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Worker Well-Being and Productivity in the Bangladesh Garment Sector
Last registered on March 20, 2016


Trial Information
General Information
Worker Well-Being and Productivity in the Bangladesh Garment Sector
Initial registration date
June 17, 2015
Last updated
March 20, 2016 7:26 AM EDT
Primary Investigator
Innovations for Poverty Action
Other Primary Investigator(s)
PI Affiliation
University of Warwick
PI Affiliation
Urban Services Initiative (J-PAL) and University of Dhaka
PI Affiliation
University of Dhaka
Additional Trial Information
In development
Start date
End date
Secondary IDs
We pilot a stress management intervention based on Cognitive Behavioral Therapy (CBT) to understand whether building skills to cope with psychological strain raises productivity and well-being levels among female workers in an urban manufacturing context. The setting is the Bangladesh ready-made garment (RMG) sector, the country’s largest employer of low-skilled workers living in urban slums and squatter settlements. Residing in these areas exposes them to high levels of noise, waste accumulation, air pollution and other distressing environmental conditions. In addition, the majority migrate from rural areas, losing access to family support and social networks. This study will use a randomized placebo-controlled trial to ascertain whether a stress reduction intervention can pay for itself through increased productivity and reduced absenteeism in factories. We will also measure its effects on the levels of stress hormone cortisol and on self-reported symptoms of anxiety and depression.
External Link(s)
Registration Citation
Lopez-Pena, Paula et al. 2016. "Worker Well-Being and Productivity in the Bangladesh Garment Sector." AEA RCT Registry. March 20. https://doi.org/10.1257/rct.738-2.0.
Former Citation
Lopez-Pena, Paula et al. 2016. "Worker Well-Being and Productivity in the Bangladesh Garment Sector." AEA RCT Registry. March 20. http://www.socialscienceregistry.org/trials/738/history/7330.
Sponsors & Partners

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Experimental Details
We evaluate the impact of a widely recognized stress reduction intervention (Cognitive Behavioral Therapy, CBT) on workers’ mental health and job performance in the garment industry in Bangladesh. CBT is one of the most extensively researched and empirically supported forms of psychotherapy and has proven highly effective for treating anxiety disorders, stress and depression when compared to placebo therapies (Farrand and Woodford, 2013; Hofmann and Smits 2008, Butler at al., 2006). This form of psychotherapy is intended to build life skills and break self-reinforcing cognitive and behavioral biases that maintain worrying and stress. It relies on highly standardized cognitive exercises (handouts, worksheets etc.) and behavioral exercises (e.g. muscular relaxation training) to teach individuals how to develop adequate coping strategies. Both treated and control individuals will receive one-hour of therapy, once per week, over a 10 week period.
Intervention Start Date
Intervention End Date
Primary Outcomes
Primary Outcomes (end points)
We will collect data on individual productivity, absenteeism and turnover continuously for a period of 5 months, in order to span the whole intervention period (3 months) and the 4 weeks preceding and following each wave. We will also measure the levels of stress, anxiety and depression two times (baseline and immediately after the intervention finishes) using two self-assessment scales. The first is a version of the State-Trait Anxiety Inventory that has already being adapted to the local context in a previous pilot study. The second is a combination of the GAD-7 and PHQ-9 questionnaires. All these instruments have been extensively used to monitor anxiety and depressive symptoms by mental health services and general practitioners in different countries. In addition, we will apply a Daily Hassle Scale that will allow us to identify the type and frequency of problems causing stress. Finally, with the aim of validating the self-reported data, we will measure the levels of cortisol, a widely used biomarker for stress, by collecting two rounds of saliva samples (before and after receiving the treatment).
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
We will use a randomized placebo-controlled trial. We will use a sample of 300 female workers from 3 garment factories (i.e. 100 workers per factory) in Dhaka. In each factory, 50 workers will be randomly selected to receive Cognitive Behavioral Therapy and the other 50 will receive a placebo intervention.
Experimental Design Details
Randomization Method
Randomization done in office by a computer
Randomization Unit
Treatment will be assigned at the individual level
Was the treatment clustered?
Experiment Characteristics
Sample size: planned number of clusters
3 factories
Sample size: planned number of observations
300 workers
Sample size (or number of clusters) by treatment arms
150 workers treatment, 150 control (50 from each of the 3 factories)
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB Name
University of Warwick Humanities and Social Sciences Research Ethics Sub-Committee (HSSRC)
IRB Approval Date
IRB Approval Number
Post Trial Information
Study Withdrawal
Is the intervention completed?
Is data collection complete?
Data Publication
Data Publication
Is public data available?
Program Files
Program Files
Reports, Papers & Other Materials
Relevant Paper(s)