub

There are many benefits of introducing a health-focused  in South Africa. FeeB-Hubdback from individuals that these interventions are intended for, is key to create relevant solutions that address the most pressing challenges along the HIV cascade. The formation of the Indlela B-Hub will offer a more efficient and streamlined use of resources and won’t require us to recruit a new sample for every test. Intervention design is iterative, and sometimes small tweaks make a big difference, thus having a way to quickly run AB tests will lead to more rapidly launched BIT projects. Furthermore, the regulatory approvals for these tests will be simpler than what is required for a larger study. 

 

Launching such a B-Hub does not come without some important ethical considerations and challenges. As researchers, we carefully ensure that participation in any study is voluntary. We have built this conversation into the recruitment consenting process, and will remind participants of their choice before each activity. We aim to recruit a large number of members, thus have used purposive and snowball sampling for recruitment at community events and high foot-traffic areas, as well as those who are already visiting a clinic or program. We are aware of this potential bias and that this may not be a fully representative sample until it is a large enough group. We acknowledge that the eligibility of owning any type of phone may exclude some participants. There is a risk of study fatigue when working with the same participants over time, so we will introduce measures to prevent this.   

 

 

 

Trial run 

Our first B-Hub project has just launched. As part of the BRAVO project  (Behavioural Research Advancing VaccinatiOn), this exercise will explore perceptions on COVID-19 vaccinations and vaccine boosters in an effort to understand how behavioural insights could be leveraged to frame messages that counter misconceptions of vaccines and vaccine boosters. The team will deploy a semi-structured survey to approximately 100 of the selected panel members which they can either complete online or telephonically. 

 

 

 

Our vision 

We have only just begun and have many ideas for the potential uses for the Indlela B-Hub. We are starting small with only 50 health care providers and 500 community members based in Gauteng province but we hope to grow our numbers to include more members and expand across other provinces in South Africa. We are currently focusing our research on HIV, but hope to broaden our reach to other areas within health. We aim to conduct independent experiments that stand alone, as well as those that might support co-creation and prototyping of interventions for behavioural insight tests. We hope to expand our model to include a physical location where we could conduct panel discussions and have the technology to support testing and surveys, a more sophisticated database and analytics approach, and a designated B-Hub team to support panel engagement and the tests undertaken. 

 

The possibilities are many, and we invite you to follow along with us as we build the Indlela B-Hub. Do you have any ideas of any behavioural interventions you might be interested in testing within the B-Hub? We encourage you to share them with us by emailing us at indlela@heroza.org

By: Laura Schmucker Indlela’s UPenn Snr Programme Manager |05.09.2022