Clinical trial NCT04802304: Beyond Bias - Reducing Provider Bias Towards Adolescents to Increase Contraception Take-Up in Tanzania, Burkina Faso, and Pakistan
Official title: Beyond Bias - Reducing Provider Bias Towards Adolescents to Increase Contraception Take-Up in Tanzania, Burkina Faso, and Pakistan
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Family Planning Services
Keywords: Human-centered design
Health provider bias
Lead sponsor: RAND
Sponsor class: OTHER
Collaborators: name: University of California, Los Angeles
name: Bill and Melinda Gates Foundation
name: Pathfinder International
First posted: 2021-03-17
Enrollment: 233
Sex: FEMALE
Maximum age (years): 24
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Half of the eligible clinics in each country (233 in total) are randomly assigned to receive the intervention, while the remaining half serves as control.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Beyond Bias will evaluate the impact of an intervention designed to reduce family planning provider bias towards young, unmarried, and nulliparous women in Tanzania, Burkina Faso, and Pakistan. The intervention has three components: 1) a summit that includes impactful stories told to and by family planning providers that highlight the consequences of provider bias, 2) a forum for continued communication between providers, and 3) a rewards program where clinics in which providers exhibit less biased client interactions or who have improved the most towards this end will be rewarded with social recognition and a ceremony.

Half of the eligible clinics in each country (233 in total) are randomly assigned to receive the intervention, while the remaining half serves as control. The objective of the evaluation is to estimate the impact of the intervention on a range of outcomes related to quality of family planning care among young, unmarried, and nulliparous women. The investigators hypothesize that the intervention will increase the share of young, unmarried, and nulliparous women who received counseling on a range of methods, counseling on long acting methods, and who received their preferred method.

The investigators will collect four types of data to evaluate the intervention: 1) provider surveys, 2) mystery clients' visits, 3) direct observations of client-provider interactions, and 4) qualitative interviews with clients, providers, and implementors.


Eligibility criteria: Inclusion Criteria for Providers:

* All providers that are part of Pathfinder Internal's supported clinic network in Burkina Faso, Tanzania, and Pakistan.

Exclusion Criteria for Providers:

* None

Inclusion Criteria for Clients:

* All clients aged 24 or under that visit a clinic that is enrolled in the study

Exclusion Criteria for Providers:

* Clients over 24
* Clients who do not visit the clinic for family planning services

Primary outcomes:
measure: Whether client was able to receive services
timeFrame: 12 months after the intervention starts
measure: Optimal Counseling
timeFrame: 12 months after the intervention starts
measure: Received modern method
timeFrame: 12 months after the intervention starts
measure: Perceived patient centeredness
timeFrame: 12 months after the intervention starts
Secondary outcomes:
measure: Provider biased attitudes
timeFrame: 12 months after the intervention starts
Other outcomes:
Locations:
city: Santa Monica
country: United States
facility: RAND
state: California
Study officials:
affiliation: RAND
name: Zachary Wagner, Ph.D
role: PRINCIPAL_INVESTIGATOR
affiliation: University of California, Los Angeles
name: Corrina Moucheraud, Ph.D
role: PRINCIPAL_INVESTIGATOR
References: