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Social Stigma and Condom Purchase: The Role of Misperceptions

Last registered on May 17, 2023

Pre-Trial

Trial Information

General Information

Title
Social Stigma and Condom Purchase: The Role of Misperceptions
RCT ID
AEARCTR-0011378
Initial registration date
May 11, 2023

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 17, 2023, 2:35 PM EDT

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

Locations

Primary Investigator

Affiliation
Center for Economic Research and Graduate Education, Economics Institute (CERGE-EI), a joint workplace of Charles University and the Economics Institute of the Czech Academy of Sciences, Politických vězňů 7, 111 21 Prague, Czech Republic

Other Primary Investigator(s)

Additional Trial Information

Status
In development
Start date
2023-06-10
End date
2023-08-31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Misperceptions regarding the social appropriateness of condom purchase can potentially lead to
the internalization of social stigma concerns, which in turn discourage people from acting on their
true preferences for condom purchase. I propose to implement a field experiment in Ghana on
a student sample, in which I will first test the existence of misperceptions regarding the social
appropriateness of condom purchase. Next, I will use an information provision treatment to correct
the largest misperception I detect and investigate if treated participants update their beliefs, and
thus, initiate behaviour change. I will use a series of condom vouchers distributed to participants
to estimate a repeated objective behavioral measure of condom purchase. This will also allow me to
determine how long treatment effects last. In order to know what makes information provision more
efficient, I will investigate if the reputation of the information conveyor magnifies the efficiency of
information provided. Owing to the re-calibrating effects of informational treatments, I anticipate
that if a participant has social image concerns, the treatment will induce this participant to act in
accordance with the views of peers he has been exposed to. The implications of my findings may
be beneficial for the healthcare sector, and for the development of effective policies.
External Link(s)

Registration Citation

Citation
Adam, Salamatu Nanna. 2023. "Social Stigma and Condom Purchase: The Role of Misperceptions." AEA RCT Registry. May 17. https://doi.org/10.1257/rct.11378-1.0
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Experimental Details

Interventions

Intervention(s)
Based on the treatment arm an individual is randomly assigned to, they will receive either risk information, information about peers' views on the social acceptability of condom use, or a combination of both. For those who receive both messages, I vary the salience on the information source. (Please refer to the Experimental Design for further details.)
Intervention Start Date
2023-06-17
Intervention End Date
2023-08-26

Primary Outcomes

Primary Outcomes (end points)
After the main survey, each participant is eligible to receive a voucher redeemable for a pack of condoms from a prespecified pharmacy. The primary outcomes are thus;

1.Take-up of the voucher after the main survey
2. Redemption of the voucher after the main survey
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Participants wil have the option of downloading a condom voucher three weeks after the main survey and after the follow-up. The secondary outcomes are thus;

3. Take-up of second and third voucher
4. Redemption of second and third voucher
5. Learning Rates based on belief updating
6. Composite index of the perceived social acceptability of contraceptive use
7. Composite index of safe sexual behaviou
Secondary Outcomes (explanation)
- Data to construct the composite index of the perceived social acceptability of contraceptive use will be based on response to statements from the follow up survey *It is not shameful/embarrassing to buy condoms, *Contraception use is not a sign of lack of self-control, and *second posterior beliefs elicited at the end of the main survey.

- Data to construct the composite index of safe sexual behaviour will be based on response to statements from the follow up survey *I used some type of contraceptives during the last 90 days, *I used a condom during my last sex, *I have been sexually active in the last 90 days, *I have had more than 1 sexual partner in the last 90 days.

Experimental Design

Experimental Design
As a supplementary survey, a sample of university students in Ghana will be recruited to document what kind of misperceptions regarding the social acceptability of contraceptives exist. Next, a larger sample of male students will be recruited and randomized into groups to receive corrective information based on the largest misperception detected in the supplementary survey. A series of condom vouchers will be distributed to participants over the period of the survey.

Experimental Design Details
A sample of university students will be recruited to participate in an experiment from the Kwame Nkrumah University of Science and Technology in Kumasi, Ghana. Participants will take an online survey on their personal phones using the platform Qualtrics.

A. Supplementary Survey
Recruitment of participants will be open to all students and non-discriminatory. Before the survey, participants will be ushered into a large room with one empty space seat between any two given sitting positions to enhance privacy during the survey. The survey will be conducted in two sessions of 250 participants each. Participants will be instructed to follow a link to the Qualtrics platform to partake in the survey. They will be informed about the benefits and risks of partaking in the survey, and given an e-mail address to send all further enquiries to. They can then choose to partake in the survey by indicating their consent. To start, I will collect some basic demographic information as well as measures of religiosity and networks. Next, I will elicit their own views and perceived other beliefs about some statements (these statements are coined from focus group discussions used to elicit normative beliefs about contraception use) by asking them to indicate if they agree or disagree to these statements, and to guess the share of other participants who agree to the statements.

Lastly, I will use a list randomization technique to collect participants self reports on the social acceptability of contraceptive use and purchase, as well as safe sexual behaviour. A randomly selected half of the participants will be asked to answer one sensitive question in the form of a true or false statement (direct elicitation), in addition to stating how many of 3 innocuous statements are true for them without indicating which ones. The other half of the participants will be asked to state how many of 4 statements (3 innocuous and 1 sensitive) are true for them without indicating which ones (indirect elicitation). Randomization to the direct or indirect elicitation group will be repeated for each of the 6 sensitive questions to be asked. This survey will end after participants indicate if they would like to be contacted for future surveys. All participants are entitled to their show up fees which will be paid in cash. In addition, winners who guess accurately will receive extra cash and 200 randomly selected participants will receive condom vouchers.


B.Main Survey
Recruitment of participants is open to all male student except those who already partook in the supplementary survey. I sample male students because they are the most suitable subjects for the contraceptive type I offer (male condoms). In order to enhance privacy during the experiment, the survey will be conducted in five sessions with 200 students per session. There will be an empty seat space between any two participant's to reduce the scope for communication. Each participant will be presented with a pseudo-ID with a unique code to link a participants self-reported responses to administrative data collected later.

Participants will be told to follow a link to the Qualtrics platform to complete the survey. They will be informed about the benefits and risks of partaking in the survey, and given an e-mail address to send all further enquiries to. They can then choose to partake in the survey by indicating their consent. This is followed by a block of questions that collect the needed baseline characteristics including questions on demographics, measures of religiosity and networks. The next block elicits the prior beliefs of all participants by asking them to indicate their own views and perceived other beliefs regarding some 3 statements (one of these statement will be based on the largest misperception detected at the supplementary survey) by agreeing or disagreeing to them, as well as guessing the share of other participants in the session who agree to the same statement. This later task is incentivized.

Participants are then randomly assigned by Qualtrics into one of either the (i.) prestige treatment group, (ii.) ordinary treatment group, (iii.) risky information treatment group or the (iv.) control group. The treatment is an informational block with a message about the dangers of risky health behaviours using unprotected sex as an example. In addition, it contains the findings of the supplementary survey indicating how many students agree and disagree to a statement (particularly, this statement will be based on the largest misperception detected at the supplementary survey). The treatments differ in this manner; in the Prestige Treatment Group, I emphasis on the characteristics of the participants in the supplementary survey while in the Ordinary Treatment Group, this information is omitted. In other words, the treatment message in both groups are the same and differ only on account of the salience of the identity of the information source in the Prestige Treatment Group. I aim to show that treatment effects vary with the identity of the information source/messenger. Both treatment messages will be complemented with a graphical illustration of the findings to enhance understanding of the message. In the risky information treatment group, I offer the same message about the dangers of risky health behaviours using unprotected sex as an example, while the control group receives no information. This is followed by a posterior belief elicitation.

Three weeks after the survey, participants will be sent a second round of condom vouchers. The experiment will end with a follow-up survey six weeks afterwards. A second posterior belief elicitation will be conducted, and participants will get access to a link to download another condom voucher. 100 randomly selected participants will be rewarded with mobile airtime.
Randomization Method
Randomization through Qualtrics
Randomization Unit
Randomization at individual level
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
500 participants for the pilot survey, and 2,000 participants for the main survey
Sample size: planned number of observations
500 participants for the pilot survey, and 2,000 participants for the main survey
Sample size (or number of clusters) by treatment arms
500 participants in each treatment arm for the main experiment.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
With as little as 10% redemption of the vouchers in the control and 20% redemption of vouchers in the treatment group, I can expect to get effect sizes of at least 1% and power of 0.99. Power and the MDE increases as voucher redeemption increases.
IRB

Institutional Review Boards (IRBs)

IRB Name
Center For Economic Research and Graduate Education Scientific Council
IRB Approval Date
2023-05-10
IRB Approval Number
N/A

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials