Clinical trial NCT01885858: Measuring Ethnic Disparities in Family Planning Services in Peru
Official title: Quality of Health Services in Indigenous Communities in Peru
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Quality of Health Care
Keywords: health services research
family planning
ethnicity
healthcare disparities
Lead sponsor: Universidad Peruana Cayetano Heredia
Sponsor class: OTHER
Collaborators: name: Inter-American Development Bank
First posted: 2013-06-25
Enrollment: 351
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This study is designed as a crossover randomized controlled trial, to investigate the effects of client's ethnic characteristics on the quality of family planning services.

Detailed description: The study aims at evaluating, in a causal way, whether health providers in Peru might be contributing to ethnic health disparities in the provision of family planning services. We perform a field experiment that combines audit studies and simulated patient methodologies. The study population consists of clinics in Metropolitan Lima that are administered by the Ministry of Health and which provide family planning counseling services. The sample in our study includes 351 clinics. The primary outcome measured in the study was a composite of service provider compliance to guideline technical tasks in family planning counseling. We pre-defined indigenous and mestizo profiles using distinctive cultural attributes such as clothing, styling of hair, posture and patterns of speech. With a 1:1 allocation as per a computer generated randomization schedule, and using permuted blocks of four, clinics were assigned to a sequence of ethnic profiles, either to receive the indigenous then the mestizo profile (sequence 1) or mestizo and then the indigenous profile (sequence 2) in two periods. The trial comprises two treatment periods each of five week's duration. The second treatment period followed the same sequence of visits than the first one to obtain at least a five-week 'wash-out' period to mask the study.

Eligibility criteria: Inclusion Criteria:

* Clinic operated by the Ministry of Health
* Clinic must provide family planning services

Exclusion Criteria:

* Primary health clinics with the lowest degree of specialization (categorized as I-1) and thus lacking the number of patients required to enable the simulated patient to pass through the facilities undetected.

Primary outcomes:
measure: Mean differences between ethnic profiles in the proportion of items on which providers exchanged information with simulated patients during counseling session
timeFrame: within the first 30 minutes after counseling session
Secondary outcomes:
measure: Mean differences between ethnic profiles in the proportion of items on which providers complied with standards of interpersonal relations during counseling session
timeFrame: Within the first 30 minutes after counseling session
measure: Mean differences between ethnic profiles in the length counseling session
timeFrame: Within the first 30 minutes after counseling session
measure: Mean differences between ethnic profiles in the length of visit to the clinic
timeFrame: Within the first 30 minutes after counseling session
measure: Mean differences between ethnic profiles in costs of appointment for counseling session
timeFrame: Within the first 30 minutes after counseling session
Other outcomes:
Locations:
Study officials:
affiliation: Universidad Peruana Cayetano Heredia
name: Patricia J Garcia, PhD
role: PRINCIPAL_INVESTIGATOR
References: