Impact of incentivizing supervisor-led monitoring and assistance to improve glasses wear adherence among the Indian garment factory workers: A clustered randomized controlled trial

The supervisors will be offered training to provide assistance, encouragement and monitoring the glasses wear adherence in the allotted worker groups of 4-6 workers on a total sample of 229 workers. The treatment assignment is clustered at supervisor level and 25 (out of 50) supervisors will be eligible for a two level progressive incentive scheme based on the proportionate percentage of workers in their group who continue wearing glasses at times of surreptitious observation.

2023-03-30

2023-04-30

Adherence to glasses wear

The proposed study is a part of a larger trial, PROSPER 3 (Trial registered online at ClinicalTrials.gov Identifier: NCT04654013). As a learning from one of our previous studies, which aimed to measure adherence to eye glasses and willingness to pay of the presbyopic sewing operators with glasses either free of cost or upon the payment of a nominal amount and consequently complying to regular wear of glasses for personal and firm’s benefits, we found out that providing glasses for free or at a nominal cost does not equate to adherence to glasses wear as less than 2% of the workers were found to be wearing glasses at the time of endline survey. Among other reasons, which have been addressed in the PROSPER 3 design, a key element that struck as a major shortcoming of the previous study was removal of the treatment arms comprising glasses wear assistance due to the third wave of Corona virus in India. This treatment arm aimed to address the glasses wear problems faced by the study participants and observe adherence through monitoring assistance from worker’s supervisors and captains. To cater to this shortfall, we conducted a month long pilot introducing incentivised monitoring and encouragement of glasses wear through supervisors among the presbyopic workers where we found that adherence increased to 47% in the first two weeks and further increased to 77% in the weeks following the distribution of the first gift to captains.

As the pilot was a non-RCT study, we now propose a clustered randomzied controlled trial focussing on measuring the adherence to glasses wear as the key outcome variable wherein we introduce a randomization to eligibility to the incentives to half of the supervisors (25 of the 50 supervisors) to explore whether the adherence to glasses wear rates are sustained through ways of habit formation for purposes of scalability of this proposed design.

self-reported well-being, self reported productivity, attitudes towards glasses

The study team would also explore other worker level outcomes that could be affected with glasses wear adherence such as self-reported wellbeing, perceived productivity and attitudes towards glasses wear. We would also explore the change in actual productivity measurements through factory collected individual and line level data.

We will provide training to all the supervisors on providing tools of monitoring, assistance and encouragement to ensure adherence of glasses wear among the workers that will be alloted to each supervsior.

We will then test the glasses wear adherence rates among the workers with supervisor-level randomization of the incentives. We will be doing a randomisation to assign 25 supervisors (out of 50) to be eligible for the treatment.
Treatment arm: Supervisors eligible for incentive scheme, along with training.
Control arm: Supervisors will only be provided with training.

The data collection will be divided in three rounds, namely:
1) Through Round 1 data collection (at the beginning of the trial) we would be able to capture the baseline adherence to glasses wear among the workers in the sample.
2) Through Round 2 data collection (after 2 weeks of introducing monitoring and assistance from supervsiors), we would explore the impact of introducing selective incentivization of supervision and assistance from supervisors/captains on adherence rates of glasses wear among the workers.
3) Through Round 3 data collection (end of the trial) , we would explore the persistence of the effects of selective incentives to supervisors/captains on worker glasses wear adherence and evidence for habit formation trends towards glasses wear. We will also be collecting worker level outcomes that could be affected with glasses wear adherence such as self-reported wellbeing, perceived productivity and attitudes towards glasses wear. We would also explore the change in actual productivity measurements through factory collected individual and line level data.

We will initially collect the first round of observations in the factory, on a sample of 229 workers, where the enumerators will surreptitiously collect observation data on the adherence to glasses wear in the factory. This will be done to capture the glasses wear self motivated habit formation trends from the workers, despite no supervision and monitoring from their captains and supervisors.

We will then create worker supervisor groups of 4-6 workers, based on the supervisor/captain's physical vicinity to their group participants and ease of supervision without hampering their daily production targets. As the supervisors/captains will be requested to take up an additional responsibility of ensuring adherence to glasses wear in their groups. They will be provided with a training to equip them to manage monitoring and provide assistance to their workers. The treatment supervisors/captains will be eligible for two rounds of incentives, the first incentive will be offered after 2 weeks of observation and the second, at the end of the study. Furthermore, the supervisors will have the option to receive a better quality incentive proportionate to the rate of adherence observed in their assigned batch of workers. Out of the 50 captains in the implementation factory, we will randomly select 25 supervisors who will continue to be incentivised for one month and 25 who won’t be receiving any incentives.

We aim to explore the following aspects through this extension:
1) Through Round 1 data collection (at the beginning of the trial) we would be able to capture adherence to glasses wear, with no additional supervision or incentives.
2) Through Round 2 data collection (after 2 weeks of introducing monitoring and assistance), we would explore the impact of introducing selective incentivization of supervision and assistance from supervisors/captains on adherence rates.
3) Through Round 3 data collection (end of the trial) , we would explore the persistence of the effects of selective incentives to supervisors/captains on worker glasses wear adherence and evidence for habit formation trends towards glasses wear. We will also be collecting worker level outcomes that could be affected with glasses wear adherence such as self-reported wellbeing, perceived productivity and attitudes towards glasses wear. We would also explore the change in actual productivity measurements through factory collected individual and line level data.

Randomization done in office by a computer

The randomization unit is clustered at supervisor level

Yes

50 supervisors

229

25 supervisors (clusters)

NA