Evaluación de llamadas de re-contacto con usuarias de la Línea 155

Last registered on June 06, 2023

Pre-Trial

Trial Information

General Information

Title
Evaluación de llamadas de re-contacto con usuarias de la Línea 155
RCT ID
AEARCTR-0009425
Initial registration date
June 02, 2023

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
June 06, 2023, 4:19 PM EDT

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

Last updated
June 06, 2023, 6:12 PM EDT

Last updated is the most recent time when changes to the trial's registration were published.

Locations

Region

Primary Investigator

Affiliation
The Behavioral Insights Team

Other Primary Investigator(s)

PI Affiliation
The Behavioral Insights Team
PI Affiliation
The Behavioral Insights Team
PI Affiliation
Inter-American Development Bank
PI Affiliation
Universidad de los Andes

Additional Trial Information

Status
In development
Start date
2023-06-08
End date
2023-12-22
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Domestic violence carries vast individual and social costs. Survivor support services have a high potential to mitigate these costs, but various barriers to access faced by survivors diminish their reach and effectiveness. This study evaluates the impact of a change in the service protocol of Colombia's national hotline for women victims of violence (Línea 155) on the likelihood of victims accessing institutional help services and the type of services used. The key change in the hotline’s service protocol introduced a follow-up call to survivors aimed at addressing behavioral barriers often faced by victims when seeking institutional help. To measure the impact of this change in the service protocol, we will use an experimental design (RCT) and compare the usage of institutional help services among callers who did and did not receive the follow-up call.
External Link(s)

Registration Citation

Citation
Perez-Vincent, Santiago M. et al. 2023. "Evaluación de llamadas de re-contacto con usuarias de la Línea 155." AEA RCT Registry. June 06. https://doi.org/10.1257/rct.9425-2.0
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Experimental Details

Interventions

Intervention(s)
Línea 155, the Colombian national hotline for women victims of violence, is introducing a change in its service protocol. The new protocol will add follow-up calls (to callers who give their consent to be recontacted) aimed at easing behavioral barriers usually faced by victims when seeking institutional help and assess their usage of victim services. We will experimentally evaluate the impact of the follow-up calls on the likelihood of callers using institutional help services and the type of services used.
Intervention (Hidden)
“Línea 155” is a hotline managed by the National Government of Colombia to orient women victims of violence to available support services. Since the beginning of its operations, the goal of “Línea 155” has been to help women victims of violence access the medical, legal, and psychosocial assistance services offered by the State. To this end, operators provide contact information (address, telephone number, etc.) about the most accessible and appropriate services according to the caller’s requirements and needs. Operators do not offer psychological or legal assistance but refer callers to complementary specialized services. The “Línea 155” also does not handle emergencies. If the caller is in an emergency, they are automatically directed to the national emergency line (“Línea 123”), which has action protocols for these situations.

In its original service protocol, “Línea 155” contemplated one task: providing contact information for victim support services. Once operators provided the information, calls ended, and operators had no further contact with the caller. “Línea 155” decided to change its service protocol to provide greater support to callers in their search for institutional help and to generate information to monitor the hotline’s operation. Under the new protocol, operators will give the contact information for victim support services and, before finishing the call, ask callers if they wish to be recontacted. If callers want to be recontacted, two recontact calls will be made: a first call (one week after the initial call) to reorient the caller to the available support services and a second call (two weeks later) to ask if she has been able to access the referred service (or another service) and, if she has not, the reason for not doing so.

The intervention evaluated in this study is the reorientation (or follow-up) call made one week after the victim contacted “Línea 155”.
The follow-up call is structured as follows: First, the operator must establish if the victim is safe and has enough time and privacy to talk. Once this is verified, the operator indicates to the respondent they are reaching out to follow up on the call received the week before. The operator also tells the victim that her safety is their priority and praises her decision to call “Línea 155” in search of orientation. Then, the operator asks if the respondent accessed the referred support services. If the victim has accessed them, the operator again congratulates her for the steps taken, emphasizes “Línea 155”’s commitment to her safety, and asks if she needs further guidance. If the victim has not accessed the services, the operator helps the victim plan how and when to access the referred services safely. Finally, the operator highlights again the importance of the steps taken and emphasizes the potential benefits of getting help.

The follow-up call uses behavioral strategies to help the victims overcome potential barriers to accessing victim services:

Implementation intentions involve making concrete plans (specify when, where and how) to help people achieve a goal. Different types of implementation intentions include barrier management, planning where/when/how, if-then plans, action and coping plans (Gollwitzer & Sheeran, 2006). There is evidence of the impact of implementation intentions on protective behaviors. For example, women who were asked in a survey to decide where and when they would perform breast self-examination were 4.5 times more likely to do so (Belanger-Gravel, Godin, & Amireault, 2011). The follow-up calls leverage implementation intentions as “Línea 155” operators will support users in developing a plan about when, where, and how to access support services.

Reciprocity refers to the social norm obliging repayment of favors, gifts, invitations, etc. and the shunning of those who freeload (Cialdini, 2007). There is strong evidence that people are more likely to follow through with behaviors if they feel others are invested in the outcome of such behavior (Regan, 1971). For example: reciprocity framings have been shown to increase organ donorship (Behavioural Insights Team, 2013) and job-search actions (Sanders & Kirman, 2014). Follow-up calls leverage the concept of reciprocity as receiving a call from the “Línea 155” can generate a bond between the caller and the hotline – users perceive the operators’ interest in their health, thereby feeling that other people are invested in the outcome of their behaviors.

The endowment effect shows how people prefer avoiding losses to acquiring similar gains, as people demand far more to give up something they already possess than they would pay to acquire it (Kahneman, Knetsch, & Thaler, 1991). In this sense, the endowed progress effect means that when people perceive any progress towards a given goal, even if small, they will be more motivated to complete remaining steps to reach the goal than they would be if they didn’t perceive themselves to have made progress. The follow-up calls make the progress towards the goal of getting help salient by highlighting how users have already completed the first and most significant step - making the initial call to the hotline.

The sunk cost fallacy tells us that people are likely to continue a course of action in order to justify a previously invested resource, even if the costs now outweigh the benefits (Arkes & Blumer, 1985). In contexts of domestic violence, it is important to highlight the future consequences of an action in a positive way, removing the attention we place on past costs, and avoiding the feeling of regret. Sunk cost rationalizations may act as a barrier to actions that may disrupt a relationship into which a survivor has invested significant time, energy, and other resources. Evidence shows that presenting the positive consequences of an action has worked well in contexts of violence (Behavioural Insights Team, 2022). The follow-up calls aim to demystify sunk costs. Operators will recognize and validate this barrier while also making the opportunity cost of not taking action salient and prompting users to imagine a future scenario in which they have seeked help and found safety.
Intervention Start Date
2023-06-08
Intervention End Date
2023-12-22

Primary Outcomes

Primary Outcomes (end points)
Use of any victim services [self-reported, binary (yes/no)]
Primary Outcomes (explanation)
Approximately one month after their call to Línea 155, callers who provide their consent to be recontacted (our sample) will be called back by Línea 155. In this call, the Línea 155 operator will ask three short questions: whether she has accessed the referred services, any other support services, and, if not, the reasons or barriers not to access the support services. The responses to the first two questions will be used to create a binary indicator variable of usage of help services. The variable will take value 1 (one) for those who have used any service, and 0 otherwise.

Secondary Outcomes

Secondary Outcomes (end points)
1. Use of specific victim help services [self-reported, four variables, binary (yes/no)]

2. Barriers to access help services [self-reported, two variables, binary (yes/no)]
Secondary Outcomes (explanation)
1. Approximately one month after their call to Línea 155, callers who provide their consent to be recontacted (our sample) will be called back by Línea 155. In this call, the Línea 155 operator will ask three short questions: whether she has accessed the referred services, any other support services, and, if not, the reasons or barriers not to access the support services. The responses to the first two questions will be used to create binary variables indicating the usage of different types of help services: medical, psychosocial, legal, and police. For each type of help service, the variable will take value 1 (one) for those who have used the service, and 0 otherwise.

2. Approximately one month after their call to Línea 155, callers who provide their consent to be recontacted (our sample) will be called back by Línea 155. In this call, the Línea 155 operator will ask three short questions: whether she has accessed the referred services, any other support services, and, if not, the reasons or barriers not to access the support services. The responses to the last question will be used to create binary variables indicating the presence of different types of access barriers to help services: behavioral and structural. For each type of barrier, the variable will take value 1 (one) for those who indicate it was their main barrier to access a service, and 0 otherwise.

Experimental Design

Experimental Design
We will conduct a Randomized Controlled Trial (RCT), with two comparison groups.
Experimental Design Details
We will conduct a Randomized Controlled Trial (RCT), with two comparison groups. Callers to Línea 155 who consent to be recontacted will be randomly assigned to a treatment or control group. The treatment group will receive a follow-up call one week after their initial call to Línea 155 and a short call for a survey approximately a month after the initial call. The control group will only receive the short call for the survey.
Randomization Method
The method will be a quasi-randomization based on data collected by the Línea 155’s system for all calls received. For example, individuals will be assigned to the treatment or control group depending on the value (even or odd) of the minute (or seconds) their first call to Línea 155 is received (or on the value of any other arbitrary system-generated variable). The underlying assumption is that the value of the minute (or seconds) of their first call to Línea 155 is exogenous to the (potential) outcomes of interest.
Randomization Unit
The randomization unit is the individual.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
Up to 6800 individuals
Sample size: planned number of observations
Up to 6800 individuals
Sample size (or number of clusters) by treatment arms
The sample will be split evenly between treatment and control groups.
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Unit: 3.38 percentage points Percentage: 6.75% Standard deviation: 0.135 SD
IRB

Institutional Review Boards (IRBs)

IRB Name
Comité de Ética de la Investigación - Universidad de Los Andes
IRB Approval Date
2021-11-29
IRB Approval Number
1480/2021

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