Sample size: planned number of clusters
Planned main study: at least 80 contributor groups, with at least 40 groups assigned to control and at least 40 groups assigned to turnover. If additional chair funding and laboratory capacity are available before confirmatory outcome analysis begins, the sample may be increased up to a prespecified maximum of 160 contributor groups, with equal allocation across treatment arms. The final sample size within this range will be determined by budget and laboratory capacity, not by estimated treatment effects from the main study. This range is based on pilot informed implementation, budget, and power calibration, including sensitivity analyses over lower, pilot based, higher, and high variance scenarios. Pilot groups are used for feasibility and calibration checks only, are excluded from the confirmatory main sample, and will not be used in the confirmatory main analysis.