Selection and impact in the sharing of stigmatized information

Last registered on August 25, 2023

Pre-Trial

Trial Information

General Information

Title
Selection and impact in the sharing of stigmatized information
RCT ID
AEARCTR-0011928
Initial registration date
August 14, 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
August 16, 2023, 11:22 AM EDT

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

Last updated
August 25, 2023, 3:33 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Region

Primary Investigator

Affiliation
Harvard University

Other Primary Investigator(s)

Additional Trial Information

Status
In development
Start date
2023-08-15
End date
2023-09-30
Secondary IDs
Prior work
This trial is based on or builds upon one or more prior RCTs.
Abstract
This project aims to identify whether there is a trade-off in how individuals prefer to spread information about stigmatized services versus what is most effective at increasing message recipients’ take-up of stigmatized services. In particular, are people more willing to share information in dismissive (relative to sincere) ways, or a manner that makes their friend feel less singled out (relative to being targeted)? Is the recipient of a dismissive and/or general message less likely to choose to use the advertised services? This project studies the above questions in the context of peer referrals for a mental health phone counseling service for Syrian refugees.
External Link(s)

Registration Citation

Citation
Smith, Emma. 2023. "Selection and impact in the sharing of stigmatized information ." AEA RCT Registry. August 25. https://doi.org/10.1257/rct.11928-2.0
Experimental Details

Interventions

Intervention(s)
The experimental intervention consists of the manner in which the counseling helpline is introduced to participants. The four framings are designed to separately alleviate the sender's image concerns regarding sharing stigmatized information, and the recipient's image concerns regarding being targeted to receive information about a stigmatized service.
Intervention Start Date
2023-08-15
Intervention End Date
2023-09-30

Primary Outcomes

Primary Outcomes (end points)
Sender’s choice of whether the recipient will receive information about the helpline from the study. (Constructed as a recipient-level indicator variable taking 1 if the sender chooses the person in the subset of friends who should receive information about the helpline, and 0 for the sender’s friends who the sender does not select.)

The recipient’s take-up of the helpline: Takes 1 if the recipient agrees that she wishes to be contacted by the helpline if found eligible (measured prior to completing the screening to confirm eligibility)
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Recipient’s self assessment of her distress: Standardized score of the recipient’s self assessment of her distress on a scale from 1 to 10 with 10 being the most distressed, standardized using the mean and standard deviation of Framing 1.

Recipient’s self-assessment of the benefit she would gain from using the helpline: Standardized score of the recipient’s self-assessment of her distress on a scale from 1 to 10 if she were to start having weekly phone sessions with the helpline for 1 month, standardized using the mean and standard deviation of Framing 1.

Recipient’s assessment of the distress that her friends believe she is experiencing: Standardized score of the recipient’s self-assessment, standardized using the mean and standard deviation of Framing 1.

Recipient’s opinion of the ideal framing to use when communicating the helpline to someone who is uncomfortable with mental health services.
- Indicator variable for preferring compensation framing over “want to share” framing.
- Indicator variable for preferring “targeting my friends” framing over general friends framing.

Accuracy of recipient’s self-assessment of the probability that she has anxiety or depression: An indicator variable taking 1 if and only if the recipient states she believes it is “likely” or “very likely” that she has experienced anxiety or depression in the past 2 months AND her PHQ-9 score or GAD-2 score indicates that she likely has depression or anxiety, using standard cutoffs.

Recipient’s opinion that she should be able to solve her own mental health problems: Standardized score of likert variable, standardized using the mean and standard deviation of Framing 1.

Recipient’s opinion that religious solutions are the best way to solve mental health problems: Standardized score of likert variable, standardized using the mean and standard deviation of Framing 1.

Heterogeneities to be tested
- Sender prior use of MH services
- Sender wants to use the advertised helpline
- Sender treatment status in prior experiment
- Sender’s guess of the recipient’s distress level
- Recipient’s depression and anxiety scores
- Sender’s depression and anxiety scores
- Recipient prior use of mental health services
- Original framing under which the sender selected the recipient to get the information
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The experimental design is as follows:
1. Participants surveyed about their social network
2. Participants randomized to a particular framing/wording to introduce the counseling helpline
3. Participants asked which friends they want informed about the helpline if using the assigned framing.
4. Participants offered a financial incentive if they are willing to have the helpline introduced using different framings.
5. Recipients (friends of the original participant) who the original participant agreed to have contacted are contacted and introduced to the helpline using a randomly selected framing from within the framings the original participant consented to.
6. Recipients’ take-up of the helpline is measured.
Experimental Design Details
Participants’ close social network will be elicited by phone survey. Participants will then be randomized to one of the following four framings, which they will be told is how the helpline could be introduced by the study to their friends if they want the study to inform their friends about the helpline:
- F1: We may tell her that the project offered to compensate you financially to help us check if your friends are interested in this helpline, and you mentioned she is one of the people you know.
- F2: We may tell her the project offered to compensate you to help us check if your friends are interested in this helpline, and you indicated she or people she knows might benefit from the information.
- F3: We may tell her you wanted us to check if your friends are interested in this helpline, and you mentioned she is one of the people you know.
- F4: We may tell her you wanted us to check if your friends are interested in this helpline, and you indicated she or people she knows might benefit from the information.

The participant then selects which of her friends, if any, she wants the study to inform about the helpline if using that framing.

Participants are then offered a financial incentive if they are willing for the study to introduce the helpline to their friends in the 3 other ways.

Recipients, that is the original participant’s friends, are then randomized to receive information about the helpline using one of the framings that the original participant agreed to.

Recipients are called, read the introduction, and asked if they want to use the helpline. Conditional on expressing interest, the recipient is screened for eligibility based on her mental health vulnerability, and if found to be eligible then her contact information is shared, with her explicit consent, with the helpline to be contacted for counseling.
Randomization Method
Randomization done in office by a computer.
Randomization Unit
Senders are randomized across all 4 framings at the sender-level.
Recipients are randomized to framings at the recipient level, randomizing across the framings to which the sender consents.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
700 senders, with an expected average of 3 friends named per sender.
The design of sender willingness to each recipient is clustered at the recipient level.
2100 recipients: Recipient treatment is not clustered.
Sample size: planned number of observations
700 senders, 2100 recipients
Sample size (or number of clusters) by treatment arms
175 senders per framing arm
525 recipients per framing arm
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
The binary variable of whether each friend is selected by the sender to receive the helpline information (constructed at the recipient level): MDE is 8.8 percentage point difference on a base sharing rate of 80%, a 10.1 percentage point difference on a base sharing rate of 70%, and an 11.5 percentage point difference on a base sharing rate of 60%. Take up of the helpline by the recipient (binary variable): 6.4 percentage point difference on a base take-up rate of 80%, 8.6 percentage point difference on a base take-up rate of 50%.
IRB

Institutional Review Boards (IRBs)

IRB Name
Harvard University-Area Committee on the Use of Human Subjects
IRB Approval Date
2023-06-14
IRB Approval Number
IRB20-1023
Analysis Plan

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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