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Completed

NCT Number: NCT01885858

Measuring Ethnic Disparities in Family Planning Services in Peru

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.

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Indigenous profile

Behavioral

Clinics receive simulated patients (SPs) enacting the indigenous profile, and interpreting a standardized script with a biographical and clinical background. The indigenous SP wears a lliclla (a traditional woven cloth that covers the back and shoulders), long braids, a woven cardigan and loose pants; she uses no make-up and, her patterns of speech are slower and her posture and movement more rigid than the mestizo SP. The script indicates that SPs do not want to have any more children and that her choice of method is the pill.

Mestizo profile

Behavioral

Clinics receive simulated patients (SPs) enacting the mestizo profile, and interpreting a standardized script with a biographical and clinical background. The mestizo SP does not wear a lliclla (a traditional woven cloth that covers the back and shoulders) or long braids, but a pony tail or loose hair; she wears make-up and, a vest made of polar fleece, tight pants and culturally salient accessories; her patterns of speech are faster and her posture and movement less rigid than the indigenous SP. The script indicates that SPs do not want to have any more children and that her choice of method is the pill.

Primary outcomes

  1. Mean differences between ethnic profiles in the proportion of items on which providers exchanged information with simulated patients during counseling session

    Time frame: within the first 30 minutes after counseling session

Secondary outcomes

  1. Mean differences between ethnic profiles in the proportion of items on which providers complied with standards of interpersonal relations during counseling session

    Time frame: Within the first 30 minutes after counseling session

  2. Mean differences between ethnic profiles in the length counseling session

    Time frame: Within the first 30 minutes after counseling session

  3. Mean differences between ethnic profiles in the length of visit to the clinic

    Time frame: Within the first 30 minutes after counseling session

  4. Mean differences between ethnic profiles in costs of appointment for counseling session

    Time frame: Within the first 30 minutes after counseling session

Sponsors and collaborators

Lead sponsor

Universidad Peruana Cayetano Heredia

Other

Collaborators

  • Inter-American Development Bank

Registry information

Official study title

Quality of Health Services in Indigenous Communities in Peru

Important dates

Study start
2012
Primary completion
2012
Study completion
2013
First posted
Jun 25, 2013
Registry last updated
Nov 13, 2013

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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