Social Signaling in Childhood Immunization: Evidence from a Field Experiment in Sierra Leone
Last registered on August 01, 2018

Pre-Trial

Trial Information
General Information
Title
Social Signaling in Childhood Immunization: Evidence from a Field Experiment in Sierra Leone
RCT ID
AEARCTR-0001299
Initial registration date
June 17, 2016
Last updated
August 01, 2018 3:44 AM EDT
Location(s)

This section is unavailable to the public. Use the button below to request access to this information.

Request Information
Primary Investigator
Affiliation
UC Berkeley
Other Primary Investigator(s)
Additional Trial Information
Status
On going
Start date
2016-06-14
End date
2019-05-31
Secondary IDs
Abstract
Can social signaling incentivize caregivers to immunize their children? Working with the Ministry of Health and Sanitation (MoHS) Sierra Leone, I introduce a social incentive in the form of differently colored bracelets that children receive upon coming for immunization visits. The differently colored bracelets make highly salient if the immunization schedule is unfinished and if other children have received immunizations that your child has missed. Different to most incentives that are material or private in nature (e.g. food, cash transfers) the bracelets make the decision to immunize your child observable and allow caregivers to signal to others that they look after their child's health. I implement a field experiment in government clinics to test the effects of the social incentive on timely and complete immunization. I further measure the effect of the bracelets on individuals' knowledge and beliefs about others' immunization choices. I vary the visibility of immunization decisions across treatment arms by implementing different variations of the bracelet scheme. This experimental design allows me to separately identify the extent to which behavior change is driven by (i) the demand for bracelets or reminder effects, (ii) learning from others or (iii) the desire to signal to others.
External Link(s)
Registration Citation
Citation
Karing, Anne. 2018. "Social Signaling in Childhood Immunization: Evidence from a Field Experiment in Sierra Leone." AEA RCT Registry. August 01. https://www.socialscienceregistry.org/trials/1299/history/32452
Sponsors & Partners

There are documents in this trial unavailable to the public. Use the button below to request access to this information.

Request Information
Experimental Details
Interventions
Intervention(s)
Intervention Start Date
2016-06-14
Intervention End Date
2018-07-31
Primary Outcomes
Primary Outcomes (end points)
Primary outcome: number of (timely) immunization visits a child made
Secondary outcomes: individual knowledge and beliefs about children's immunization status; take-up and retention of bracelets over time
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
Government clinics in the selected districts will be randomly assigned into one of the four intervention arms: 1) Clinic staff distributes two differently colored bracelets. A yellow bracelet is given at the 1st immunization visit. The bracelet will be exchanged for an identical bracelet of the same color (yellow) at the 4th immunization visit. The yellow bracelet will be exchanged for a green bracelet when a child comes for the 5th immunization visit on time. The bracelets show whether a child has come for all immunizations on time (~fully informative bracelets).
2) Clinic staff distributes two differently colored bracelets. A yellow bracelet is given at the 1st immunization visit. The yellow bracelet will be exchanged for a green bracelet when a child comes for the 4th immunization visit on time. The bracelet will be exchanged for an identical bracelet of the same color at the 5th immunization visit. The bracelets show whether a child has completed four out of the five required immunization visits on time (~partially informative bracelets).
3) Clinic staff distributes two differently colored bracelets. A yellow or green bracelet is given at the 1st immunization visit. The caregiver can choose the color. No color change takes place for later vaccine visits. The bracelet will be exchanged for an identical bracelet of the same color at the 4th and 5th immunization visit irrespective of whether a child came timely for immunization (~uninformative bracelets).
4) Status quo. No bracelets are given.

Clinic staff and caregivers in all four intervention arms will be sensitized on the importance of immunization and enumerators will visit clinics at the same frequency across arms to collect data from administrative records and survey individuals.
Experimental Design Details
Not available
Randomization Method
The randomization was conducted using a computer random number generator.
Randomization Unit
Clinics
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
120 clinics
Sample size: planned number of observations
12000 children observed from administrative records, 6000 individual survey respondents
Sample size (or number of clusters) by treatment arms
30 clinics yellow bracelets for 1st and green bracelets for 5th immunization visit, 30 clinics yellow bracelets for 1st and green bracelets for 4th immunization visit, 30 clinics yellow and green bracelets for 1st immunization visit, 30 clinics control.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Sierra Leone Ethics and Scientific Review Committee
IRB Approval Date
2016-05-16
IRB Approval Number
N/A
IRB Name
Human Subjects Committee for Innovations for Poverty Action IRB-USA
IRB Approval Date
2016-05-12
IRB Approval Number
13983
IRB Name
Committee for Protection of Human Subjects (CPHS) UC Berkeley
IRB Approval Date
2016-06-14
IRB Approval Number
2016-03-8471