Text messaging for mental health management during the COVID-19 pandemic

Last registered on November 28, 2022


Trial Information

General Information

Text messaging for mental health management during the COVID-19 pandemic
Initial registration date
July 21, 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
July 22, 2020, 10:26 AM EDT

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

Last updated
November 28, 2022, 10:26 AM EST

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



Primary Investigator

Duke University

Other Primary Investigator(s)

PI Affiliation
World Bank
PI Affiliation
Duke University
PI Affiliation
Duke University

Additional Trial Information

Start date
End date
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
There are several reasons health experts worldwide fear an increase in intimate partner violence (IPV) during the Covid-19 pandemic, including economic stress and higher levels of conflict due to physical proximity of family members. Declines in household income are likely to increase the emotional stress levels of potential perpetrators and thereby increase rates of expressive aggression. Moreover, while lock-down and shelter-in-place measures are prudent for slowing the spread of coronavirus, such measures put women and children at higher risk of domestic violence as they are confined with potential abusers and have limited access to support services, potentially increasing perpetrators ability and willingness to commit acts of violence.

In Peru, during the first week of the lockdown, Linea 100, a helpline dedicated to domestic violence, registered a 30 percent increase in calls. However, higher reporting of IPV episodes may be driven by changes in reporting behavior rather than incidence of violence. For instance, victims may simply feel more isolated, so have fewer opportunity to seek help from friends and family leading them to seek police or hotline help more often. Hence, the degree to which the worldwide Covid-19 pandemic has been accompanied by significant increases in rates of IPV remains an important unanswered empirical question. Moreover, it is unclear which intervention and response options may have an impact.

To tackle these issues, we are conducting a randomized experiment in which we are: (i) exploiting two rounds of phone-based surveys to a large sample of couples in urban Peru to understand the impact on IPV and intra-household conflict of restrictions instituted to contain the spread of Covid-19; (ii) characterizing couples at heightened risk of IPV as a result of these measures in order to increase understanding of risk factors for IPV and inform the government’s response to IPV by helping them target services to couples most in need; and (iii) evaluate the efficacy of an SMS intervention designed to help men manage emotional regulation while at heightened risk of committing expressive violence.
External Link(s)

Registration Citation

Acosta, Gustavo et al. 2022. "Text messaging for mental health management during the COVID-19 pandemic ." AEA RCT Registry. November 28. https://doi.org/10.1257/rct.6180-2.0
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Experimental Details


The campaign would draw on psychological interventions designed to help individuals at risk of violence due to affect regulation better manage impulse control and channel emotional outbursts in order to mitigate episodes of violence. Components of well-vetted anger management training programs that have specifically targeted individuals with a history of violence would be reduced to short text-based messages, some of which will contain links to Internet-based resources. Men in our sample – who have already been targeted as eligible for IPV programming based on age, location and relationship status – who are assigned to the treatment arm of our intervention would be sent a series of texts every 72 hours. The content will be relevant to high-stress circumstances such as the current lock-down and economic downturn impacting urban areas of Peru, and include information on coping mechanisms for stress-related emotional responses and general tips for managing interpersonal conflict that arises between domestic partners and other family members in high stress situations (e.g. identifying triggers, avoiding conflict, regulating anger, and practicing healthy communication).
Intervention Start Date
Intervention End Date

Primary Outcomes

Primary Outcomes (end points)
1. Response to the SMS campaign (interest, trust, intent to follow recommendations)
2. Intimate Partner Violence
3. Wellbeing
4. Health-seeking behavior
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The intervention we propose to evaluate will provide information to a large sample of men who have been selected for a government program that works with men, in urban areas, around tolerance of domestic violence (MFE) that is now on hold until regular nonessential government services are resumed. We will enroll a random subset of these men (cross-randomized with the MFE treatment group) into a text-based information campaign. At the end of the survey, the enumerator will offer men the option of opting into a text message-based intervention providing tips on how to manage personal stress and maximize domestic harmony during a time of reduced mobility and limited access to external resources. Among the subset of men who opt into receiving the SMS treatment, we will randomize households into a treatment group who will receive IPV-relevant messaging (described above), and a control group who will receive “placebo” texts that contain more general advice not thought to directly influence affect regulation and thereby reduce episodes of violence. Men who opt in, along with any other household members they choose to enroll in the intervention, would then be sent text messages of either type 3 times per week for 10 weeks. We then, would administer a second round of phone-based surveys in order to measure the efficacy of the SMS intervention.
Experimental Design Details
Randomization Method
Randomization will be done on a computer. Individuals will be randomized to treatment after conducting a pre-treatment phone-based survey.
Randomization Unit
Was the treatment clustered?

Experiment Characteristics

Sample size: planned number of clusters
Sample size: planned number of observations
900 men
Sample size (or number of clusters) by treatment arms
450 treatment, 450 control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)

Institutional Review Boards (IRBs)

IRB Name
Duke University
IRB Approval Date
Details not available
IRB Approval Number
IRB Name
Study has received IRB approval. Details not available.
IRB Approval Date
Details not available
IRB Approval Number
Details not available


Post Trial Information

Study Withdrawal

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Is the intervention completed?
Data Collection Complete
Data Publication

Data Publication

Is public data available?

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials