| Field | Before | After |
|---|---|---|
| Field Abstract | Before Is teacher stress holding back student achievement? How does psychological and pharmacological aid to teachers influence their mental health and students? We hope to answer these questions, by conducting a field experiment with one of the largest charter school networks in the world, the PEN Education Network of Pakistan. Using detailed data on teachers’ self-reported stress, life satisfaction, teachers stress hormonal concentrations in blood plasma, we explore whether and under which conditions do teacher stress is alleviated and whether this impacts student achievement. We randomize teachers into 6 treatment arms. The teachers are further cross-randomized into social signaling treatment using color-coded bracelets that aims to reduce stigma associated with mental health. In the first treatment group, we assign teachers in 4 weekly sessions with a psychologist practicing cognitive behavioral therapy. The second, third and fourth group is assigned a session with the psychiatrist with possibility to prescribe medicines where we subsidize the prescription medicines to varying degrees (0% vs 50% vs 100% subsidies of prescriptions). Finally, we randomly assign the teachers into 4 weekly sessions of mindfulness meditation of same length of time as the psychologist treatment. | After Is teacher stress holding back student achievement? Does stress transmit from teacher to students? How does psychological and pharmacological aid to teachers influence their mental health and students? We hope to answer these questions, by conducting a field experiment with one of the largest charter school networks in the world, the PEN Education Network of Pakistan. Using detailed data on teachers’ self-reported stress, life satisfaction, teachers stress hormonal concentrations in blood plasma, we explore whether and under which conditions do teacher stress is alleviated and whether this impacts student achievement. We randomize teachers into 6 treatment arms. The teachers are further cross-randomized into social signaling treatment using color-coded bracelets that aims to reduce stigma associated with mental health. In the first treatment group, we assign teachers in 4 weekly sessions with a psychologist practicing cognitive behavioral therapy. The second, third and fourth group is assigned a session with the psychiatrist with possibility to prescribe medicines where we subsidize the prescription medicines to varying degrees (0% vs 50% vs 100% subsidies of prescriptions). Finally, we randomly assign the teachers into 4 weekly sessions of mindfulness meditation of same length of time as the psychologist treatment. |
| Field Last Published | Before September 10, 2022 01:51 PM | After October 17, 2022 10:47 AM |
| Field Primary Outcomes (Explanation) | Before The primary outcomes measure teacher stress in a self reported survey but as well as more objective hormonal secretion in response to stress i.e. cortisol concentration. | After The primary outcomes measure teacher stress in a self reported survey but as well as more objective hormonal secretion in response to stress i.e. cortisol concentration. Specifically, the first set of outcome variables concern teacher stress measured on a 5-point Likert Scale, Cohen Perceived Stress Scale (PSS), cortisol concentration in blood plasma that we will standardize to mean zero and standard deviation one. The second set of outcomes concern hours of teaching, attendance of teachers, whether medication was prescribed by the psychiatrist and self-reported use of prescribed medicine by the teacher. The third set of outcomes concern student outcomes that include students’ self-reported stress, Cohen Perceived Stress Scale (PSS), test scores in mathematics and Urdu language and self-reported corporal punishment by the teacher. Marlowe–Crowne framework will be used to rigorously speak to social desirability and misreporting concerns. |
| Field Experimental Design (Public) | Before Our sample consists of 850 teachers with about 140 teachers per treatment arm and 25000 students across Punjab and Sindh provinces of Pakistan. We randomly assign teachers into the following 6 groups: T1) Psychology Treatment: 4-week of weekly sessions with a psychologist administrating cognitive behavioral therapy. T2) Psychiatrist with no subsidy of prescription medicines: 1 session with a psychiatrist who has an option to prescribe medicines (zero subsidy of medicine: 100% payment from teachers own pocket) T3) Psychiatrist with full subsidization of prescription medicines- 1 session with a psychiatrist prescribing medicines, with the prescribed medications provided for free (100% subsidization). T4) Psychiatrist with co-paying - 1 session with a psychiatrist prescribing medicines and providing those medications for 50% of total costs (co-paying) T5) 4 sessions each week mindfulness meditation for one month (equal to time spent for psychologist treatment). T6) Placebo lectures (4 lectures) on macroeconomic facts, concepts and trends of equal length and frequency of meetings with psychologist and mindfulness meditation. The teachers are further cross-randomized into social signaling treatment using color-coded bracelets that aims to reduce stigma associated with mental health. | After Our sample consists of 850 teachers with about 140 teachers per treatment arm and 25000 students across Punjab and Sindh provinces of Pakistan. We randomly assign teachers into the following 6 groups: T1) Psychology Treatment: 4-week of weekly sessions with a psychologist administrating cognitive behavioral therapy. T2) Psychiatrist with no subsidy of prescription medicines: 1 session with a psychiatrist who has an option to prescribe medicines (zero subsidy of medicine: 100% payment from teachers own pocket) T3) Psychiatrist with full subsidization of prescription medicines- 1 session with a psychiatrist prescribing medicines, with the prescribed medications provided for free (100% subsidization). T4) Psychiatrist with co-paying - 1 session with a psychiatrist prescribing medicines and providing those medications for 50% of total costs (co-paying) T5) 4 sessions each week mindfulness meditation for one month (equal to time spent for psychologist treatment). T6) Placebo lectures (4 lectures) on macroeconomic facts, concepts and trends of equal length and frequency of meetings with psychologist and mindfulness meditation. The teachers are further cross-randomized into social signaling treatment using bracelets with message that aims to reduce stigma associated with mental health. |
| Field Public analysis plan | Before No | After Yes |
| Field Secondary Outcomes (End Points) | Before Exact pre-registered secondary outcome variables: 1) Teacher score on analytical creativity task 2) Student creative writing test scores 3) A measure of extent of mental health stigma perceived by the teacher. | After Exact pre-registered for heterogeniety anlaysis: (1) wrist bands public signaling the teacher goes to see a psychiatrist and (2) treatment impact on those that have higher pre-treatment self-reported stigma see a psychiatrist. Other outcomes that may be used for exploratory analysis but analyzed only if the data becomes available: 1) Teacher score on analytical creativity task 2) Student creative writing test scores 3) A measure of extent of mental health stigma perceived by the teacher, pre and post-treatment. |
| Field Secondary Outcomes (Explanation) | Before As a secondary outcomes, want to also assess how stress impacts teacher and their students creativity. | After As a secondary outcomes, want to also assess how stress impacts teacher and their students stress level and if we can get data on creative writing scores of students also assess the impact on creativity achievement scores. |
| Field | Before | After |
|---|---|---|
| Field Document | Before |
After
Mental_Health_Pre_Registry.pdf
MD5:
bcc0694c34c1f178b6c59d8409af65eb
SHA1:
67c363c7475e0e071a04a5631dc990f877cd2ac2
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| Field Title | Before | After Pre-Analysis Plan for the Project Mental Health Interventions |