跳至主要内容
临床试验/NCT03955562
NCT03955562Unknown不适用

Impact of Pedestrian Footbridges on Economic, Health and Educational Outcomes in Rural Communities

University of Colorado, Boulder1 个研究点 分布在 1 个国家目标入组 2,400 人开始时间: 2019年2月15日最近更新:
适应症
干预措施

试验速览

阶段
不适用
入组人数
2,400
试验地点
1
主要终点
Mid-upper arm circumference (MUAC)

研究概览

简要总结

Isolation caused by lack of transportation infrastructure affects almost every facet of life for the rural poor. Without adequate transportation access, families cannot access schools, health care, employment, or local markets to sell and buy goods. The World Bank estimates that nearly a billion people worldwide lack access to an all-season road within two kilometers, illustrating the scope of the problem, and the challenge of addressing it at scale.

Bridges to Prosperity (B2P) is a non-profit organization that builds footbridges to connect rural communities facing isolation to road networks and critical destinations and services. B2P has constructed more than 280 footbridges in 20 countries, an infrastructure intervention that is cost-effective, durable, and relatively simple to scale. B2P's field program in Rwanda started in 2012 and has led to the completion of 37 footbridges that have created new safe access for an estimated 225,000 people. Over the next five years, B2P plans to construct approximately 350 footbridges in Rwanda. This rapid program growth presents an unprecedented opportunity for rigorous investigation of the effects of new footbridges on a number of key economic, health, agricultural and education outcomes for rural communities.

As such, the research team has been brought on to carry out an impact evaluation of B2P-constructed footbridges in rural Rwanda. This protocol is for the first phase of the study and will focus on 12 footbridge sites and 12 comparison sites over the course of one year, while the larger study will encompass approximately 350 sites over the planned five-year construction period. The results of this first phase will inform the design of the larger study.

详细描述

The study will be a matched-cohort study, in which twelve bridge sites will be matched to twelve comparison sites. The bridge sites have been defined and identified by B2P staff in conjunction with government officials through a systematic needs assessment carried out in 2014. Of the twelve bridge sites that have been confirmed for the study, seven are located in the Southern Province, and five are located in the Western Province. Comparison sites were identified from a 2018 needs assessment carried out by B2P. As with the bridge sites, seven of the comparison sites are in the Southern Province and five are in the Western Province. The table of bridge and control sites with their respective districts and provinces can be found in Appendix A.

The minimum detectable effect analysis for outcomes of interest determined that, with these 24 sites, the investigators should survey representatives from 100 households in each treatment site (those receiving a bridge) and comparison site (those that will not). For both treatment sites and comparison sites, B2P will identify the impacted side - that which their assessment indicates would benefit the most from the bridge. Investigators will then obtain the administrative list of households from the umudugudu chief (village leader) or cell secretary for the village that is closest to the bridge on the impacted side. If the list consists of at least 100 households, investigators will randomly select the 100 households to visit from this list. If the village has fewer than 100 households, enumerators will visit all households in that village and then, from the list for the next closest village, randomly select the remaining number required to reach 100 households.

As part of the pilot study, investigators are testing an experimental method to determine which households to sample within a community. This method involves tracing satellite imagery of the relevant communities to derive a vector dataset of all the households in the area, from which investigators randomly select certain ones based upon an algorithm. This approach is intended to make the sampling more robust by reducing the opportunity to introduce human bias. The tracing of homesteads will be done using freely available Bing aerial imagery and the data generated will be contributed to OpenStreetMap (OSM), in accordance with the Bing imagery license for OpenStreetMap. While all the households traced will be uploaded to OSM and be publicly available, all subsequent analysis of which households are to be surveyed and survey results themselves will be kept in private on password-protected devices and will only be used for the purposes of the study.

The study will utilize a difference-in-difference empirical design. That is, it will compare changes over time in communities that receive a bridge against those that do not. This is recovered from a linear regression:

y_vt = a + β*Bridge_vt + E_vt In this equation, y_vt is some outcome of interest in community v at time t and Bridge_vt is an indicator of community v has a bridge at time t. Under the identification procedure described above, the coefficient β estimated in the above regression identifies the causal effect of bridge construction.

研究设计

研究类型
Interventional
分配方式
Non Randomized
干预模型
Parallel
主要目的
Diagnostic
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Random selection of first 100 households in a village from administrative data
  • Head of household in intervention and comparison villages

排除标准

  • 未提供

研究组 & 干预措施

Intervention

Experimental

Communities that receive a pedestrian footbridge.

干预措施: Footbridge (Other)

Comparison

Experimental

Communities that do not receive a pedestrian footbridge.

干预措施: Comparison villages (Other)

结局指标

主要结局

Mid-upper arm circumference (MUAC)

时间窗: 18 months

Centimeters - percentage change from baseline With household representative's permission, the MUAC of children in the household between 6 months and 5 years will be measured using an MUAC tape.

Household income

时间窗: 18 months

Rwandan francs - percentage change from baseline Household representatives will be asked survey questions regarding the income generating activities of adults in the household and the amount of income from each activity to determine total household income.

Monetary value of livestock

时间窗: 18 months

Rwandan francs - percentage change from baseline Household representatives will be asked survey questions regarding the types, quantities, and value of livestock their household owns.

Access to health care

时间窗: 18 months

Yes/no - change in percentage Household representatives will be asked whether or not household members have visited a health clinic in the last month.

Household food expenditure

时间窗: 18 months

Rwandan francs - percentage change from baseline Household representatives will be asked survey questions regarding the prices and quantities of consumption of food items to determine total household expenditure on food, including distinction between own-produced food and market purchases.

Household use of fertilizer

时间窗: 18 months

Yes/no - change in percentage Household representatives will be asked whether or not their household uses fertilizer when growing crops.

Work outside of community

时间窗: 18 months

Yes/no - change in percentage yes/no) - change in percentage Household representatives will be asked survey questions regarding the location of work for adults in the household, and specifically whether individuals leave the community to work daily, seasonally or for longer periods of time.

次要结局

  • Child enrollment in school(18 months)
  • Days of school missed(18 months)
  • Access to prenatal care(18 months)
  • Type of prenatal services received(18 months)
  • Prenatal tetanus vaccination(18 months)
  • Child vaccination(18 months)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Evan Thomas

Associate Professor & Mortenson Endowed Chair in Global Engineering, and Director, Mortenson Center

University of Colorado, Boulder

研究点 (1)

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