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

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Listed:
  • 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
    Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, China)

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.

Suggested Citation

  • Jin Zhao & Huan Wang & Hongyu Guan & Kang Du & Yunyun Zhang & Nathan Congdon, 2022. "Impact of Teacher Incentive Intervention on Students’ Vision Healthcare Uptake: A Cluster-Randomized Controlled Trial," IJERPH, MDPI, vol. 19(19), pages 1-14, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12727-:d:933967
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    References listed on IDEAS

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    1. Xiuqin Wang & Nathan Congdon & Yue Ma & Min Hu & Yuan Zhou & Weiqi Liao & Ling Jin & Baixiang Xiao & Xiaoyi Wu & Ming Ni & Hongmei Yi & Yiwen Huang & Beatrice Varga & Hong Zhang & Yongkang Cun & Xians, 2017. "Cluster-randomized controlled trial of the effects of free glasses on purchase of children's glasses in China: The PRICE (Potentiating Rural Investment in Children's Eyecare) study," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-14, November.
    2. Glewwe, Paul & Park, Albert & Zhao, Meng, 2016. "A better vision for development: Eyeglasses and academic performance in rural primary schools in China," Journal of Development Economics, Elsevier, vol. 122(C), pages 170-182.
    3. Yue Ma & Yujuan Gao & Yue Wang & Haoyang Li & Lina Ma & Jiangchao Jing & Yaojiang Shi & Hongyu Guan & Nathan Congdon, 2018. "Impact of a Local Vision Care Center on Glasses Ownership and Wearing Behavior in Northwestern Rural China: A Cluster-Randomized Controlled Trial," IJERPH, MDPI, vol. 15(12), pages 1-12, December.
    4. Hongyu Guan & Huan Wang & Juerong Huang & Kang Du & Jin Zhao & Matthew Boswell & Yaojiang Shi & Mony Iyer & Scott Rozelle, 2018. "Health Seeking Behavior among Rural Left-Behind Children: Evidence from Shaanxi and Gansu Provinces in China," IJERPH, MDPI, vol. 15(5), pages 1-19, April.
    5. Yi, Hongmei & Zhang, Linxiu & Ma, Xiaochen & Congdon, Nathan & Shi, Yaojiang & Pang, Xiaopeng & Zeng, Junxia & Wang, Lei & Boswell, Matthew & Rozelle, Scott, 2015. "Poor vision among China's rural primary school students: Prevalence, correlates and consequences," China Economic Review, Elsevier, vol. 33(C), pages 247-262.
    6. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
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