Can Household Engagement Shift Care Burdens? A Randomized Experiment with Unpaid Caregivers in Antioquia, Colombia

Intervention

The experiment is embedded in the apuesta formativa (formative program) of the Sistema Departamental del Cuidado de Antioquia (SCA), an initiative of the Governorate of Antioquia designed to strengthen the autonomy, leadership, and well-being of women caregivers. The formative program started in 2025 and has an ongoing 2026 cohort. It is organized into three thematic schools: Del pasado, presente y futuro (identity, life planning, and productive projects), Del amor propio (self-care and economic autonomy), and De las autonomías (gender rights, labor autonomy, and civic participation). Each school comprises several modules delivered through in-person group sessions at the municipal level. The 2026 stage, on which this study focuses, covers nine modules across several sessions and emphasizes deepening the reflections from 2025 into concrete tools for leadership, economic autonomy, and rights-based participation. The program is directed at women identified by municipal administrations and Governorate databases as unpaid caregivers of children, the elderly, or persons with disabilities or illness. Participation is voluntary, and the program does not involve the women's household members in any of its standard activities.

The two interventions evaluated in this study are designed to extend the program's reach into the household by involving a co-resident adult member alongside the participating woman. Both are additions to the standard program and do not modify its content or delivery.

Component B — WhatsApp-based information campaign
Component B consists of a WhatsApp-based information campaign that delivers content for each thematic component of the formative program to both the participating woman and a co-resident adult household member she nominates. For each thematic component, both recipients receive two pieces: an infographic and an audio message. The infographic is a didactic image that summarizes the main learning of that component and includes conversation-opener questions intended to prompt discussion between the woman and her household member about the topics covered in the session, including care responsibilities, gender roles, and time use. The audio message covers the same content in spoken form. The two formats carry identical information and are always delivered together, so that all participants have an accessible way to engage with the material regardless of reading proficiency or visual limitations. Treated women are asked to provide the phone number of a co-resident adult household member at baseline; both numbers are then used for delivery throughout the campaign. Women assigned to the control condition receive no infographic, and the research team does not contact their nominated household member
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Component C — Family closing session
Component C consists of a family closing session held at the end of the formative program. Women attending the program in treatment municipalities are invited to bring a co-resident adult household member or close family contact to a final program session. The session is facilitated by program staff and focuses on the themes covered throughout the formative program, with particular emphasis on care co-responsibility, time use, and household task distribution. Women in control municipalities receive the standard program closing without this session. To avoid anticipatory effects or changes in behavior prior to the session, women are not informed about the existence of Component C until the invitation is issued at program closure.

2026-05-27

2026-11-01

The study has six primary outcome variables, all measured at endline (October–December 2026). Effects on these outcomes will be estimated separately for Component B (information campaign) and Component C (family session), with multiple hypothesis correction across the two co-primary components using the Benjamini-Hochberg FDR procedure (q=0.05).

PRIMARY OUTCOMES:
1. Hours of unpaid care work per day (continuous)
- Total daily hours dedicated to direct care (children, elderly, ill household members) plus indirect care (cooking, cleaning, household errands)
- Reference period: typical weekday in the past four weeks
- Source: endline survey, time use module

2. Hours of paid work per day (continuous)
- Total daily hours dedicated to all forms of paid work (formal employment, informal work, self-employment, occasional jobs)
- Reference period: typical weekday in the past four weeks
- Source: endline survey, labor module

3. Index of gender norms (Anderson standardization, continuous)
- Standardized index combining items measuring beliefs about gender roles in care work, women's economic participation, and household decision-making
- Includes 1st-order norms (respondent's own beliefs) and 2nd-order norms (perceived community beliefs)
- Standardization following Anderson (2008), with sign-adjusted direction (positive values indicate more egalitarian norms)
- Source: endline survey, norms module, compatible with baseline norms module

4. Disposition to engage in paid work (Likert composite, continuous)
- Composite measure combining willingness to seek paid work, perceived feasibility given household constraints, and concrete intentions in the next 12 months
- Standardized to mean zero, unit variance
- Source: endline survey, disposition module

5. Disposition to engage in recreational activities (Likert composite, continuous)
- Composite measure combining self-reported frequency of leisure and rest activities relative to other household members, perceived legitimacy of dedicating time to leisure, and concrete intentions to engage in recreational activities in the next 12 months
- Standardized to mean zero, unit variance
- Source: endline survey, disposition module

6. Index of internalized gender norms around care (Anderson standardization, continuous)
- Standardized index combining items measuring the degree to which the respondent feels her personal value in the household is tied to time dedicated to domestic tasks, guilt experienced when not fulfilling care responsibilities, and perceived social and family pressure to conform to caregiver roles
- Standardization following Anderson (2008), with sign-adjusted direction (positive values indicate lower internalization of norms that tie women's worth to care work)
- Source: endline survey, norms module

1. Intra-household distribution of care tasks (index, continuous)
-Standardized index combining the share of domestic and care tasks performed by the respondent versus other household members, and whether tasks are performed alone or shared with a co-resident adult
-Sign-adjusted direction: positive values indicate a more equal distribution of tasks within the household
-Standardization following Anderson (2008)
-Source: endline survey, household tasks module

2. Perceived barriers to care redistribution (index, continuous)
-Standardized index combining items measuring the degree to which the respondent perceives lack of household support, lack of communication, absence of decision-making power over task division, and belief that no one else will perform the tasks if she does not
-Sign-adjusted direction: positive values indicate fewer perceived barriers to redistribution
-Standardization following Anderson (2008)
-Source: endline survey, barriers module

3. Emotional well-being (index, continuous)
-Standardized index combining items measuring the frequency with which the respondent feels guilt when unable to dedicate time to household tasks, the emotional response when household tasks are not completed, and self-reported life satisfaction
-Sign-adjusted direction: positive values indicate higher emotional well-being
-Standardization following Anderson (2008)
-Source: endline survey, well-being module

4. Household decision-making autonomy (index, continuous)
-Standardized index combining items measuring the respondent's perceived role in household decisions about finances, time allocation, and care arrangements
-Sign-adjusted direction: positive values indicate greater autonomy in household decision-making
-Standardization following Anderson (2008)
-Source: endline survey, autonomy module

Experimental Design
The experiment evaluates two household-inclusive components of a public caregiver training program (Sistema Departamental del Cuidado de Antioquia, SCA) in Colombia: (1) a WhatsApp-based information campaign delivering content to the woman and a co-resident adult household member throughout the program (Component B), and (2) a family closing session attended jointly by the woman and a household member at the end of the program (Component C). These two components are co-primary and form a 2x2 factorial design.

Study Population
The experimental universe consists of women attending the 2026 cohort of the SCA's formative program (apuesta formativa) across 51 prioritized municipalities in Antioquia. All women who have attended at least one program session in 2026 are eligible for inclusion.

Design Overview
The experiment combines two independent randomizations:

Component B — Household information cartillas (co-primary):
At the individual level, all 2026 program attendees are randomized 1:1 to receive the information campaign (T=1) or to a control condition with no information campaign (T=0). Randomization is stratified by municipality × sub-region × number of prior attendance sessions (categorized as 0, 1–2, 3+), using blocks of 4.

The information campaign is delivered via WhatsApp throughout the treatment period (May to October 2026), with one delivery per thematic component of the formative program. Each delivery consists of an infographic and an audio message. The infographic is a didactic image summarizing the main learning from that component and including conversation-opener questions designed to prompt discussion between household members. The audio message covers the same content in spoken form. The two formats carry identical information and are delivered together to ensure all participants have an accessible way to engage with the material, regardless of reading proficiency or visual limitations. Both the participating woman and the co-resident adult household member she nominates receive each delivery directly on their phones.

Component C — Family closing session (co-primary):
At the cluster level, all 51 prioritized municipalities are randomized 1:1 to treatment (approximately 25 municipalities) or control (approximately 26 municipalities), stratified by sub-region and municipality operational status. Women attending the program in treatment municipalities are invited to a final program session together with a co-resident adult household member or close family contact. Women in control municipalities receive the standard program closing without this session. Women are not informed about the existence of Component C until the session takes place at program closure.

Factorial Structure
Components B and C are crossed, generating four cells: women in municipalities assigned to control for both components (B=0, C=0); women assigned to information campaign only (B=1, C=0); women in treatment municipalities who do not receive information campaign (B=0, C=1); and women assigned to both information campaign and the family session (B=1, C=1). The main effects of each component and their interaction will be estimated within this 2x2 structure. The interaction effect is treated as exploratory.

Not available

Randomization will be conducted in office using a reproducible computer algorithm (Python), with documented seeds for full replicability. The experiment includes two independent randomizations:

(1) Component B (WhatsApp-based information campaign, all 2026 program attendees): individual-level block randomization within strata defined by municipality × sub-region × number of prior attendance sessions (categorized as 0, 1–2, 3+). Block size of 4, with 1:1 allocation to treatment (cartillas delivered to the woman and her nominated household member) versus control (no information campaign).

(2) Component C (family closing session): cluster-level randomization at the municipality level. All 51 prioritized municipalities are randomized 1:1 (approximately 25 treatment vs. 26 control), stratified by sub-region and municipality operational status. Women in treatment municipalities will be invited to attend a final program session with a co-resident adult household member or close family contact; women will not be informed of this component until the invitation is issued at program closure.

All randomizations will use the Python random library with documented seeds. Scripts and assignment files will be archived prior to implementation to ensure reproducibility. Balance checks will be conducted post-randomization on observable characteristics immediately, with re-randomization triggered if more than 10% of variables show significant imbalance (p<0.05).

The experiment uses two levels of randomization:

(1) Component B: individual-level randomization. Each attending woman is independently assigned to receive the information campaign (T=1) or control (T=0).

(2) Component C: cluster-level randomization at the municipality level. All 51 prioritized municipalities are randomized as clusters; all attending women within a treated municipality are eligible for the family session, while women in control municipalities are not.

Components B and C form a 2x2 factorial design and are the co-primary components of the study.

Yes

51 municipalities

3,349 women

The following figures are based on program attendance records available as of May 2026 and should be understood as a lower bound. The Governorate of Antioquia has not yet confirmed the final 2026 cohort size; as additional women enroll and attend program sessions, the experimental universe may expand. The randomization will be updated accordingly as new attendees are incorporated.

Component B (individual-level randomization, all 2026 program attendees):
~1,250 women: control (no information campaign)
~1,250 women: treatment (information campaign delivered to woman and nominated household member)
Total: ~2,500 women, stratified by municipality × sub-region × number of 2025 attendance sessions (categorized as 0, 1–2, 3+), 1:1 allocation

Component C (cluster-level randomization at municipality level):
26 municipalities: control (no family session)
25 municipalities: treatment (family session offered)
Total: 51 municipalities, stratified by sub-region and municipality operational status, 1:1 allocation

Power calculations are reported for each co-primary component separately. Because baseline variance estimates and intraclass correlation coefficients are not yet available for this population, MDEs are discussed across a range of plausible assumptions rather than fixed to a single point estimate. All calculations assume 80% power and a two-sided significance level of 0.05. Component B (individual-level randomization) With approximately 1,250 women per arm (N ≈ 2,500, lower bound), the MDE under a simple difference-in-means specification is 0.112 SD. Where baseline data are available and explain 20–40% of endline variance, the MDE falls to 0.087–0.100 SD. Using time use estimates for rural women in Colombia from the Encuesta Nacional de Uso del Tiempo as a reference (SD ≈ 3–4 hours per day), this corresponds to a detectable effect of roughly 15–27 minutes per day in unpaid care work. Under a worst-case scenario in which only 50% of the women reported by the Governorate attend the program (N ≈ 1,250, approximately 625 per arm), the MDE rises to 0.159 SD without baseline controls, or 0.123–0.142 SD with baseline controls explaining 20–40% of variance. The design retains the ability to detect meaningful effects under this scenario, though with reduced precision. Component C (cluster-level randomization) With 51 municipalities (25 treatment, 26 control) and an average cluster size of approximately 49 women, the MDE depends critically on the intraclass correlation (ICC) at the municipality level. Applying a t-distribution correction with 49 degrees of freedom, at low ICC values (0.01–0.02), typical of community-level interventions in similar settings, the design can detect effects of 0.139–0.160 SD. At higher ICC values (0.10–0.20), the MDE grows to 0.275–0.372 SD, reflecting the limited number of available clusters. The cluster structure is fixed at 51 municipalities regardless of individual-level attendance, so a 50% reduction in women per cluster would reduce the average cluster size to approximately 25, increasing the design effect modestly but leaving the number of clusters unchanged. At ICC = 0.05 and a cluster size of 25, the MDE rises from 0.211 to 0.261 SD, which remains within a plausible range for norm and time use outcomes in this context. Power calculations will be updated in an amendment to this pre-registration once the Governorate confirms the final 2026 cohort size and empirical variance estimates from the baseline data are available.