How can behavior change communication interventions be mobilized to effectively promote adoption of healthy behaviors in urban slums in Kenya during the COVID-19 outbreak?

Last registered on June 10, 2020
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Pre-Trial

Trial Information

General Information

Title
How can behavior change communication interventions be mobilized to effectively promote adoption of healthy behaviors in urban slums in Kenya during the COVID-19 outbreak?
RCT ID
AEARCTR-0005971
Initial registration date
June 09, 2020

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
June 10, 2020, 10:42 AM EDT

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

Locations

Country
Kenya
Region
Nairobi

Primary Investigator

Name
Jessie Pinchoff
Affiliation
Population Council
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Other Primary Investigator(s)

PI Name
Timothy Abuya
PI Affiliation
Population Council
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PI Name
Thoai D Ngo
PI Affiliation
Population Council
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PI Name
Karen Austrian
PI Affiliation
Population Council
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Additional Trial Information

Status
On going
Start date
2020-04-01
End date
2020-10-01
Keywords
Gender, Health
Additional Keywords
COVID-19, behavior change communication, SMS campaign, stigma
JEL code(s)
Secondary IDs
Abstract
To control the spread of coronavirus, the Kenyan Ministry of Health COVID-19 Taskforce has implemented initial prevention and mitigation measures. Of concern are the densely overcrowded, poor urban slums where sanitation and social distancing measures are near impossible. COVID-19 would spread rapidly and be devastating under these conditions. To inform the Taskforce strategy, this study will deploy rapid phone-based surveys on knowledge, attitudes and practices to heads of household sampled from existing randomized evaluation cohorts across five Nairobi urban slums (n~7,500). Iterations of the survey will be conducted every month. Three surveys have been completed to date beginning in March 2020, to better understand awareness of COVID-19 symptoms, perceived risk, awareness of and ability to carry out preventive behaviors, misconceptions, and the social and economic effects of COVID-19 mitigation measures. The Ministry of Health in Kenya has been sending SMS to all Kenyans. A key concern is stigma toward COVID-19 cases or suspected cases, and that household members would not care for asymptomatic COVID-19 infected household members. Before sending messages out on this topic, we will be testing three different versions of the SMS to determine which is the most effective. Participants in our cohort (n=1,910) will be randomly assigned to receive one of three versions of an SMS message meant to reduce stigma. The messages will be simple (control), prosocial or self-benefit motivated. The messages will be sent at two time points 6 days apart and then a survey will be conducted to assess knowledge, attitudes, and behavioral intention. This study aims to measure the effectiveness of these messages in increasing knowledge and reducing stigma, and to determine which motivational approach is more effective. Findings will be shared with the Ministry of Health and used to refine government run SMS campaigns to increase knowledge and adoption of the promoted behaviors.
External Link(s)
Dataverse Page

Registration Citation

Citation
Abuya, Timothy et al. 2020. "How can behavior change communication interventions be mobilized to effectively promote adoption of healthy behaviors in urban slums in Kenya during the COVID-19 outbreak?." AEA RCT Registry. June 10. https://doi.org/10.1257/rct.5971-1.0
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Experimental Details

Interventions

Intervention(s)
Study participants will be randomly assigned to one of three groups of SMS behavior change messages. The control group will receive a basic SMS message and the two intervention arms will receive a version of the control message that employs one of two motivational approaches. The intervention groups will receive either prosocial or self-benefit motivational messages. We will compare the effects of these messages on knowledge and awareness of the key information promoted in the SMS, improved perceptions toward COVID-19 cases and reduced stigma around COVID-19, as well as self-reported behavioral intention to care for potential asymptomatic COVID-19 infected household members. These changes in knowledge and attitudes will be measured by a mobile-phone based survey.
Intervention Start Date
2020-06-06
Intervention End Date
2020-06-12

Primary Outcomes

Primary Outcomes (end points)
participants will be randomly assigned to receive one of three different SMS messages around how to care for sick household members that are suspected COVID-19 cases. Through a mobile-phone based survey, we will ascertain knowledge and behavior change based on the type of message received. Questions will include knowledge/awareness of the key SMS message, attitudes around stigma and COVID-19, and intention to care for a sick household member at home.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
Three arm randomized trial with participants randomly assigned to receive one of three SMS’s.
Experimental Design Details
Randomization Method
we will randomize participants using STATA v15, stratified by informal settlement location (out of five) and gender.
Randomization Unit
individual randomization
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
NA
Sample size: planned number of observations
we will collect surveys on each individual included in the stud.
Sample size (or number of clusters) by treatment arms
we will randomize 1,910 individuals to one of the three SMS groups (583 per group).
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
We conducted a power calculation using STATA v15 and estimate that for a 10% minimum detectable effect and specifying alpha=0.0167 to accommodate the 3 group comparison, for a 50% baseline (to be conservative), with 80% power, this yields a sample size of 517 individuals per group, a total of 1,551. The SMS will be sent to 1,910 participants (583 per group) so even with some loss to follow up we should be sufficiently powered to measure an effect.
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
AMREC ESRC
IRB Approval Date
2020-05-06
IRB Approval Number
P803/2020
IRB Name
Population Council IRB
IRB Approval Date
2020-05-06
IRB Approval Number
p936
Analysis Plan

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Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials