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Volunteering to retain rural healthcare workers

Last registered on May 30, 2024
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Pre-Trial

Trial Information

General Information

Title
Volunteering to retain rural healthcare workers
RCT ID
AEARCTR-0013695
Initial registration date
May 28, 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
May 30, 2024, 3:50 AM EDT

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

Locations

Country
China
Region

Primary Investigator

Name
Lambert Zixin Li
Affiliation
Stanford University
Contact Primary Investigator

Other Primary Investigator(s)

Additional Trial Information

Status
On going
Start date
2023-11-21
End date
2024-12-01
Keywords
Agriculture, Behavior, Firms & Productivity, Gender, Health, Labor
Additional Keywords
volunteering, retention, turnover, burnout, global health, rural health, health equity
JEL code(s)
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
We will randomly assign healthcare providers in rural or township hospitals to volunteer, in order to test the effect of volunteering on their turnover (retention), burnout, and performance. Healthcare providers will be randomly assigned to different types of volunteering to assess mechanisms. We register the trial design and analysis plan before the first wave of outcome assessment in June 2024.
External Link(s)

Registration Citation

Citation
Li, Lambert Zixin. 2024. "Volunteering to retain rural healthcare workers." AEA RCT Registry. May 30. https://doi.org/10.1257/rct.13695-1.0
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
We will randomly assign healthcare providers in rural or township hospitals to volunteer, in order to test the effect of volunteering on their turnover (retention), burnout, and performance. Healthcare providers will be randomly assigned to different types of volunteering to assess mechanisms. An encouragement design may be used to preserve the voluntary nature of the intervention.
Intervention (Hidden)
Intervention Start Date
2023-12-01
Intervention End Date
2024-03-01

Primary Outcomes

Primary Outcomes (end points)
Retention
Primary Outcomes (explanation)
Retention, which is the opposite of turnover, will be assessed from human resources records.
Retention will be measured after this pre-registration, at the 6-month endpoint and 1-year follow-up.
Turnover intention and reasons and the next job after turnover will be measured to complement the primary outcome measure.

Secondary Outcomes

Secondary Outcomes (end points)
Burnout and performance (quality of care).
Secondary Outcomes (explanation)
Burnout will be measured with the validated MBI-HSS-MP scale. Performance will be measured through standardized patients (registered elsewhere), focusing on clinical skills that can be controlled by individual clinicians.
These secondary outcomes will be measured after this pre-registration, at the 6-month endpoint and 1-year follow-up.

Experimental Design

Experimental Design
We will use a factorial design of treatments to manipulate following factors:
1) whether the content of volunteering is related to professional work (i.e., environmental sustainability vs. health promotion); 2) whether volunteering involves contacts with co-workers (i.e., volunteer alone vs. volunteer with co-workers); 3) whether volunteering involves contacts with community members/patients (i.e., posting health educational materials vs. free clinic).

As such, primary care providers will be assigned to the following 6 treatment conditions:
1) volunteering alone for environmental sustainability; 2) volunteering with co-workers for environmental sustainability; 3) volunteering alone for health promotion without community patient contact (e.g., posting health educational materials); 4) volunteering with co-workers for health promotion without community patient contact; 5) volunteering alone for health promotion with community/patient contact (e.g., free clinic); and 6) volunteering with co-workers for health promotion with community/patient contact.

Primary care providers in the control group (no volunteering) will be assigned to work as usual or have time off.
Data may be collected from another urban hospital as the secondary comparison group.
Experimental Design Details
Randomization Method
Randomization done in office by a computer
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
800
Sample size: planned number of observations
800
Sample size (or number of clusters) by treatment arms
100 clinicians per treatment * 6 treatments = 600 clinicians in treatment conditions.
200 clinicians in control conditions.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Stanford University
IRB Approval Date
2022-09-14
IRB Approval Number
65289
Analysis Plan

Analysis Plan Documents

Hypothesis and analysis plan

MD5: 3f2ea51808df787cc115a52f12faef89

SHA1: 625df13676e82dab4260bd497d1cce78ac640783

Uploaded At: May 28, 2024

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