Increasing immunization compliance among schools and daycare centers in D.C.

Last registered on January 10, 2020

Pre-Trial

Trial Information

General Information

Title
Increasing immunization compliance among schools and daycare centers in D.C.
RCT ID
AEARCTR-0002486
Initial registration date
January 09, 2018

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
January 11, 2018, 6:54 PM EST

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

Last updated
January 10, 2020, 12:20 PM EST

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Primary Investigator

Affiliation
IFPRI

Other Primary Investigator(s)

PI Affiliation
Office of Evaluation Sciences
PI Affiliation
Washington, D.C. Department of Health

Additional Trial Information

Status
Completed
Start date
2017-11-01
End date
2018-08-30
Secondary IDs
Abstract
The Office of Evaluation Sciences (OES) in the General Services Administration and the National Vaccine Program Office in the U.S. Department of Health and Human Services are collaborating to identify low-cost, behaviorally-informed program changes to improve immunization compliance through the application and evaluation of behavioral insights.

Working with the District of Columbia Department of Health (DOH) Immunization Program, OES will co-design and field a new communication tool targeted at increasing immunization compliance at schools and childcare centers. DOH will – at two different times during the school year - mail report cards to school principals and childcare center directors to highlight their organization’s immunization compliance rates relative to schools in their category, e.g., elementary, middle, high, etc., and childcare centers with compliance rates in the top 10%, and DC’s compliance targets. The evaluation will entail randomization at the level of the school/childcare to a treatment arm that will receive report cards, and a control arm that will not receive report cards. The research team will then estimate the effects of the report card intervention on immunization compliance rates at the school/childcare level and, in the nearer-term, on compliance-related activities carried out by the sites. If effective, the Immunization Program will adapt the report card to incorporate it into the Program’s electronic communications plan.
External Link(s)

Registration Citation

Citation
Davidson, Donna, Jessica Leight and Elana Safran. 2020. "Increasing immunization compliance among schools and daycare centers in D.C.." AEA RCT Registry. January 10. https://doi.org/10.1257/rct.2486
Former Citation
Davidson, Donna, Jessica Leight and Elana Safran. 2020. "Increasing immunization compliance among schools and daycare centers in D.C.." AEA RCT Registry. January 10. https://www.socialscienceregistry.org/trials/2486/history/60453
Experimental Details

Interventions

Intervention(s)
DOH will – at two different times during the school year - mail report cards to school principals and childcare center directors to highlight their organization’s immunization compliance rates relative to schools in their category, e.g., elementary, middle, high, etc., and childcare centers with compliance rates in the top 10%, and DC’s compliance targets.
Intervention Start Date
2017-11-01
Intervention End Date
2018-06-30

Primary Outcomes

Primary Outcomes (end points)
School-level immunization rates
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The evaluation will entail randomization at the level of the school/childcare to a treatment arm that will receive report cards, and a control arm that will not receive report cards. The research team will then estimate the effects of the report card intervention on immunization compliance rates at the school/childcare level and, in the nearer-term, on compliance-related activities carried out by the sites.
Experimental Design Details
Randomization Method
Randomization is done in office by computer.
Randomization Unit
School
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
700 schools
Sample size: planned number of observations
700 schools
Sample size (or number of clusters) by treatment arms
350 treatment schools, 350 control schools
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
American University Institutional Review Board
IRB Approval Date
2017-08-09
IRB Approval Number
IRB-2018-97

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
June 01, 2018, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
July 15, 2018, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
Was attrition correlated with treatment status?
Final Sample Size: Total Number of Observations
Final Sample Size (or Number of Clusters) by Treatment Arms
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Abstract
This paper reports on the results of a randomized controlled trial in which researchers collaborated with a department of health in a mid-size city to evaluate the effectiveness of targeted communications highlighting descriptive social norms to increase immunization compliance across 700 schools. Schools were randomly selected to receive a twice-annual immunization compliance report card reporting in detail their compliance rates compared to other schools of the same school type; the comparison rates reported included the school-type average, average compliance among the top 10% of performers, and the city target of 98% compliance. Shifts in immunization compliance are tracked in a city-wide administrative vaccine registry. The results suggest that there was no significant difference in compliance rates between treatment and control schools six months post-treatment. To our knowledge, it is the first randomized controlled trial evaluating the use of descriptive social norms in increasing immunization compliance rates in a school-based setting. In addition, it serves as an example of embedding a behaviorally-informed experiment in a government program utilizing high-quality administrative data.
Citation
Leight, J., & Safran, E. (2019). Increasing immunization compliance among schools and day care centers: Evidence from a randomized controlled trial. Journal of Behavioral Public Administration, 2(2). https://doi.org/10.30636/jbpa.22.55

Reports & Other Materials