Impact of Teacher Incentive Intervention on Students’ Vision Healthcare Uptake: A Cluster-Randomized Controlled Trial

Jin Zhao, Huan Wang (), Hongyu Guan (), Kang Du, Yunyun Zhang and Nathan Congdon
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Jin Zhao: School of Marxism, Xi’an University of Finance and Economics, Xi’an 710110, China
Huan Wang: Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA 94305, USA
Hongyu Guan: Center for Experimental Economics for Education, Shaanxi Normal University, Xi’an 710110, China
Kang Du: School of Economics, Xi’an University of Finance and Economics, Xi’an 710110, China
Yunyun Zhang: Center for Experimental Economics for Education, Shaanxi Normal University, Xi’an 710110, China
Nathan Congdon: Centre for Public Health, Queen’s University Belfast, Belfast BT7 1NN, UK

IJERPH, 2022, vol. 19, issue 19, 1-14

Abstract: Less than one-third of rural Chinese children with refractive error own or wear eyeglasses. To study the effect of teacher incentives on the acceptance of vision care offered to rural students with uncorrected refractive error, we conducted a cluster-randomized controlled trial in 18 townships in one county in Shaanxi Province. Primary and junior high schools within each township were assigned to either intervention (all teachers received an incentive) or control (no teacher incentives were offered) groups. A total of 42 schools were assigned to either the intervention group (13 schools) or the control group (29 schools). Teachers in the intervention group could elect to receive high-value (sunglasses worth USD 148), moderate-value (eyeglasses worth USD 89), or cash incentives (USD 35) if ?70% of eligible students (uncorrected visual acuity (VA) ? 6/12 in both eyes and corrected VA ? 6/9.5 in both eyes) in the teacher’s class visited a program-affiliated vision center (VC) within 60 days after their vision screening. Among 8238 students, 3401 (41.2%, of which 53.0% were girls with a mean age of 12 (SD 1.75)) met the enrollment criteria and were randomly allocated to the intervention (n = 1645, 49.0%) and control groups (n = 1579, 51.0%). Among these, 3224 (94.8%) completed the study and underwent analysis. Nearly equal numbers of students had classroom teachers selecting the high-value (n = 524, 31.9%), moderate-value (n = 582, 35.4%), and cash incentives (n = 539, 32.8%). The rate of the acceptance of offered vision care was significantly higher in the intervention group (382/1645 = 23.2%) compared to the control group (172/1579 = 10.9%, 95% confidence interval for observed difference 12.3%, p < 0.001). Teacher incentives appeared effective in improving Chinese rural school-aged children’s uptake rate of vision services provided by county hospital-based VCs.

Keywords: cluster-randomized controlled trial; rural China; school-aged children; uptake; vision care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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