Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda
Last registered on June 01, 2016

Pre-Trial

Trial Information
General Information
Title
Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda
RCT ID
AEARCTR-0000137
Initial registration date
June 01, 2016
Last updated
June 01, 2016 2:37 PM EDT
Location(s)
Region
Primary Investigator
Affiliation
Northwestern University
Other Primary Investigator(s)
PI Affiliation
Consumer Financial Protection Bureau, Innovations for Poverty Action
PI Affiliation
Yale University, Innovations for Poverty Action
Additional Trial Information
Status
Completed
Start date
2008-12-31
End date
2013-05-01
Secondary IDs
Abstract
We evaluate the impact of a health information intervention implemented through mobile phones, using a clustered randomized control trial augmented by qualitative interviews. The intervention aimed to improve sexual health knowledge and shift individuals towards safer sexual behavior by providing reliable information about sexual health. The novel technology designed by Google and Grameen Technology Center provided automated searches of an advice database on topics requested by users via SMS. It was offered by MTN Uganda at no cost to users. Quantitative survey results allow us to reject the hypothesis that improving access to information would increase knowledge and shift behavior to less risky sexual activities. In fact, we find that the service led to an increase in promiscuity, and no shift in perception of norms. Qualitative focus group discussions support the findings of the quantitative survey results. We conclude by discussing a potential mechanism explaining the counterintuitive findings.
Registration Citation
Citation
Jamison, Julian, Dean Karlan and Pia Raffler. 2016. "Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda." AEA RCT Registry. June 01. https://www.socialscienceregistry.org/trials/137/history/8583
Experimental Details
Interventions
Intervention(s)
Randomized evaluation in 60 villages across the four districts of Masaka, Mpigi, Mityana and Mubende in Central Uganda. Treatment villages were exposed to a targeted high-intensity marketing campaign by a professional marketing firm to encourage use of the service. No benefit or incentive accrued to respondents in the treatment group other than being informed about the free service and trained in using it. The goal was to achieve higher uptake in treatment locations than in control locations.
Intervention Start Date
2009-08-01
Intervention End Date
2010-03-01
Primary Outcomes
Primary Outcomes (end points)
HIV knowledge, contraception knowledge, attitudes toward condom use, non-promiscuity, safe sexual behavior, sexual health outcomes, health seeking behavior
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The quantitative data come from four sources: an individual survey conducted at baseline, another at endline, a community survey, and metadata on topics queried at 6001 from MTN. The qualitative data come from eight focus group discussions and 39 individual in-depth interviews in eight treatment villages after the endline. Men and women were interviewed separated and conducted in the local language. Literacy levels are balanced across treatment and control group.
Experimental Design Details
Randomization Method
Randomization was ex post stratified on a computer.
Randomization Unit
The unit of randomization is the trading center. Randomization was ex post stratified on the following variables, all measured at baseline: number of households, distance to tarmac road, distance to next periodic market, remoteness by category, urbanity by category, MTN network coverage, average education level, average sexual and reproductive health knowledge level, average sexual and reproductive health behavior score and predominant religion.
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
60 villages
Sample size: planned number of observations
1,791 individuals in Feb. 2009 and 2,424 individuals in Feb. 2010.
Sample size (or number of clusters) by treatment arms
In terms of respondents, it is n=894 in the treatment group and n=897 in the control group. In terms of clusters (trading centers), it is J=30 in each group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Yale University
IRB Approval Date
2008-12-31
IRB Approval Number
0901004653
IRB Name
Innovations for Poverty Action IRB-USA
IRB Approval Date
2008-12-31
IRB Approval Number
08December-002.No101
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
Yes
Intervention Completion Date
March 01, 2010, 12:00 AM +00:00
Is data collection complete?
Yes
Data Collection Completion Date
March 01, 2010, 12:00 AM +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
60 villages; 2,424 respondents (a randomly selected 1,200 baseline respondents were interviewed again for the follow-up, and 1,224 new respondents were chosen from among the sample communities according to the same criteria as in the baseline.)
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
A total of 385 selected respondents had to be replaced with other randomly selected respondents from the baseline because they could not be located for the interview at endline. Attrition is balanced across treatment and control groups.
Final Sample Size (or Number of Clusters) by Treatment Arms
30 control villages and 30 treatment villages.
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
No
Reports and Papers
Preliminary Reports
Relevant Papers
Abstract
We evaluate the impact of a health information intervention implemented through mobile phones, using a clustered randomized control trial augmented by qualitative interviews. The intervention aimed to improve sexual health knowledge and shift individuals towards safer sexual behavior by providing reliable information about sexual health. The novel technology designed by Google and Grameen Technology Center provided automated searches of an advice database on topics requested by users via SMS. It was offered by MTN Uganda at no cost to users. Quantitative survey results allow us to reject the hypothesis that improving access to information would increase knowledge and shift behavior to less risky sexual activities. In fact, we find that the service led to an increase in promiscuity, and no shift in perception of norms. Qualitative focus groups discussions support the findings of the quantitative survey results. We conclude by discussing a potential mechanism explaining the counterintuitive findings.
Citation
Jamison, Julian and Karlan, Dean S. and Raffler, Pia, Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda (May 1, 2013). Yale University Economic Growth Center Discussion Paper No. 1025; Yale Economics Department Working Paper No. 116. Available at SSRN: http://ssrn.com/abstract=2272746