Household Communication and Health Investments for Elderly Women in Tamil Nadu

(Part 2 - Take-up RCT) Pairs of elders and caretakers will be randomized into one of the four cross-randomized treatment arms. The first randomized intervention is telling both the elder and caretaker about the checkup – compared to an arm in which we only tell the elder. The second randomized intervention is providing free arranged transportation to and from the check-up – compared to an arm in which no transportation is provided.

2025-11-10

2026-06-01

Part 1: Demand for check-up (survey-based choice). This will be a measure of whether the respondent chose check-up over alternative free gift/program in the incentivized choice questions. We have this measure for both elders and caretakers.

Part 2: Demand for check-up (behavior). This will be a measure of whether households signed up for the check-up.

1. (Take-up) Whether the caretaker calls to sign up for the check-up
2. (Take-up) Attendance at check-up
3. (Mention rates) Whether elder chooses to mention check-up to caretaker when offered
4. (Mention rates) Whether elder mentions check-up to caretaker, as reported by caretaker

Part 1: Measuring demand for check-ups for elders and caretakers. The sample for the initial elder survey will comprise approximately 1,200 elderly women from Ranipet district in Tamil Nadu, India. In the initial survey, we will measure elders’ demand for check-ups, barriers to healthcare, and collect caretaker information. In this survey, we will also collect incentivized choices to measure demand for health check-ups and how this varies with the degree of caretaker involvement required. We will then survey caretakers and ask them the same set of incentivized choices to measure demand for check-ups for the elder.

Part 2: RCT to test interventions to increase take-up of check-ups. Among households where we are able to reach both the elder and caretaker for a follow-up survey, we will invite all elders to a free heart check-up at a nearby private hospital. We will cross-randomize two interventions aimed at improving take-up of the check-up. Informing the caretaker (as well as the elder) of the check-up directly will be randomized across households, and free transportation will be randomized across small clusters of households that are geographically close to one another. The primary outcome of take-up for the check-up will be measured approximately one week after the invitations are delivered. Other outcomes will be measured in the few days after the invitations are delivered (mention rates and whether caretaker called to sign up for the check-up).

Not available

Part 1 (Measuring demand): Randomization will be done in SurveyCTO.
Part 2 (Take-up RCT): Randomization will be done in Stata and R.

Part 1 (Measuring demand):
Randomization of which choice is implemented will be at the pair-level (elder-caretaker pairs).
Other logistical randomizations regarding the presentation of the choice questions in the survey are all independently randomized at the individual respondent-level (e.g. ordering of choices, which choices are shown, cash transfer amount).

Part 2 (Take-up RCT):
Who is told about check-up (elder only vs both elder and caretaker) will be randomized at the elder-level
Free transportation will be randomized at the cluster-level, where clusters are defined as small groups of households that are geographically close to one another

Yes

(Part 2 - Take-up RCT) For the free transport intervention: Between 200 and 500 clusters, small groups of households that are geographically close to one another

(Part 1 - Measuring demand from elders) Approximately 1,200 elders. We expect a maximum sample size of up to 1,500 elders, if recruiting permits. (Part 1 - Measuring demand from caretakers; Part 2 - Take-up RCT) Approximately 800 pairs of elders and caretakers (1,600 individuals). We expect a maximum sample size of up to 1,200 pairs of elders and caretakers if recruiting permits (2,400 individuals)

(Part 2 - Take-up RCT) Among pairs of elders and caretakers where we were able to survey both participants:
- 50% of pairs (N=400 pairs) will be assigned to “tell elder only” arm and - 50% of pairs (N=400 pairs) will be assigned to “tell caretaker and elder” arm
- 20% of clusters will be assigned to “free transport” arm (M=40 clusters) and 80% of clusters will be assigned to “no transport” arm (M=160 clusters)