Maternal Beliefs, Mental Health, and Economic Resources on Human Capital Accumulation in Early Life

Last registered on July 20, 2024

Pre-Trial

Trial Information

General Information

Title
Maternal Beliefs, Mental Health, and Economic Resources on Human Capital Accumulation in Early Life
RCT ID
AEARCTR-0012108
Initial registration date
September 28, 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
October 04, 2023, 4:44 PM EDT

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

Last updated
July 20, 2024, 4:22 AM EDT

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

Locations

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Primary Investigator

Affiliation
University of Sydney

Other Primary Investigator(s)

PI Affiliation
University of Melbourne
PI Affiliation
American University

Additional Trial Information

Status
In development
Start date
2023-09-01
End date
2024-12-31
Secondary IDs
ACTRN12623000659606
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Using a novel locally grown health service delivery model in Bangladesh that tracks the universe of newly married couples and connects them to local health services, we aim to study whether targeting mothers early in pregnancy with three complementary interventions -- individually or in combination -- can improve their own wellbeing as well as their children’s developmental outcomes. Our outcomes of interest include women’s empowerment, parental inputs, physical and mental health, and children’s health and development.
External Link(s)

Registration Citation

Citation
Baranov, Victoria, Shyamal Chowdhury and Valentina Duque. 2024. "Maternal Beliefs, Mental Health, and Economic Resources on Human Capital Accumulation in Early Life." AEA RCT Registry. July 20. https://doi.org/10.1257/rct.12108-1.1
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Experimental Details

Interventions

Intervention(s)
We will have a single control group, and three treatment groups. Villages will be assigned to one these groups (see Sections ‘Experimental Design’ and ‘Experiment Characteristics’ below for details). Treatment households will receive information. Additional intervention includes psychological counselling in group sessions, which will be cross-randomized.
Intervention Start Date
2023-10-01
Intervention End Date
2024-12-31

Primary Outcomes

Primary Outcomes (end points)
We will measure women’s empowerment, parental investment, mother’s physical and mental health, IPV, and child’s physical health and cognitive and socio-emotional development.
Primary Outcomes (explanation)
Women’s empowerment (women’s agency in fertility planning, personal expenditures and expenditures on children, children and household investment decisions, savings accounts, and participation in social programs and local leaderships); Women’s beliefs (about importance of early life conditions, self-efficacy in parenting, beliefs about modifiability of child skills); Parental Investment (time, monetary, and warmth); Physical health (self-reported physical health, body-mass index, and mid-upper arm circumference (MUAC)); Mental health (PHQ-9 a screener for depression, GAD-7 a screener for anxiety); IPV; and Stress (Cohen Stress Scale, Biomarkers of stress using hair samples. We plan to collect biomarkers of stress from mothers and their infants. Using hair samples, we can extract HPA axis hormones such as cortisol. Hair-derived biomarker measurement indicates HPA axis activity over the course of months (analytes in each centimeter of hair approximate hormone secretion over one month), and thus more accurately reflect chronic hormone secretion (see Baranov et al. 2022 for a discussion and an example of successful hair cortisol measurement with mother and child dyads in Pakistan). Hair sample collection will be funded with this proposal but further funding will be sought for laboratory extraction of analytes. Hair samples are easily storable and stable for 1-2 years.

Secondary Outcomes

Secondary Outcomes (end points)
Health at birth (birth weight and low birth weight); Developmental outcomes (Bayley Scales of Infant and Toddler Development that captures children’s cognitive, language, motor, adaptive); Health (weight-for-length, length-for-age, acute respiratory illnesses); Stress (Biomarkers of stress from hair samples).
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We will have two information treatments and a single control group, consisting of 40, 40, 40 villages, respectively. In addition, a psychological counselling treatment will be cross-randomized with the information interventions (for details, see section "Intervention" above).
Experimental Design Details
Not available
Randomization Method
Randomization will be conducted in office by a computer.
Randomization Unit
Two-step randomization: first villages will be assigned to treatment and control groups. Second, treatment villages were further assigned to receive information treatment or information plus psychological counselling treatments.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
120 villages
Sample size: planned number of observations
2,640
Sample size (or number of clusters) by treatment arms
1. Information plus enrolment support: 40 villages, 22 households from each villages, 880 households in total.
2. Information on the importance of early life conditions: 40 villages, 22 households from each villages, 880 households in total.
3. Psychological counselling: 20 villages from treatment 1 and 20 villages from treatment 2, 880 households in total
4. Control group: 40 villages, 22 households from each villages, 880 households in total.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Given the sample sizes above and accounting for the varied clustered design, we would be powered to detect a Minimum Detectable Effect (MDE) size of 0.31 of a standard deviation (SD) change for the mental health intervention (randomized at the Health Centre (UHFWC) level with the conservative estimate of 20 centers). For the information arms, we would be powered to detect a 0.19SD change for either of the information interventions (main effects only). As benchmark for the MDEs on mental health interventions, Rahman et al. (2008) found that a mental health intervention similar to the one proposed here improved mothers’ mental health by 0.70SD, while Sikander et al. (2019) found that a more scalable, peer-delivered version of the intervention increased mothers’ mental health by 0.30SD. A tele-counseling intervention in Bangladesh improved mental health by 0.65SD (Vlassopolous et al. (2021)).
IRB

Institutional Review Boards (IRBs)

IRB Name
The University of Sydney Human Research Ethics Committee
IRB Approval Date
2023-03-15
IRB Approval Number
2023/004
Analysis Plan

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