A Randomized-Controlled Trial to Increase the Uptake of LARCs in Cameroon

NCT ID: NCT03733678

Last Updated: 2025-05-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-23

Study Completion Date

2024-12-31

Brief Summary

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Cameroon exhibits a high and non-decreasing level of maternal mortality (roughly 600 per 100,000 live births), partially related to its relatively high total fertility rate (roughly 4.6). Survey evidence furthermore suggests that a significant fraction of these pregnancies is unwanted or considered mistimed by the mother, especially among females aged 15-19. Despite this, the rate of utilization of family planning (FP) is low: e.g. only 48% of sexually active unmarried women use any form of (modern) contraception, or MC, and even then, it is primarily condoms. The use of LARCs (long-acting reversible contraceptives, i.e. the IUD and implant) is less than 1% according to the most recent Demographic Health Survey.

The study investigators propose to use an integrated behavioral science approach to increase the take-up of both SARCs (short-acting reversible contraceptives, i.e. the pill and injectable) and especially LARCs among reproductive-age females in Cameroon, including adolescents who may be unmarried and/or nulliparous. In addition to decreasing maternal mortality and undesired pregnancies, indirect effects for the community will include: increased welfare from reduced side effects that arise due to current one-size-fits-all FP counseling; healthier children due to improved birth spacing; and increased human capital formation both for children and for young (often school-aged) potential mothers.

The study investigators propose to conduct the study at HGOPY for a duration of 12 months. The study investigators will provide tablets to each of five nurses that conduct FP counseling to participants at the hospital. The tablets contain a counseling "app" (or decision-support tool or a job-aid) that was jointly developed by professionals from HGOPY, the World Bank, and the Ministry of Health. The study investigators propose an individually-randomized experiment, where the participants will be offered randomly varying discounts for the modern contraceptive methods they wish to adopt. The study investigators also propose to experiment with certain aspects of the "app" to improve its effectiveness - both for the participant and for the nurse. More details on the experimental design are provided below.

Detailed Description

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Conditions

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Contraception Contraception Behavior Contraceptive Usage Contraceptive Method Switching

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

The study independently experiments with two aspects of the health provider-client relationship:

1. First, a tablet-based counseling app that is used by the provider gives random discounts to clients - separately for LARCs and SARCs.
2. Second, the tablet-based app presents recommendations to the client sequentially (i.e. the top-ranked method, followed by the next one if that recommendation is declined by the client, etc.) vs. simultaneously (i.e. presenting the top recommendations to the client all at once and asking her to choose which one to discuss further).
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants
Participants are masked in some interventions related to the workings of the tablet-based decision-support tool, but not to the price discounts they receive for the contraceptive methods.

Study Groups

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Free SARC, Free LARC, Recommendation

Free SARC, Free LARC, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Free SARC, LARC=500, Recommendation

Free SARC, LARC=500 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Free SARC, LARC=1000, Recommendation

Free SARC, LARC=1000 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Free SARC, LARC=2140, Recommendation

Free SARC, LARC=2140 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Free SARC, LARC=5000, Recommendation

Free SARC, LARC=5000 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Regular SARC, Free LARC, Recommendation

Regular price SARC, Free LARC, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Regular SARC, LARC=500, Recommendation

Regular price SARC, LARC=500 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Regular SARC, LARC=1000, Recommendation

Regular price SARC, LARC=1000 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Regular SARC, LARC=2140, Recommendation

Regular price SARC, LARC=2140 CFA, Sequential recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Regular SARC, LARC=5000, Recommendation

Regular price SARC, LARC=5000 CFA, Sequential recommendation

Group Type NO_INTERVENTION

No interventions assigned to this group

Free SARC, Free LARC, No Recommendation

Free SARC, Free LARC, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Free SARC, LARC=500, No Recommendation

Free SARC, LARC=500 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Free SARC, LARC=1000, No Recommendation

Free SARC, LARC=1000 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Free SARC, LARC=2140, No Recommendation

Free SARC, LARC=2140 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Free SARC, LARC=5000, No Recommendation

Free SARC, LARC=5000 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for SARCs

Intervention Type BEHAVIORAL

SARCs are offered free to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Regular SARC, Free LARC, No Recommendation

Regular Price SARC, Free LARC, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Regular SARC, LARC=500, No Recommendation

Regular Price SARC, LARC=500 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Regular SARC, LARC=1000, No Recommendation

Regular Price SARC, LARC=1000 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Regular SARC, LARC=2140, No Recommendation

Regular Price SARC, LARC=2140 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Price discounts for LARCs

Intervention Type BEHAVIORAL

LARCs are offered at lower prices to the client

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Regular SARC, LARC=5000, No Recommendation

Regular Price SARC, LARC=5000 CFA, Simultaneous recommendation

Group Type EXPERIMENTAL

Sequential vs. simultaneous recommendations

Intervention Type BEHAVIORAL

Top ranked methods are presented to the client sequentially or simultaneously

Interventions

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Price discounts for SARCs

SARCs are offered free to the client

Intervention Type BEHAVIORAL

Price discounts for LARCs

LARCs are offered at lower prices to the client

Intervention Type BEHAVIORAL

Sequential vs. simultaneous recommendations

Top ranked methods are presented to the client sequentially or simultaneously

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Female
* Ages 10-49
* Presenting at HGOPY seeking FP counseling/services
* HGOPY clients referred to the family planning unit for consultation
Minimum Eligible Age

10 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Stanford University

OTHER

Sponsor Role collaborator

George Washington University

OTHER

Sponsor Role collaborator

University of Exeter

OTHER

Sponsor Role collaborator

University of California, San Diego

OTHER

Sponsor Role collaborator

Yaounde Gynecology, Obstetrics and Pediatrics Hospital

UNKNOWN

Sponsor Role collaborator

World Bank

OTHER

Sponsor Role lead

Responsible Party

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Berk Ozler

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Berk Ozler, PhD

Role: PRINCIPAL_INVESTIGATOR

World Bank

Locations

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Hôpital gynéco-obstétrique et pédiatrique de Yaoundé (HGOPY)

Yaoundé, , Cameroon

Site Status

Countries

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Cameroon

Other Identifiers

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LARCs-2018

Identifier Type: -

Identifier Source: org_study_id

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