Mixed Method Evaluation of a Passive mHealth Sexual Information Texting Service in Uganda

Last registered on June 01, 2016
View Trial History

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

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
June 01, 2016, 2:37 PM EDT

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

Locations

Country
Uganda
Region
Africa

Primary Investigator

Name
Dean Karlan
Affiliation
Northwestern University
Contact Primary Investigator

Other Primary Investigator(s)

PI Name
Julian Jamison
PI Affiliation
Consumer Financial Protection Bureau, Innovations for Poverty Action
Contact Investigator
PI Name
Pia Raffler
PI Affiliation
Yale University, Innovations for Poverty Action
Contact Investigator

Additional Trial Information

Status
Completed
Start date
2008-12-31
End date
2013-05-01
Keywords
Health
Additional Keywords
HIV, AIDs, sexual health, sexual health knowledge, mHealth, ICT4D
JEL code(s)
D13, O12, O31, O33
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.
External Link(s)
J-PAL website evaluation summary

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://doi.org/10.1257/rct.137-1.0
Former 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
Sponsors & Partners
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)
Supporting Documents and Materials
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
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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

Request Information

Intervention

Is the intervention completed?
Yes
Intervention Completion Date
March 01, 2010, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
March 01, 2010, 12:00 +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, Papers & Other Materials

Relevant Paper(s)

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
URL
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2272746

Reports & Other Materials