Alleviating Loneliness Among Female Migrant Garment Workers in India

Last registered on September 14, 2021

Pre-Trial

Trial Information

General Information

Title
Alleviating Loneliness Among Female Migrant Garment Workers in India
RCT ID
AEARCTR-0008235
Initial registration date
September 13, 2021
Last updated
September 14, 2021, 4:54 PM EDT

Locations

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Primary Investigator

Affiliation

Other Primary Investigator(s)

PI Affiliation
University of Pennsylvania
PI Affiliation
University of Michigan
PI Affiliation
University of Michigan
PI Affiliation
Queen Mary University of London

Additional Trial Information

Status
In development
Start date
2022-03-01
End date
2025-03-01
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Migration is central to economic mobility among many of the world’s poor, opening the door to higher wages and human capital accumulation. Yet, rates of migration are much lower than predicted given the substantial wage premium available in urban areas (Roy 1951; Young 2013; Akram et al. 2017; Beegle et al. 2011; Bryan & Morten 2015). Many potential reasons for this puzzle have been examined, but much of the gap remains unexplained (Clemens 2014; Bryan et al. 2014; Munshi & Rosenzweig 2016; Morten 2016). In this project, we aim to increase the economic opportunities of young female migrants in India by addressing an additional growing global concern that may limit migration: loneliness and social isolation.

We implement a low-cost scalable program delivered in garment factories to address loneliness and social isolation and thereby improve both the mental health and economic outcomes of the young female employees. We pair employees that recently migrated to work in those factories ("juniors") with seasoned employees who have been there for at least 7 months ("seniors"). Pairs of junior and senior buddies will be randomly assigned to a control arm (no intervention) or one of the following treatment arms: i) social support, in which juniors and seniors are asked to meet regularly. During the meetings, the pair is prompted to discuss and perform activities are intended to foster a closer emotional bond and a source of emotional comfort in a challenging new environment, and ii) senior buddies are also trained in and deliver a curriculum which draws on Problem Management Plus (PM+) in order to help their junior buddy adjust to the new environment and address the negative beliefs caused by loneliness. During these meetings, the junior and senior engage in joint problem solving, with the senior helping the junior develop strategies to address and to cope with challenges they face. Importantly, PM+ is designed to be delivered by lay-people in resource-poor settings.

The study will rigorously evaluate the effectiveness of these interventions on: a) loneliness and depression, b) social networks, including new links and their mental health, c) labor market outcomes, d) female empowerment, and e) self reported physical health and wellbeing. In measuring the flow of mental health through social networks, we aim to quantify the pathways through which the intervention operates and spillover effects. We plan to enroll 1,000 pairs (2,000 participants) in the RCT sample and 3 contacts per RCT participant (6,000 total) in the social network sample. However, these sample sizes may be adjusted based on additional power calculations following the next pilot.
External Link(s)

Registration Citation

Citation
Adhvaryu, Achyuta et al. 2021. "Alleviating Loneliness Among Female Migrant Garment Workers in India." AEA RCT Registry. September 14. https://doi.org/10.1257/rct.8235-1.0
Experimental Details

Interventions

Intervention(s)
Intervention Start Date
2022-03-15
Intervention End Date
2023-09-01

Primary Outcomes

Primary Outcomes (end points)
The primary mental well-being outcome is loneliness, and the primary economic outcome is retention at the factory.
Primary Outcomes (explanation)
Loneliness will be measured using the UCLA Loneliness Scale, Version 3. Retention at the factory will be measured using firm administrative records.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary mental well-being outcomes are depression, self-reported well-being, and an index combining mental health outcomes. Secondary economic outcomes are productivity and attendance. We will also measure female empowerment, self-reported physical health, and participant social networks, including new links and their mental well-being.
Secondary Outcomes (explanation)
Depression will be measured using the Patient Health Questionnaire. Self reported well-being will be measured using the Gallup life satisfaction survey question and the Cantril Ladder. Productivity and attendance will be measured using firm administrative records. Female empowerment and self-reported physical health will be measured using survey questions informed by J-PAL’s “A Practical Guide to Measuring Women’s and Girls’ Empowerment in Impact Evaluations” and the Longitudinal Survey of Aging in India (LASI). Participant social network outcomes will be measured using surveys of the participant and some of their contacts. Social network measurement will be assisted using a newly developed tablet-based application, which we will test during piloting activities. After assessing whether the new application and mapping protocol can accurately measure networks in the study context at scale, we may write a second paper with social network measures as the primary outcomes. In addition, further outcomes and analyses have been proposed in a related but distinct funding application. If that work is funded, we will register that work on clinicaltrials.gov.

Experimental Design

Experimental Design
RCT participants will be randomized to one of three experimental arms:

1) Control - Participants in this arm would receive no intervention. Pairs are not introduced by the study.
2) Treatments - Juniors will be introduced to a senior living in the same hostel and speaking the same language. This senior will meet with the junior for eight weeks and provide:
a) Social support – The pair will be asked to do weekly activities that provide them with opportunities to form a friendship. They will be guided to discuss both practical topics (which can be very mentally costly when new to an environment -- e.g., where to buy medicine) and questions intended to create a closer bond (e.g., What would be a perfect day for you and why?)

b) Social support supplemented by WHO Problem Management Plus (PM+) - PM+ is an intervention in which lay-people in low-resource settings are trained to assist others with adversity (WHO 2016). This program was tailored to suit the context with expert guidance from Dr Shekhar Saxena, a leading global mental health expert. The senior will be trained as a lay-counselor under the PM+ program, and pairs are asked to meet twice weekly to hold discussions and complete exercises. After sessions, the senior will also ask the junior to complete short “homework” assignments (e.g., talk with two people you haven’t met before during lunch) in order to put learned skills into practice.

We plan to enroll 1,000 pairs of juniors and seniors (2,000 participants) in the experiment, though these sample sizes may be adjusted based on additional power calculations following the next pilot. Juniors and seniors in the treatment and control arms will complete surveys at baseline, weeks 2, 4, 6, and 8 (intervention endline), and 3 and 6 months post-intervention. A comprehensive plan to track participants who leave the factory and return to their villages through phone surveys is in place. Three baseline contacts of each RCT participant will be enrolled in the social network sample (6,000 participants). Social network participants will complete brief surveys at baseline and endline.
Experimental Design Details
Not available
Randomization Method
Randomization will be conducted using Stata.
Randomization Unit
First, junior and senior migrants will be paired randomly, conditional on language and hostel. Pairs are then randomized across experimental arms. The randomization of pairs will be stratified by above/below-median baseline loneliness of the junior as well as the arrival “batch” of the junior. We stratify on loneliness because it is both a crucial “first-stage” outcome and our pilot suggested heterogeneous effects by baseline loneliness. We will also stratify by the “batch” of junior migrants arriving from the same training center given the temporal and geographic clustering.

As pairs are randomized, analyses will be clustered at the pair level, with the exception of analyses of the junior and senior separately. After baseline, outcomes may be measured once per participant (e.g. retention, mental health of social network contacts, etc) or at multiple points (e.g. loneliness, productivity, attendance, etc). Analyses of outcomes with multiple measurements after baseline will be clustered at the individual level.
Was the treatment clustered?
Yes

Experiment Characteristics

Sample size: planned number of clusters
1,000 pairs
Sample size: planned number of observations
2,000 migrants
Sample size (or number of clusters) by treatment arms
333 pairs control, 333 pairs social support, 333 pairs social support plus PM+
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Pennsylvania Institutional Review Board
IRB Approval Date
2019-05-06
IRB Approval Number
832602
IRB Name
Good Business Lab Institutional Review Board
IRB Approval Date
2019-05-01
IRB Approval Number
GBL042019