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Field
Abstract
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Before
In 2013, the World Health Organization (WHO) set eye health as a priority by creating the “Universal Eye Health: A Global Action Plan 2014-2019.” The WHO’s reasoning is intuitive; poor visual health can impair quality of life in a number of ways- by limiting physical activity, causing emotional health problems, damaging work performance. In India, 55 million people suffer from presbyopia (the degeneration of sight related to age). Apart from the large-scale negative impact on quality of life, untreated visual impairments including presbyopia, are estimated to cost the Indian economy $37 billion in productivity losses annually.
This study is an extension of a previous trial, 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 did not equate to adherence to glasses wear as we found less than 2% of the workers wearing glasses at the endline survey . We then conducted a short one month non-randomized pilot on 253 workers, where we introduced an element of incentivising monitoring and encouragement of glasses wear through supervsiors to improve adherence rates where we found that adherence to glasses wear among the workers increased to 47% in the first two weeks and further increased to 77% by the end the pilot (after four weeks).
To further explore the validity and scalability of the incentive based monitoring through supervisors for glasses wear adherence encouragement, we now propose conducting a clustered randomised controlled trial on a sample of the same 253 workers, where we randomly assign 27 (out of 54) supervisors to receive incentives based on tasks related to monitoring, assisting and encouraging workers with presbyopia to wear and get accustomsed to the glasses. Each supervisor will be responsible for a group of 4-6 workers. The trial takes the form of a clustered randomised controlled trial with randomisation at the supervisor level (clusters) and stratification by baseline glasses wear adherence rates of workers.
We hypothesize that providing supervisor-led monitoring and assistance to glasses wear to workers with presbyopia will improve the usability and adherence to eyeglasses, increase their perceived and actual productivity, and ultimately contribute to their wellbeing.
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After
In 2013, the World Health Organization (WHO) set eye health as a priority by creating the “Universal Eye Health: A Global Action Plan 2014-2019.” The WHO’s reasoning is intuitive; poor visual health can impair quality of life in a number of ways- by limiting physical activity, causing emotional health problems, damaging work performance. In India, 55 million people suffer from presbyopia (the degeneration of sight related to age). Apart from the large-scale negative impact on quality of life, untreated visual impairments including presbyopia, are estimated to cost the Indian economy $37 billion in productivity losses annually.
This study is an extension of a previous trial, 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 did not equate to adherence to glasses wear as we found less than 2% of the workers wearing glasses at the endline survey . We then conducted a short one month non-randomized pilot on 253 workers, where we introduced an element of incentivising monitoring and encouragement of glasses wear through supervsiors to improve adherence rates where we found that adherence to glasses wear among the workers increased to 47% in the first two weeks and further increased to 77% by the end the pilot (after four weeks).
To further explore the validity and scalability of the incentive based monitoring through supervisors for glasses wear adherence encouragement, we now propose conducting a clustered randomised controlled trial on a sample of the same 247 workers, where we randomly assign 27 (out of 54) supervisors to receive incentives based on tasks related to monitoring, assisting and encouraging workers with presbyopia to wear and get accustomed to the glasses. Each supervisor will be responsible for a group of 4-6 workers. The trial takes the form of a clustered randomised controlled trial with randomisation at the supervisor level (clusters).
We hypothesize that providing supervisor-led monitoring and assistance to glasses wear to workers with presbyopia will improve the usability and adherence to eyeglasses, increase their perceived and actual productivity, and ultimately contribute to their wellbeing.
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Field
Last Published
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Before
February 14, 2023 11:59 PM
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After
February 16, 2023 12:48 AM
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Field
Intervention (Public)
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Before
The supervisors will be offered training to provide assistance, encouragement and monitoring the glasses wear adherence in the alloted worker groups of 4-6 workers on a total sample of 253 workers. The treatment assignment is clustered at supervisor level and 27 (out of 54) 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.
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After
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 247 workers. The treatment assignment is clustered at supervisor level and 27 (out of 54) 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.
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Field
Primary Outcomes (Explanation)
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Before
The prosposed 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 (27 of the 54 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.
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After
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 (27 of the 54 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.
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Field
Experimental Design (Public)
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Before
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 randomly assign 27 supervisors (out of 54) to be eligible for the treatment, stratifying baseline glasses wear adherence rates of workers.
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 begining 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.
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After
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 27 supervisors (out of 54) 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.
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Field
Planned Number of Observations
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Before
253
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After
247
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Field
Intervention (Hidden)
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Before
Explore the effectiveness of incentives to supervisors/captains in sustaining adherence to glasses wear among the workers. We aim to conduct a clustered RCT for one month wherein a sample of 253 workers, who are presbyopic and have been offered glasses free of cost, will be divided into groups of 4-7 workers and alloted a supervisor/captain(clusters). As the supervisors will be requested to take up an additional responsibility of ensuring adherence to glasses wear in their groups, the supervisors in the treatment group 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 also have the option to receive a better quality incentive proportionate to the rate of adherence observed in their assigned batch of workers.
We will explore the variation in glasses wear compliance by randomising eligibility to incentives to only 50% of the supervisors/captains for the scalability purpose of the research design. Out of the 54 captains in the implementation factory, we will randomly select 27 supervisors who will continue to be incentivised for one month and 27 who won’t be receiving any incentives.
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After
Explore the effectiveness of incentives to supervisors/captains in sustaining adherence to glasses wear among the workers. We aim to conduct a clustered RCT for one month wherein a sample of 247 workers, who are presbyopic and have been offered glasses free of cost, will be divided into groups of 4-7 workers and allotted a supervisor/captain(clusters). As the supervisors will be requested to take up an additional responsibility of ensuring adherence to glasses wear in their groups, the supervisors in the treatment group 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 also have the option to receive a better quality incentive proportionate to the rate of adherence observed in their assigned batch of workers.
We will explore the variation in glasses wear compliance by randomising eligibility to incentives to only 50% of the supervisors/captains for the scalability purpose of the research design. Out of the 54 captains in the implementation factory, we will randomly select 27 supervisors who will continue to be incentivised for one month and 27 who won’t be receiving any incentives.
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