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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.


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Challenges: Behavior Change
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BEMPU: The Newborn Temperature Monitoring Band

Ratul Narain, BEMPU Technologies (Bengaluru, Karnataka, India)
Oct 28, 2014

Ratul Narain of BEMPU Technologies Private Ltd. in India will develop and test a temperature monitoring baby bracelet to reduce the incidence of hypothermia in newborns. Newborns are unable to regulate their body temperature, and low temperatures can lead to life-debilitating illnesses. Skin-to-skin warming (kangaroo care) can maintain a healthy body temperature, but is not commonly practiced in resource-poor regions in India, where newborn hypothermia rates are high. To address this, they will further develop an inexpensive and simple bracelet to be worn by babies during the first two months of life that sounds an alarm when the baby's temperature gets too low to prompt the parent to respond. Sensitivity and specificity will be optimized, and the bracelet evaluated in field trials.

Inciting Healthy Behaviors Using a Human Computation Game

Eamonn Keogh, University of California, Riverside (Riverside, California, United States)
Oct 28, 2014

Eamonn Keogh from University of California, Riverside in the U.S. will design and test a human computational game for individuals in developing countries to encourage positive behavior such as taking medication or attending school. The game is played on mobile phones, and begins with an automatic prompt to perform a specific healthy behavior, which then requires the individual to respond by sending photographic evidence of the behavior to a randomly selected individual for evaluation, with rewards offered for compliance. They will develop the game, write the necessary open source software, and conduct a case study in the developed world to evaluate and refine the approach.

Introducing Group Prenatal Care (GPC) in Bangladesh

Abdur Razzaque Sarker, International Centre for Diarrhoeal Disease Research, Bangladesh (Dhaka, Bangladesh)
Oct 28, 2014

Abdur Razzaque Sarker from the International Centre for Diarrhoeal Disease in Bangladesh will test whether group prenatal care for women has a positive effect on maternal and child health when compared with traditional one-on-one prenatal care. They hypothesize that prenatal classes with groups of 8-10 women will promote support networks and social interactions, and facilitate learning, thereby improving health outcomes. This will be tested using a prospective study in selected health centers in Bangladesh.

Priming HIV-Infected Patients to Adhere to Treatment

Sandra McCoy, University of California, Berkeley (Berkeley, California, United States)
Oct 22, 2014

Sandra McCoy from University of California, Berkeley in the U.S. will analyze whether behavioral priming methods such as associational cues and social influence can promote adherence to HIV treatment in Tanzania. HIV prevalence in Tanzania is high, at 5.1%, and poor adherence to antiretroviral therapy is a major problem due in part to long patient waiting times and stigmatizing attitudes. Behavioral priming involves using a stimulus to indirectly or subconsciously influence behavior. They will hold group discussions with HIV patients and healthcare workers to identify several behavioral priming strategies such as positive feedback cues on health cards, and conduct a pilot study to evaluate their effect on adherence.

HIV Projection Mapping with Crack Users in Mexico City

Alice Cepeda, University of Southern California (Los Angeles, California, United States)
Oct 15, 2014

Alice Cepeda from the University of Southern California in the U.S. will project short 3-D messages given by crack users on selected walls and buildings to illustrate the dangers of crack use on HIV risk, and to promote healthy behavior and testing in local communities. Mexico has seen a recent increase in crack cocaine consumption, which is associated with an increased risk of HIV. They will focus on a vulnerable community in Mexico City, and select message content and ideal sites and times to project the messages. During the projections, they will provide trained individuals to offer additional health advice and on-site HIV testing. The effects will be evaluated on the behavior of 50 local crack users.

Father-Baby Bonding for Infant Health and Family Nonviolence

Marilyn Nations, Universidade de Fortaleza (Fortaleza, Ceará, Brazil)
Oct 13, 2014

Marilyn Nations from the University of Fortaleza in Brazil will evaluate a program established in 1990 at a public hospital in Fortaleza that was designed to increase bonding between fathers and their newborns and thereby improve overall health, as well as reducing crime rates. Fortaleza has a high crime rate mostly linked to low socioeconomic class males. Given fathers had been traditionally excluded from pregnancy and birth-related events, the hypothesis was that encouraging father-baby bonding could establish a 'life-valuing' ethos that would have a knock-on effect on a variety of health and social factors. They will now formally assess this program using questionnaires and in-depth interviews to measure its effect on factors such as violent behavior and employment status after five years. Evidence that the approach is successful will be used to promote its application in other hospitals in Brazil and beyond.

Nudging TB Sufferers to Cover Mouths Through Social Pressure

Ann Don Bosco, Good Business (London, United Kingdom)
Oct 10, 2014

Ann Don Bosco of Good Business in the United Kingdom will run a prevention campaign to reduce the transmission of tuberculosis by making coughing without covering your mouth socially unacceptable. Tuberculosis is a major problem in developing countries, particularly in South Africa, and is primarily spread by coughing. Previous cough prevention campaigns have focused on changing the behavior of the infected person. However, healthy individuals should be more willing to promote preventative behavior in order to avoid becoming infected. Therefore, their campaign will involve promoting the use of a simple, humorous catchphrase by uninfected individuals to express displeasure when someone coughs in their presence without covering their mouths. They will utilize radio, billboards, and mobile phones to spread the message, and analyze the impact on behavior.

Fostering TB Medication Adherence via Innovative Packaging

Andrew Cross, Karma Healthcare (Udaipur, Rajasthan, India)
Oct 9, 2014

Andrew Cross of Microsoft Research India in India will try to improve adherence to tuberculosis medication in India by evaluating an inexpensive approach combining personalized pill packaging with mobile phones to report when medication has been taken and to receive reminders. Less than half of people with chronic diseases take their medication correctly. And for diseases like tuberculosis this can lead to drug-resistance, which is a serious problem. Solutions such as the electronic pillbox have been successful, but are expensive. They will conduct a randomized controlled trial of their pill blister packet, which exposes a unique number when a pill is taken and prompts the user to make a free mobile phone call to report it. Frequent reminders to take medication will be sent by SMS, and if medication is missed, individuals will be contacted directly by health care workers.

Inciting Healthy Behaviors by Simplifying the Financial Lives of the Poor

Manuela Angelucci, University of Michigan (Ann Arbor, Michigan, United States)
Oct 9, 2014

Manuela Angelucci from the University of Michigan in the U.S. will test whether addressing financial insecurity and chronic stress in poor Mexican women can improve health. They will perform a randomized control trial involving 15,000 low-income Mexican women who are currently in a national program that provides cash when they receive regular health checks. They hypothesize that automatically transferring 10% of that money into a savings account will simplify the women's finances and thereby reduce stress and improve mental health. In turn, this could enhance the mental resources of these women and enable them to more readily adopt healthier behavior such as improving nutrition and getting their children vaccinated.

Manicures and Preventative Healthcare!

Nicholas Sowden, Penda Health (Nairobi, Kenya)
Oct 8, 2014

Nicholas Sowden from Penda Health in Kenya will test whether offering free manicures to health center visitors increases the number of visitors and frequency of visits by low-income Kenyan women and their families. Kenyan women with a limited income still spend money on personal care including manicures and hairstyling. They hypothesize that coupling these desirable goods and services with preventative health services will motivate more women to attend medical centers. This will be tested at one of their medical centers in Nairobi, which is frequented by low-income families and offers health services including antenatal care and HIV testing.

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