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Table 2 Advanced planning intervention: Diagnosis and Design

From: A behavioral design approach to improving a Chagas disease vector control campaign in Peru

DIAGNOSIS DESIGN
Actionable bottlenecks Relevant behavioral economic principle Original intervention design element Implementation challenge Revised design
Preparing home for spraying is perceived as difficult and stressful. Present bias will lead households to discount the burden of participating in the future
Self-consistency bias [38] suggests that once a household commits in advance, they will be more likely to follow up on that commitment
Schedule households for spraying 2–4 weeks in advance. 2–4 weeks was too far in advance for both households and the spray brigade. Brigade chiefs could not plan that far ahead of time due to water shortages, health sector strikes, holidays, and a canine rabies outbreak.
Households scheduled in advance were often not home for spray appointment.
Advance scheduling was revised to 7–10 days ahead of spraying.
Spray brigade schedule was intentionally “overbooked” to account for no-shows.
Households are not able to plan for spraying when scheduled only 1 day prior. Planning prompts can help follow through on desired behavior. [39,40,41] Offer planning prompts as well as email, text message, phone call or visit reminders to advance scheduled households. Few households chose email or text message reminders Only call or visit reminders were offered.
Those working during the day cannot participate.   Provide more flexible scheduling options to households (evenings and weekends, more choice of spraying time). Evening hours were not feasible for the spray brigade, although frequently requested by households. Weekend spraying was used for “recuperation,” or to catch up, but could not be scheduled in advance. Households scheduling in advance could choose preferred appointment times during the regular spray day but not weekend or evening hours.
Sprayer arrival time is unpredictable.   Spray households according to pre-arranged schedule (rather than proceeding house-by-house down a block). If households scheduled in advance were not at home for spray appointment, sprayers could not “make up” the missed appointments by spraying nearby households, as these were also scheduled in advance. We staffed up extra sprayers to fill in when regular spray brigades could not accommodate the pre-arranged schedule.