Estimating mental health stigma among Syrian refugees

Last registered on June 24, 2022

Pre-Trial

Trial Information

General Information

Title
Estimating mental health stigma among Syrian refugees
RCT ID
AEARCTR-0009483
Initial registration date
May 24, 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 26, 2022, 11:44 AM EDT

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

Last updated
June 24, 2022, 12:01 PM EDT

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

Locations

Region

Primary Investigator

Affiliation
Harvard University

Other Primary Investigator(s)

Additional Trial Information

Status
On going
Start date
2022-05-17
End date
2022-07-31
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Mental health problems and psychological distress are prevalent among displaced populations, and most adult Syrian refugees in urban areas of Jordan have symptoms of depression (Miguel et al., 2021). Yet mental health care-seeking in this setting is low. This project will investigate whether stigma may be a barrier to mental health care-seeking, by using a list experiment to estimate rates of discrimination against mental health care-seekers. The estimates of the list experiment will be compared both to directly elicited 2nd order beliefs and to the respondent’s own directly elicited beliefs from a prior survey administered multiple months earlier. Heterogeneity analysis will be conducted comparing respondents who score above or below median on a short mental health questionnaire, and testing for differences by respondent gender.
External Link(s)

Registration Citation

Citation
Smith, Emma. 2022. "Estimating mental health stigma among Syrian refugees." AEA RCT Registry. June 24. https://doi.org/10.1257/rct.9483
Experimental Details

Interventions

Intervention(s)
The sample comprises of 800 adult Syrian refugees living in Jordan. A list experiment will be conducted by phone, within a household survey on a range of standard topics including employment, physical and mental health, food security, and child schooling. Respondents are individually randomized to one of two lists (List A and List B). List A contains 4 items which are opinions with which the respondent may agree or disagree. List B contains 5 items, which include the same 4 opinions provided in List A, plus an additional sensitive item asking whether the respondent agrees or disagrees that if he/she were young and unmarried he/she would not marry someone who once sought out professional mental health care. All respondents are instructed to listen to the full list of items and indicate only the count of the items with which they agree.
Intervention Start Date
2022-05-17
Intervention End Date
2022-07-31

Primary Outcomes

Primary Outcomes (end points)
i) The count of items reported.
ii) Directly elicited agreement with the sensitive statement, reported multiple months earlier by phone during a general household questionnaire.
iii) The difference between (i) and (ii)
Primary Outcomes (explanation)
i) The difference-in-means in the count of items reported by respondents who received List A and those who received List B will provide the population estimate of those who discriminate against mental health care-seekers in the marriage market.
ii) This estimates the rate of respondents’ public agreement with the sensitive statement.
iii) This provides an estimate of social desirability bias and other types of misreporting. It is specifically an estimate of the average difference between respondents’ public and private agreement with the sensitive statement.

Secondary Outcomes

Secondary Outcomes (end points)
i) Directly elicited 2nd order beliefs about others’ willingness to report agreement with the sensitive statement.
ii) Directly elicited 2nd order beliefs about others’ private agreement with the sensitive statement.
iii) The difference between (i) and (ii).
iv) The difference between Secondary(i) and Primary(i).
v) The difference between Secondary(ii) and Primary(i).
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
(See Intervention Details above)
Experimental Design Details
Randomization Method
Participants are randomized individually, stratifying on gender and governorate of current residence. Randomization is done by computer (Stata).
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
N/A
Sample size: planned number of observations
800 Individuals
Sample size (or number of clusters) by treatment arms
400 in the control group (List A) and 400 in the treatment group (List B)
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Assuming alpha = 0.05 and 80% power the minimum detectable effect without using individuals' covariates will be 0.20 standard deviations.
IRB

Institutional Review Boards (IRBs)

IRB Name
Harvard University-Area Committee on the Use of Human Subjects
IRB Approval Date
2022-04-04
IRB Approval Number
IRB20-1023
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