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Poverty, Mental Health and Child Development
Last registered on September 18, 2020

Pre-Trial

Trial Information
General Information
Title
Poverty, Mental Health and Child Development
RCT ID
AEARCTR-0006445
Initial registration date
September 14, 2020
Last updated
September 18, 2020 2:17 PM EDT
Location(s)

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Primary Investigator
Affiliation
Yale University
Other Primary Investigator(s)
PI Affiliation
Yale University, Department of Economics
PI Affiliation
Yale School of Medicine and Child Study Center
Additional Trial Information
Status
In development
Start date
2021-01-01
End date
2023-12-31
Secondary IDs
Abstract
A key mechanism for the perpetuation of poverty across generations is the accumulated developmental deficits of children from deprived backgrounds, who often lack a nurturing and stimulating environment. Moreover, poverty is associated with an incidence of maternal depression of at least 50%, which, in turn leads to reduced economic opportunities and reduced engagement with children potentially perpetuating poverty intergenerationally. Addressing these effects of poverty on maternal mental health and on child development is an urgent policy matter. We propose to test an intervention delivered virtually via Telehealth with sequential complementary components: (i) Cognitive Behavioral Therapy and information about parenting skills for low-income pregnant women with depressive symptoms; and (ii) group sessions fostering child stimulation until the child is 15 months old. To evaluate the impacts, we will recruit approximately 500 low-income women with depressive symptoms and allocate them randomly to treatment and control. Outcomes will include child development measured by the Bayley and maternal and child health and development indicators available in the electronic medical records, as well as mother’s mental health and economic outcomes. Long term follow-up will eventually allow a better understanding of the impact of human capital interventions on both mother and child.
External Link(s)
Registration Citation
Citation
Attanasio, Orazio, Konstantinos Meghir and Megan Smith. 2020. "Poverty, Mental Health and Child Development." AEA RCT Registry. September 18. https://doi.org/10.1257/rct.6445-1.0.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
The target population are low-income pregnant women with depressive symptoms. The intervention contains three components:

Cognitive Behavioral Therapy from recruitment in the second trimester of pregnancy until birth, followed by parenting sessions promoting mother child attachment, immediately after birth. We then implement a version of Reach-up and Learn to promote child stimulation.

The intervention will be delivered online and will involve groups
Intervention Start Date
2021-01-01
Intervention End Date
2023-07-31
Primary Outcomes
Primary Outcomes (end points)
Maternal Mental Health, Child Cognitive and Language Development.
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary outcomes will include parenting quality (Parent Child Relationship Inventory), social connectedness and substantiated child welfare referrals. We will also evaluate access to and use of welfare programs, child care facilities and other services. At endline we will collect information on maternal employment and earnings.
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
Women who attend the Yale/New Haven health system will be recruited and once consent has been obtained as well as baseline data they will be screened for eligibility and depression. Eligible women will be randomised to treatment and two control groups, forming groups of about 6-8 treated women and 6-8 women in control. One control group will receive nothing, while the other will receive a tablet and internet connection, just like the treatment but without any intervention. Once a group is formed the intervention will start on that group and we will continue recruiting for the next group.
Experimental Design Details
Not available
Randomization Method
Randomization done in office by a computer
Randomization Unit
The randomization unit is an individual.
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
The designed is not clustered.
Sample size: planned number of observations
500 women and their newborn child.
Sample size (or number of clusters) by treatment arms
200 women in treatment, 150 in one control (without control) and 150 in the second control (with tablet)
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
0.30 of a standard deviation
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
IRB Approval Date
IRB Approval Number