Completion or Task-based Engagement incentives for Well-child Visits

Last registered on May 09, 2024

Pre-Trial

Trial Information

General Information

Title
Completion or Task-based Engagement incentives for Well-child Visits
RCT ID
AEARCTR-0013516
Initial registration date
April 29, 2024

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
May 09, 2024, 2:10 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

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Primary Investigator

Affiliation
USC

Other Primary Investigator(s)

PI Affiliation
University of Southern California

Additional Trial Information

Status
On going
Start date
2024-03-06
End date
2025-03-31
Secondary IDs
Health Insurance, Public and Private
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
In a Medicaid managed health care system, patients age off their parent’s electronic health record at 18 years old but are still eligible for annual “Well Child” visits until age 21. In many cases, these "adult" patients are “lost” to the health care system because the system is no longer legally allowed to coordinate care with the patient’s parents. In this work, we test approaches to engaging these patients with the health care system and encouraging them to complete an annual Well Child visit. In particular, we test whether financial incentives can increase engagement and whether a completion-based incentive that rewards patients for completing a Well Child visit, is as effective at increasing Well-Child visit completion rates as a task-based incentive that reward patients for each step in the process of completing the visit (electronic health record sign-up, appointment set-up, and appointment completion). By setting total compensation the same across these two financial incentive arms, standard economic theory would predict that the completion and task-based incentives have the same effect on completion rates. However, a task-based incentive, which provides intermediate rewards, may better maintain engagement and thus further increase completion rates.
External Link(s)

Registration Citation

Citation
Chang, Tom and Mireille Jacobson. 2024. "Completion or Task-based Engagement incentives for Well-child Visits." AEA RCT Registry. May 09. https://doi.org/10.1257/rct.13516-1.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
Financial incentives are offered to encourage Well-child visit completion.
Intervention Start Date
2024-03-06
Intervention End Date
2024-06-30

Primary Outcomes

Primary Outcomes (end points)
Well-Child Visit completion within 6 months of letter shipment
Primary Outcomes (explanation)
Indicator variable for patient completion of a Well-child visit within 6 months of letters being sent out by health system.

Secondary Outcomes

Secondary Outcomes (end points)
Mychart (electronic health record system) sign-up; Well child appointment made
Secondary Outcomes (explanation)
Indicator variable for patient electronic health record system sign up within 6 months of letters being sent out by the health system; Indicator variable for patient setting up a Well Child visit within 6 months of letters being sent out by the health system;

Experimental Design

Experimental Design
Patients are randomized to 1 of 3 arms:

1) a completion incentive arm where patients are sent a letter explaining the three-step process for completing a Well-child visit and are offered a $75 incentive for completing a Well-child visit
2) a task-based incentive arm where patients are sent the same basic letter but are offered $25 each for sign-up, appointment setting, and completion of a Well Child visit and
3) a usual care (control) arm that receives only the letter explaining the three-step process for completing a Well-child visit.

Experimental Design Details
Not available
Randomization Method
computer
Randomization Unit
patient
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
1465
Sample size: planned number of observations
1465
Sample size (or number of clusters) by treatment arms
0
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Based on assumptions of 80% power and 2.5% alpha (adjusting for the two comparisons from our main hypotheses), we will be able to detect a change in the completion rate of 2.63 percentage points with a control group completion rate of 0.5%, 3.11 percentage points with a control group completion rate of 1%and 3.82 percentage points with a control group completion rate of 2%. Adding controls to the regression will further reduce the MDE.
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Southern California
IRB Approval Date
2022-03-02
IRB Approval Number
UP-21-01124
Analysis Plan

Analysis Plan Documents

Pre-analysis plan

MD5: 82cb9caea255552c364f5267f9a3aee4

SHA1: 1f79219d87c6a5b6923f75045f397a69d2148d19

Uploaded At: April 29, 2024