Information Gaps and Financial Duress: Understanding Demand for Vaccination Services of Pakistani Households

Last registered on May 03, 2022

Pre-Trial

Trial Information

General Information

Title
Information Gaps and Financial Duress: Understanding Demand for Vaccination Services of Pakistani Households
RCT ID
AEARCTR-0008985
Initial registration date
May 02, 2022

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
May 03, 2022, 9:48 AM EDT

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

Locations

Region

Primary Investigator

Affiliation
University of Technology Sydney

Other Primary Investigator(s)

PI Affiliation
American University of Sharjah
PI Affiliation
University of Michigan

Additional Trial Information

Status
On going
Start date
2022-03-01
End date
2023-06-01
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Only half of Pakistani children receive all their basic vaccinations by their second birthday. Due to this lack of vaccination coverage, Pakistan is one of only three countries in the world where polio is still endemic, and other preventable diseases are still rampant. Improving and expanding routine immunization coverage can significantly reduce children malnutrition, morbidity and mortality. Moreover, by preventing illnesses, immunizations can improve a child's cognitive skills and performance at school, which can lead to increased productivity in the long term. We propose to design and implement interventions with mothers of young infants to increase the uptake of basic vaccinations by (1) alleviating maternal mental stress, and/or (2) improving knowledge about the costs, risks, and benefits of immunization. We further hypothesize that mothers may be preoccupied with other short-term concerns, and so the information interventions by themselves may have little impact even when individuals are misinformed. To investigate this, we propose to provide a brief psychological first aid (PFA) to some mothers, and a PFA combined with relevant information about vaccines to other mothers.
External Link(s)

Registration Citation

Citation
Delavande, Adeline, Javed Younas and Basit Zafar. 2022. "Information Gaps and Financial Duress: Understanding Demand for Vaccination Services of Pakistani Households." AEA RCT Registry. May 03. https://doi.org/10.1257/rct.8985-1.0
Experimental Details

Interventions

Intervention(s)
Our design is a randomized controlled trial. The participants will be divided in 3 groups as follows:
(1) Control group
(2) Treatment 1: information package + psychotherapy first aid (PFA)
(3) Treatment 2: psychotherapy first aid (PFA)

The PFA and information package will be delivered over the phone as follows:
Phone Call 1 - Psychological First Aid: for participants allocated to Treatments 1 and 2, a 20-30 min call by a trained interviewer to provide PFA package to deliver general mental health support.
Phone Call 2 - Information Intervention: for participants in the treatment 1, a 20-30 min call by a trained interviewer (the same as the one who conducts the first call) to provide information about childhood vaccinations, their effectiveness, side effects, and religious compliance etc.
Phone Call 2 or 3: Psychological First Aid: for participants in the treatments 1 and 2, a 20-30 min call by a trained interviewer to provide a PFA package. Specifically, the interviewer/counselor will provide visualization examples related to immunization and concrete plans for immunizing children.
Intervention Start Date
2022-03-15
Intervention End Date
2023-03-15

Primary Outcomes

Primary Outcomes (end points)
Childhood immunization; Childhood immunization Intention; Subjective beliefs about the benefits and cost of childhood immunization; Willingness-to-pay for a text reminder prior to the date of when a child’s vaccination is due
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
Willingness-to-pay for a PFA, mental health
Secondary Outcomes (explanation)
Mental health is measured through the PHQ9 score and self-reported time “feeling depressed or anxious, without doing anything?”

Experimental Design

Experimental Design
Our design is a randomised controlled trial. The 2,400 participants will be divided in 3 groups as follows:
(1) Control group (N=800)
(2) Treatment 1: information package + psychotherapy first aid (N=800)
(3) Treatment 2: psychotherapy first aid (N=800)
Experimental Design Details
Randomization Method
Using randomization feature in SPSS , each of the respondents would be allotted into treatments and control group at the Gallup office by the project managers.
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
No cluster
Sample size: planned number of observations
2,400 observations
Sample size (or number of clusters) by treatment arms
No cluster
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
We propose to recruit 2,400 mothers and anticipate a 32.5% attrition rate per 6-month period, so we expect to re-interview 1,620 households the endline. Power calculations using Optimal Design Software for randomized experiment with individual outcomes (power = 80%, α=0.05, R^2=0.06) suggest that our study design is able to identify minimum detectable effect sizes of 23%.
IRB

Institutional Review Boards (IRBs)

IRB Name
American University of Sharjah IRB
IRB Approval Date
2021-08-29
IRB Approval Number
22-008
Analysis Plan

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Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials