A Mobile Phone-based Intervention to Improve Health Screening Uptake: A Randomized Experiment in Indonesia

Last registered on April 24, 2023
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Pre-Trial

Trial Information

General Information

Title
A Mobile Phone-based Intervention to Improve Health Screening Uptake: A Randomized Experiment in Indonesia
RCT ID
AEARCTR-0005047
Initial registration date
November 17, 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
November 20, 2019, 2:59 PM EST

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

Last updated
April 24, 2023, 2:20 AM EDT

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

Locations

Country
Indonesia
Region
Aceh

Primary Investigator

Name
Anna Reuter
Affiliation
Heidelberg Institute of Global Health, Heidelberg University
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Other Primary Investigator(s)

PI Name
Lisa Rogge
PI Affiliation
University of Goettingen
Contact Investigator
PI Name
Maja E. Marcus
PI Affiliation
University of Goettingen
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PI Name
Sebastian Vollmer
PI Affiliation
University of Goettingen
Contact Investigator

Additional Trial Information

Status
Completed
Start date
2019-11-21
End date
2020-09-30
Keywords
Health
Additional Keywords
Noncommunicable Diseases, Health Systems, Screening Uptake, mHealth
JEL code(s)
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Our study measures the impact of informative text messages on the uptake of screening for non-communicable diseases (NCDs) such as hypertension and diabetes. The text messages contain information on free public screening services as well as facts about hypertension and diabetes. We test the effect of these messages against no treatment. Our main outcome is the self-reported usage of screening services in the past months, measured at the endline.
External Link(s)

Registration Citation

Citation
Marcus, Maja E. et al. 2023. "A Mobile Phone-based Intervention to Improve Health Screening Uptake: A Randomized Experiment in Indonesia." AEA RCT Registry. April 24. https://doi.org/10.1257/rct.5047-3.1
Sponsors & Partners
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2020-01-06
Intervention End Date
2020-03-06

Primary Outcomes

Primary Outcomes (end points)
NCD screening uptake (individual)
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
NCD diagnosis, NCD screening uptake within households, NCD knowledge
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We conduct a baseline survey in November and December 2019 to collect information on our respondents as well as the mobile phone numbers. After the baseline, we randomize half of our participants to treatment and half to control. The intervention will take place from January until March 2020. The treatment group receives text messages prior to screening dates, containing facts about diabetes and hypertension as well as information when and where free public screening is available. At the endline, information on screening usage, diagnoses and NCD knowledge is collected for both groups.
Experimental Design Details
Randomization Method
Randomization done in office by a computer
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
2000
Sample size: planned number of observations
2000
Sample size (or number of clusters) by treatment arms
1000 in the treatment arm, 1000 in the control arm
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
Ethics committee of the University of Göttingen
IRB Approval Date
2019-11-14
IRB Approval Number
N/A
Analysis Plan

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Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
Yes
Intervention Completion Date
March 24, 2020, 12:00 +00:00
Data Collection Complete
Yes
Data Collection Completion Date
May 02, 2020, 12:00 +00:00
Final Sample Size: Number of Clusters (Unit of Randomization)
1388 phone numbers
Was attrition correlated with treatment status?
No
Final Sample Size: Total Number of Observations
1412 individuals
Final Sample Size (or Number of Clusters) by Treatment Arms
719 individuals (704 phone numbers) in control arm, 693 individuals (684 phone numbers) in treatment arm
Data Publication

Data Publication

Is public data available?
No

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Program Files

Program Files
No
Reports, Papers & Other Materials

Relevant Paper(s)

Abstract
As cardiovascular diseases (CVD) become the leading cause of death in low- and middleincome countries (LMICs), this raises new challenges for health systems. Regular screening is a key measure against CVD risk factors, but the uptake of such services remains low despite free provision. We conducted a randomized controlled trial in Indonesia to assess whether personalized and targeted text messages increase the usage of public screening services for diabetes and hypertension in the at-risk population. Our intervention increased screening uptake by 6.6 percentage points. Among those who received and read the messages, the effect size was 17 percentage points. We show that text messages can be effective in a context of a relatively new disease burden in LMICs, where population responses may still be shaped by low salience and missing screening routines.
Citation
Marcus, M.E., Reuter, A., Rogge, L., Vollmer, S., 2023. The Effect of SMS Reminders on Health Screening Uptake: A Randomized Experiment in Indonesia (No. 284), Discussion papers. Courant Research Centre: Poverty, Equity and Growth, Göttingen.
URL
http://www2.vwl.wiso.uni-goettingen.de/courant-papers/CRC-PEG_DP_284.pdf

Reports & Other Materials

Description
Replication data and questionnaires
Citation
Marcus, Maja-Emilia; Reuter, Anna; Rogge, Lisa; Vollmer, Sebastian, 2021, "Replication data for: The effect of SMS reminders on health screening uptake: A randomized experiment in Indonesia", https://doi.org/10.25625/SE4IDP, Göttingen Research Online / Data.
URL
https://doi.org/10.25625/SE4IDP