Text Messaging to Caregivers to Improve Early Child Development in Ecuador

Last registered on September 02, 2021
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Pre-Trial

Trial Information

General Information

Title
Text Messaging to Caregivers to Improve Early Child Development in Ecuador
RCT ID
AEARCTR-0004251
Initial registration date
August 31, 2021
Last updated
September 02, 2021, 10:12 AM EDT

Locations

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Primary Investigator

Name
Megan Rounseville
Affiliation
Tufts University and The World Bank
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Other Primary Investigator(s)

PI Name
Olga Namen
PI Affiliation

Additional Trial Information

Status
In development
Start date
2021-08-23
End date
2022-05-31
Keywords
Behavior, Health, Other
Additional Keywords
Early Childhood Development, Nutrition, Health, Text Messaging, Parenting, Behavioral Change, Field Experiment
JEL code(s)
C93; J13; O15; I15; I28; D91; I38
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Some 24 percent of children under the age of five in Ecuador are stunted, according to World Bank figures, and reversing this in the early years is critical to building human capital so all children can thrive and succeed. The Government of Ecuador is seeking to improve child development and nutrition during the first 1000 days of life, by revamping existing nationwide programs where program staff discuss prenatal care, early child development, healthy nutrition, breastfeeding, and hygiene. Due to COVID-19 these services are being provided virtually or in hybrid modalities. Previous evidence from Chimborazo, Ecuador shows that families can be unaware of their child’s under nutrition and they lack information about behaviors that can improve their child's health and development. This evaluation will test whether sending text messages to caregivers increase their knowledge about early childhood development, nutrition, and healthy behaviors and leads to improved health and development outcomes for their children.
External Link(s)
Study Description

Registration Citation

Citation
Namen, Olga and Megan Rounseville. 2021. "Text Messaging to Caregivers to Improve Early Child Development in Ecuador." AEA RCT Registry. September 02. https://doi.org/10.1257/rct.4251-1.0
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
Within a national early childhood development program that provides support to caregivers of children 0-36 months and pregnant women, we will send text messages to caregivers of children from 0 to 12 months old, with age-specific contents. These text messages aim to promote changes in knowledge, actions, and attitudes of caregivers in the following topics: breastfeeding (exclusive from 0-6 months old and continued through two years old), the importance of attending regular child health checkups (vaccination, anthropometric measures, counseling), correct timing to initiate complementary feeding, dietary diversity, handwashing, good hygiene and water practices, ensuring safe spaces, attachment and child development, among others.
Intervention Start Date
2021-08-31
Intervention End Date
2021-11-08

Primary Outcomes

Primary Outcomes (end points)
Our primary outcome measure will be caregiver knowledge about exclusive breastfeeding, the timing of complementary feeding, healthy water, sanitation, and hygiene practices, diet diversity, and child development. These indicators will be constructed using information from an endline phone survey and administrative records.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Child development, health, and nutrition.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The study participants are drawn from an eligible population of approximately 7,500 households that are beneficiaries of a nationwide early child development program that provides individual counseling to households with children under three years of age and pregnant women through home visits and virtual support. From the beneficiaries that give their consent to participate in the study we will draw a sample of approximately 5,000 caregivers of children under 12 months. This sample will be divided into two groups: a control group that will receive the regular ECD services (approx. 2,500 caregivers) and a treatment group that will receive weekly text messages with age-specific information about child development, nutrition and healthy behaviors in addition to their regular ECD services (approx. 2,500 caregivers).
Experimental Design Details
Not available
Randomization Method
Randomization will be done in office by computer
Randomization Unit
Randomization will be carried out at the attention center level, these centers provide services to several beneficiaries. From each one of the centers assigned to the treatment group, all beneficiaries will receive the SMS treatment intervention. All beneficiaries from the attention centers assigned to control group will not receive the SMS intervention.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
Approximately 2,000 attention centers
Sample size: planned number of observations
Approximately 5,000 caregivers
Sample size (or number of clusters) by treatment arms
Approximately, 1,000 attention centers assigned to treatment group and 1,000 assigned to control group.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Innovations for Poverty Action IRB
IRB Approval Date
2020-12-24
IRB Approval Number
14852
Analysis Plan