Habits

Low medication adherence when initiating antiretroviral treatment (ART) is a key barrier to HIV virologic suppression, resulting in avoidable cases of drug resistance, death, and viral transmission. Routinized pill-taking can lead to successful long-term ART adherence, and short-term behavioral economics-based supports are a novel way to overcome the limited success of existing routinization interventions. This study proposes to test this combined approach for promoting long-term ART adherence using a Stage III Sequential, Multiple Assignment, Randomized Trial (SMART) design in one of the largest HIV clinics in Uganda to identify the most cost-effective adaptive intervention that if found effective is generalizable to other settings and other chronic diseases.

H22 - Unconscious Mind Training and Memory Encoding Phase I The core problem this clinical trial, H22, seeks to address is the pervasive challenge of modifying deeply ingrained, often unconscious, unwanted behaviors within the general population. Many individuals struggle with habits or actions that negatively impact quality of life, productivity, or well-being, yet conventional methods often fall short due to the unconscious nature of these behaviors. Specifically, the trial aims to investigate the efficacy of H22, a novel intervention designed to engage and train the unconscious mind, in mitigating these unwanted behaviors. The central hypothesis guiding this research is that H22 training will empower volunteers to significantly reduce the frequency and intensity of identified unwanted behaviors.

The goal of this clinical trial is to determine the effectiveness of a novel mobile health-based habit formation intervention for increasing and maintaining adherence to anti-hypertensive (AH) medication among people living with hypertension and indicate medication nonadherence. The main questions it aims to answer are: * Can daily incentives for AH pill taking increase and maintain AH medication adherence, control blood pressure, and reduce healthcare utilization and costs? * Can daily incentives for AH pill taking, combined with action planning (e.g., "After I drink my morning coffee, I will take my medication.") increase and maintain medication adherence, control blood pressure, and reduce healthcare utilization and costs? * What aspects of daily incentives and/or action planning do participants find most helpful or effective for AH medication adherence? * What barriers exist for participants who receive daily incentives and/or action planning? Researchers will compare three study groups: those who only receive daily incentives for the AH pill taking, those who receive daily incentives for AH pill taking combined with action planning, and a control group (who do not receive daily incentives for AH pill taking or action planning). By comparing these three groups, the researchers will be able to determine the effectiveness of the daily incentives with or without action planning for promoting long-term AH medication adherence, reduce healthcare costs, and improve blood pressure. Participants will: * Complete 5 online surveys over the course of 2 years (baseline, month 4, month 8, month 12, month 24). * Submit blood pressure reading for 7 consecutive days after each survey timepoint. * Submit photo evidence of their AH pill taking for 4 months (intervention groups only). The highest- and lowest-performing participants in each intervention group will also be invited to complete a 30-minute interview to identify additional factors that contributed to either successful or unsuccessful completion of the intervention.

The goal of this clinical trial is to evaluate whether different approaches to action planning can promote physical activity (PA) habits, increase PA behavior, and improve cognitive functioning in older adults who are currently inactive or insufficiently active. The main questions it aims to answer are: 1. Does a trial-and-error approach to PA action planning lead to greater improvements in PA habits, PA behavior, and cognitive functioning compared to standard PA planning or non-PA planning? 2. Does greater consistency and successful enactment of action plans result in more substantial changes in PA habits, behavior, and cognitive functioning? Researchers will compare three groups to determine which planning approach yields superior outcomes.: 1. Non-PA planning (generic weekly planning) 2. PA planning (weekly planning for PA) 3. PA trial-and-error planning (weekly PA plans followed by preferred plan adoption) Participants will: 1. Wear Fitbit monitors continuously for 9 months to track PA behavior 2. Complete mobile cognitive assessments daily for 7 days before the intervention, monthly during the intervention, and at follow-up 3. Create action plans and report on PA habits, intentions, and plan enactment weekly during the intervention and at follow-up