Evaluating the impact of reduced facility waiting time on HIV treatment adherence

Last registered on August 26, 2020

View Trial History

Pre-Trial

Trial Information

General Information

Title

Evaluating the impact of reduced facility waiting time on HIV treatment adherence

RCT ID

AEARCTR-0004190

Initial registration date

May 10, 2019

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

May 20, 2019, 2:23 PM EDT

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

Last updated

August 26, 2020, 4:43 PM EDT

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

Locations

Country

Mozambique

Region

Primary Investigator

Name

Maria Steenland

Affiliation

Brown University

Contact Primary Investigator

Other Primary Investigator(s)

PI Name

Sandra Sequeira

PI Affiliation

London School of Economics

Contact Investigator

PI Name

Margaret McConnell

PI Affiliation

Harvard TC Chan School of Public Health

Contact Investigator

PI Name

Amanda de Albuquerque

PI Affiliation

The Pontifical Catholic University of Rio de Janeiro

Contact Investigator

Additional Trial Information

Status

In development

Start date

2020-09-14

End date

2021-10-08

Keywords

Health

Additional Keywords

JEL code(s)

Secondary IDs

Abstract

Patients receiving HIV treatment need to visit health facilities frequently to obtain antiretroviral treatment (ART) refills and clinical care. At the facility, services are provided on a first-come first-serve basis and long waiting time is pervasive. This proposal aims to evaluate an appointment scheduling intervention for HIV patients receiving ART. This study will be randomized at the health facility level. Half of the study health facilities will be randomized to the scheduling intervention treatment group. In these facilities, all patients receiving HIV treatment will be given a scheduled appointment – with a return date and time – for their next visit. We will measure waiting time in all facilities during three rounds of data collection, and administrative data will be used to assess return visit delays up to one year after the start of the intervention.

External Link(s)

Registration Citation

Citation

de Albuquerque, Amanda et al. 2020. "Evaluating the impact of reduced facility waiting time on HIV treatment adherence." AEA RCT Registry. August 26. https://doi.org/10.1257/rct.4190-1.1

Former Citation

de Albuquerque, Amanda et al. 2020. "Evaluating the impact of reduced facility waiting time on HIV treatment adherence." AEA RCT Registry. August 26. https://www.socialscienceregistry.org/trials/4190/history/74753

Sponsors & Partners

Experimental Details

Interventions

Intervention(s)

Appointment scheduling (with a date and time window) for HIV clinical care and ART pharmacy pick-up

Intervention Start Date

2020-10-05

Intervention End Date

2021-10-08

Primary Outcomes

Primary Outcomes (end points)

• Average hourly volume of patients waiting (6 months after the start of the intervention)
• Waiting time for HIV clinical services measured at midline (6 months after the start of the intervention) in minutes
• Waiting time for HIV pharmacy services measured at midline in minutes
• Number of ≥ 7-day delays between months 0-6 among patients who initiated ART in the month after the start of the intervention
• Medication possession ratio (MPR) at least 95%, 6-month window [ Time Frame: 0-6 month interval from date of study enrollment] among patients who initiated ART in the month after the start of the intervention

Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)

• Time spent on remunerative activities on day of visit to HIV clinic
• Time spent on childcare responsibilities on day of visit to HIV clinic
• Health worker friendliness
• Health worked asked how the patient was doing emotionally
• Health worker perceived to be rushed
• Any ≥ 7-day delay in recommended testing
• Retention in care during one year of follow-up
• Burnout index for health care providers measured at midline and endline
• waiting time for HIV clinical services measured at endline
• waiting time for HIV pharmacy services measured at endline
• Number of ≥ 7-day delays between months 6-12 among patients who initiated ART in the month after the start of the intervention
• Medication possession ratio (MPR) at least 95%, 6-month window [ Time Frame: 6-12 month interval from date of study enrollment] among patients who initiated ART in the month after the start of the intervention
• Providers’ reported satisfaction with their work at the facility

Secondary Outcomes (explanation)

Experimental Design

Randomized controlled trial

Experimental Design Details

Randomization Method

Randomization done in office by a computer - Stata

Randomization Unit

Health facility

Was the treatment clustered?

Yes

Experiment Characteristics

Sample size: planned number of clusters

Sample size: planned number of observations

• Waiting time data collected from patients seeking HIV treatment: 43,750 (approximately 25 per day from 70 health facilities for a total of 25 days (10 days at baseline, 5 days at midline, and 10 days at endline) • Number of patients whose administrative records we expect to observe: 5,250 (approximately 75 new patients in 70 health facilities) • Number of people we expect to collect time use data from: 3,500 (approximately 50 patients in 70 health facilities at endline) • Number of health workers we plan to survey: 350 (approximately 5 health workers in 70 facilities) • Number of health /facility staff we plan to interview for the management survey: 350 (approximately 5 health workers in 70 facilities)

Sample size (or number of clusters) by treatment arms

35 health facilities control, 35 health facilities treatment

Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

Supporting Documents and Materials

IRB