Motivating cord blood donations
Last registered on January 30, 2017

Pre-Trial

Trial Information
General Information
Title
Motivating cord blood donations
RCT ID
AEARCTR-0000695
Initial registration date
April 15, 2015
Last updated
January 30, 2017 11:09 AM EST
Location(s)
Region
Primary Investigator
Affiliation
University of Toronto
Other Primary Investigator(s)
PI Affiliation
Johns Hopkins University
PI Affiliation
Additional Trial Information
Status
Completed
Start date
2014-11-01
End date
2016-07-31
Secondary IDs
Abstract
Umbilical cord blood is a key source of hematopoietic stem cells for patients who face life-threatening diseases and need transplants from unrelated donors. However, only a very small share of parents opts for donating the cord blood upon the birth of their children. Why are donation rates so low and what can be done to increase them? How can conceptual and methodological perspectives from the social sciences provide helpful insights?
We implement a natural field experiment in collaboration with an OB-GYN clinic. We are interested, in particular, in the effect of providing information about an activity that might not be known by most expectant parents, and in the effect of the timing at which information, as well as the request of interest to donate, is provided to these prospective parents. For example, if someone is asked early in the pregnancy, the temporal distance from the actual event might lead to both cognitive and emotional distance, such that individuals might not fully appreciate the value of their choice. Conversely, issues such as self-control may be relevant; at a certain point during the pregnancy, parents may agree on donating the cord blood upon delivery, but they might change their mind or simply overlook this issue as delivery comes close. In a condition of informational and emotional overload, the salience of this issue may also play a relevant role.
Hundreds of pregnant women visiting the clinic will be randomly assigned to the following experimental conditions: (1) the provision of information about the importance of donating cord blood; (2) the possibility for the subjects to express the (non-binding) will to donate upon delivery; and (3) reminders about the subjects’ reported intention to donate or not. Treatment groups (1) and (2) will be split in two, and subjects in each half will be treated at one of two stages of the pregnancy. The main outcome of interest is the decision on how to use the cord blood upon delivery (including the self-storage decision). We will also have access to hospital data, which will include demographics, basic health information about the subjects, and information about their pregnancy. In addition to the hospital data, information on the subjects will be obtained from a questionnaire administered at baseline, i.e., at the subjects’ first visit in their pregnancy. The main goal of the baseline survey is to obtain socio-economic information about the subjects which is not available in hospital records, such as education, occupation, and family structure. The survey will also contain items aimed at eliciting risk preferences.
The proposed study will contribute to the literature on the motivations for altruistic behavior, by providing evidence on a specific activity that has been seldom considered in the social sciences, and by devising new mechanisms to increase donations. Some of the mechanisms that we propose build on the research on the power of “soft commitments” as well as on the effect of reminders and “multiple asking”. A particular feature of this setting is that the analyzed decision includes, in addition to the non-use, both an altruistic option (donate to a public bank) and a “selfish” option (self-storage), unlike other comparable contexts such as blood or organ donations where this three-way choice set is not present. The findings will inform the scholarly debate but also be of primary relevance for organizations engaged in enhancing donations (in particular, public cord blood bank that are growing in several countries), and for policymakers.
External Link(s)
Registration Citation
Citation
Grieco, Daniela, Nicola Lacetera and Mario Macis. 2017. "Motivating cord blood donations." AEA RCT Registry. January 30. https://doi.org/10.1257/rct.695-3.0.
Former Citation
Grieco, Daniela et al. 2017. "Motivating cord blood donations." AEA RCT Registry. January 30. http://www.socialscienceregistry.org/trials/695/history/13551.
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Experimental Details
Interventions
Intervention(s)
About 1,800 pregnant women visiting the OB-GYN clinic are randomly assigned to the following conditions:

T0: Control. Subjects in this group do not receive any additional information other than what the hospitals regularly provide to expecting parents.
T1: Information – first trimester. Subjects in this group who visit the clinic in the first trimester of the pregnancy are provided with a two-page document containing information about the importance of donating cord blood and its current and potential future uses.
T2: Prompted choice – first trimester. Subjects in this group who visit the clinic in the first trimester of the pregnancy, in addition to being given the same information as in T1 are also asked to state their (non-binding) intention to donate cord blood or not upon delivery. The subjects who express their intention to donate the cord blood will then be provided with the required forms to fill and submit to the hospital at their convenience. Thus the subjects are not required to fill these forms and submit them “on the spot”; they are simply given the forms.
T3: Information – third trimester. Same as T1, but information is provided during the third trimester of the pregnancy.
T4: Prompted choice – week 30. Same as T2, but information and request of interest are administered during the third trimester of the pregnancy.
T5: Prompted choice in first trimester, reminder and “second chance” in third trimester. Subjects in this group are treated as in T2 in the first trimester. In addition, during a visit in the third trimester they are given the opportunity to revise their choice.

Women in all conditions are administered the same baseline questionnaire including demographic questions as well as questions about risk attitudes, knowledge of medical issues, as well as the possibility to participate to a lottery and to donate part of the potential prize to charity, as a way to measure altruism.
Intervention Start Date
2014-11-01
Intervention End Date
2016-05-31
Primary Outcomes
Primary Outcomes (end points)
The main outcomes of interest are the response to the prompted choice questions (for women in T2, T4 and T5), whether women fill in and hand in the forms for the donation consent, and whether a donation actually occurred at delivery.

We are mainly interested in testing the average differences in these outcome measures between treatment, and to explore heterogeneous treatment effects among subpopulation, based on observables collected from administrative data as well as our survey.
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
See the "interventions" entry
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
About 1800 individuals in one hospital
Sample size: planned number of observations
About 1800 individuals
Sample size (or number of clusters) by treatment arms
About 300
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Sample sizes of about 300 subjects per condition would allow us to detect a 10 percentage point increase in donations with 95% confidence level and 80% power
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
University of Toronto Ethical Review Board
IRB Approval Date
2014-08-07
IRB Approval Number
30487
IRB Name
Johns Hopkins University IRB
IRB Approval Date
2014-09-24
IRB Approval Number
HIRB00002183
Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports and Papers
Preliminary Reports
Relevant Papers