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Ghana Financial Incentives Trial Wave II: Spillover and Tuberculosis Screening

Last registered on February 28, 2024

Pre-Trial

Trial Information

General Information

Title
Ghana Financial Incentives Trial Wave II: Spillover and Tuberculosis Screening
RCT ID
AEARCTR-0013055
Initial registration date
February 18, 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
February 28, 2024, 4:14 PM EST

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

Locations

Primary Investigator

Affiliation
University of Oxford

Other Primary Investigator(s)

Additional Trial Information

Status
In development
Start date
2024-02-19
End date
2024-03-29
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
The Wave I Ghana Financial Incentive trial confirmed that financial incentives have a positive effect on COVID-19 vaccine intentions, reported vaccination status and verified vaccination status. Wave II provides an opportunity to understand whether this financial incentive effect generalizes to other types of health behavior: Does a similar financial incentive design with tuberculosis screening produce similar positive results? The Wave I trial was designed to identify any spillover effects across treatment arms or on untreated individuals within treated communities. We found no evidence of negative spillover effects of cash incentives on individuals who received no cash compensations. An unanswered question is whether the financial incentives affect within-subject behavior. Wave II examines the willingness of those who received financial incentives in the initial TB screening treatment to adopt similar preventative health behaviors six months later. Wave II is also designed to evaluate the relative impact of financial incentives compared to simple informational reminders.

Registration Citation

Citation
Duch, Raymond. 2024. "Ghana Financial Incentives Trial Wave II: Spillover and Tuberculosis Screening." AEA RCT Registry. February 28. https://doi.org/10.1257/rct.13055-1.0
Sponsors & Partners

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Experimental Details

Interventions

Intervention(s)
We will implement a pilot for the full study. The pilot will be a scaled-down version of the design described in the attached pdf document. We will test for fewer treatment effects. The reduced sample size will be sufficiently large such that we will be appropriately powered to detect the hypothesized treatment effects.
There are three treatment arms in the pilot study:
TB Health: A 45 second TB promotional and information video (based on the English NHS videos);

TB Health + Text: A 45 second TB promotional and information video (based on the English NHS videos) followed (three days before the screening) with a reminder voice/text message;

TB Health + \$3.00: A 45 second TB promotional and information video (based on the English NHS videos) that includes a 15 second message offering \$3.00 if the respondent receives the TB screening scheduled for their village.
Intervention (Hidden)
The detailed description of the interventions is available in the attached pdf document.
Intervention Start Date
2024-02-19
Intervention End Date
2024-03-04

Primary Outcomes

Primary Outcomes (end points)
There are two primary outcomes: 1) an expressed intention to get a TB screening after the subjects view one of the three treatment videos; 20 whether or not the subject gets a TB screening within two weeks of the intervention. Three months later the outcome variable of interests is 1) expressed intention to get a hypertension/blood pressure screening; and 2) whether they actually get a hypertension/blood pressure screening two weeks after the intervention.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Whether members of the treated individuals' households get TB screenings.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Enumerators prepare a complete itemization of adult members of the household. With a random number generator they select one adult to participate in the study. They record the name of the study participant.
Participants are presented with the purposes of the study and an informed consent form that they must agree to before proceeding to the survey.
Subjects are then presented with one of the short 45-second treatment videos.
Subjects in the Cash Incentive treatment arms are informed that they will receive their $3.00 TB testing compensation via cell phone if show up for the TB testing to be conducted the following week in their village.
Subjects in both are asked a set of questions regarding their intention to get the TB testing the following week in their village.
Subjects receive their participation compensation of \$1.00 in cash.
Working with each of the Health Districts, we will organize a two-day TB screening clinic in each of the villages within two-week of the treatment interventions.
Experimental Design Details
A detailed description is available in the attached pdf document.
Randomization Method
Working with our partners in each district, we will identify the list of District villages that could feasibly be enumerated by our enumeration team (the primary consideration here was either road access or the quality of the road access). Then, within each District, we will generate a complete list of all of the villages that are candidates for enumeration. The villages were then ranked according to their population size (population statistics provide by the 2020 Ghana census). We then formed groups of five villages by putting five consecutive villages on these lists in the same quintuple. In a typical district we would have approximately 50 quintuples.

Note this randomisation method was modified slightly for the Pilot study since we only have three treatments.

A more detailed description is available in the attached pdf document.
Randomization Unit
Village clusters are the initial unit of randomisation
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
For the Pilot we plan to have a total of 78 villages
Sample size: planned number of observations
2028 individuals
Sample size (or number of clusters) by treatment arms
676 individuals in each treatment arm.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
We are powered at 0.78 with margin of error +/- 0.026 (at 95% confidence level) to etfect effect size of 0.5
Supporting Documents and Materials

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IRB

Institutional Review Boards (IRBs)

IRB Name
Ghana Health Service Ethics Committee
IRB Approval Date
2023-07-16
IRB Approval Number
(GHS ERC Approval Notification: Protocol ID NO: GHS-ERC 016/07/23)
IRB Name
University of Oxford Social Sciences Department of Economics Research Ethics Committee (DREC)
IRB Approval Date
2023-04-27
IRB Approval Number
R82364/RE002
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