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Trial registered on ANZCTR
Registration number
ACTRN12622000055707
Ethics application status
Approved
Date submitted
22/12/2021
Date registered
18/01/2022
Date last updated
11/01/2023
Date data sharing statement initially provided
18/01/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
The Role of Vaccine Ambassadors on COVID-19 vaccine take-up in Indonesia
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Scientific title
The Role of Vaccine Ambassadors on COVID-19 vaccine take-up in Indonesia
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Secondary ID [1]
306050
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
COVID-19 vaccination uptake
324694
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COVID-19
324798
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Condition category
Condition code
Public Health
322144
322144
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0
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Health promotion/education
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Respiratory
322249
322249
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment Group 1 --
In villages assigned to this treatment, we will approach local health cadres to serve as ambassadors for the COVID-19 vaccination program. We will recruit an effective science communicator to train ambassadors to deliver information in a consistent, compassionate, empathetic, and honest manner since communication is a key to convince people to get vaccinated. Training for the ambassadors will commence two weeks prior to the intervention delivery to ensure knowledge retention and effectiveness of the training.
The training will be provided in both online and offline sessions. Online sessions will take 3 hours to complete, consisting of interactive lecture, discussion, and quiz. Offline sessions will consist of role-play sessions that will last 45 minutes to complete.
The ambassador will be tasked with doing personal visits to respondents’ house. During the meeting, the ambassador will talk about scripted messages containing:
General information about COVID-19, the private and social benefits of COVID-19 vaccine (e.g., higher vaccination rate translates to more freedom in movement and better economy), how to access the vaccine (such as location of vaccination site and registration help if needed), mortality and take-up rates in their district.
Moral messages regarding responsibility of taking COVID-19 vaccine during emergency situations to protect others.
The meetings will take place twice during the intervention period and take at most 30 minutes every time. The second meeting will take place a week after the first meeting. The second meeting will focus on clarifying respondents' understanding of the messages delivered by the ambassador in the first meeting. In addition to meetings, we will deliver leaflet containing information on private and social benefits of as well as reminder for getting Covid-19 vaccine. The leaflets will be designed specifically for this study. The leaflets will be delivered during the second meeting.
Treatment Group 2
In the second intervention group, we will recruit an ambassador who has the same tasks as the ambassador in Treatment Group 1. The second group only differs in the selection mechanism. We will leverage social networks in the village to choose an ambassador in Treatment 2. We will ask a random subset of our sample in each village to nominate 3 individuals who in their view are respected, trusted, and good at spreading news and information in their village. To get a rather more complete picture of the situation in the village, we will also ask random vaccinated people—that we identified during screening—the same question. Afterwards, we will approach the individual who receives the most nominations and ask them to serve as the ambassador. The selected individuals should already be vaccinated or at least have registered to get vaccinated.
All ambassadors in the treatment group 2 will receive the same training provided to the ambassadors in the treatment group 1.
The duration of the intervention in all treatment groups (including control) will be two weeks : first home visit in the first week of intervention and second (and last) home visit in the following week.
Quality control strategies :
We will require all ambassadors to maintain participant logs, where we will check when the home visits will take place. The study team will do random check to the participants house during the planned visiting time. Additionally, we will do random spot check where we will call the participants and ask confirmatory questions to check whether ambassadors did delivered the intervention.
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Intervention code [1]
322467
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Behaviour
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Comparator / control treatment
In this intervention, we will approach and recruit any layperson to become an ambassador in a randomly assigned village. Selection of the ambassadors (both in treatment and control groups) will commence 1-2 weeks prior to the training. They will have the same tasks as ambassadors in Treatment groups 1 and 2. and will receive the same training provided to the treatment groups.
Following several current studies in COVID-19-related literature, we decided not to have a pure control group—one that does not receive COVID-19 ambassador intervention—in this project for two reasons. First, we want to combat misinformation about COVID-19 vaccine and COVID-19 in general because misinformation can have non-negligible consequences on health outcomes. Thus, we consider excluding villages from receiving information about COVID-19 vaccine as unethical. Second, having no pure control group allows us to test and compare the effectiveness of three actors as ambassadors to combat misinformation. Thus, if successful, this project can help decision makers formulate or scale-up a similar program.
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Control group
Active
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Outcomes
Primary outcome [1]
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Changes in the Covid-19 Vaccination status as shown by official record (vaccine certificate)
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Assessment method [1]
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Timepoint [1]
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6-8 weeks after intervention commencement (the first home visit).
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Primary outcome [2]
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Changes in the intention to receive Covid-19 vaccine (using questionnaire developed specific for this study)
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Assessment method [2]
329957
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Timepoint [2]
329957
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6-8 weeks after intervention commencement (the first home visit).
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Secondary outcome [1]
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Nil
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Assessment method [1]
404425
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Timepoint [1]
404425
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Nil
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Eligibility
Key inclusion criteria
We will recruit participants who are :
1. Have not received full Covid-19 vaccine (2 doses)
2. Minimum of 18 years of age to maximum of 65 years of age
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Medically exempt from Covid-19 vaccination
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
We will randomly select 300 villages with ten individuals (one individual per household) per village out of three regencies in West Java. We will randomize intervention at the village level. In total, we will have 3600 respondents across 3 treatment groups. Our randomisation strategy is the following :
1. We will pick 3 regencies in West Java province with the lowest vaccination rates
2. We will randomly select villages within these 3 regencies into 3 treatment groups
3. In each village we will conduct a screening survey prior to recruitment to ensure balance in baseline characteristics, such as gender, education background, and socioeconomic background.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
We estimate the number of cluster and participants needed via power calculation with the following assumptions :
1. Minimum detectable effect : 0.10 (10 percent)
2. Intra-cluster correlation (ICC) between villages : 0.2
Which resulted in 300 clusters (villages)/3600 participants
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
21/01/2022
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Actual
14/02/2022
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Date of last participant enrolment
Anticipated
13/02/2022
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Actual
14/04/2022
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Date of last data collection
Anticipated
30/04/2022
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Actual
8/09/2022
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Sample size
Target
3600
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Accrual to date
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Final
2877
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Recruitment outside Australia
Country [1]
24450
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Indonesia
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State/province [1]
24450
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West Java
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Funding & Sponsors
Funding source category [1]
310387
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University
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Name [1]
310387
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Monash University
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Address [1]
310387
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900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country [1]
310387
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Australia
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Funding source category [2]
310426
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Other Collaborative groups
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Name [2]
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The Abdul Latif Jameel Poverty Action Lab (JPAL) Southeast Asia
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Address [2]
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Gedung LPEM lt. 6
Jl. Salemba Raya 4 • Jakarta 10430 • Indonesia•
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Country [2]
310426
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Indonesia
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Primary sponsor type
Individual
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Name
Asad Islam
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Address
Centre for Development Economics and Sustainability (CDES)
Monash University
Building H, Level 4
900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country
Australia
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Secondary sponsor category [1]
311532
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Individual
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Name [1]
311532
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Armand Sim
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Address [1]
311532
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Centre for Development Economics and Sustainability (CDES)
Monash University
Building H, Level 4
900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country [1]
311532
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Australia
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Secondary sponsor category [2]
311550
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Individual
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Name [2]
311550
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Giovanni Empel
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Address [2]
311550
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Centre for Health Economics (CHE)
Monash University
Building H, Level 5
900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country [2]
311550
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Australia
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Secondary sponsor category [3]
311551
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Individual
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Name [3]
311551
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Jahen Rezki
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Address [3]
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Lembaga Penyelidikan Ekonomi dan Masyarakat (LPEM)/Institute for Economic and Social Research
Faculty of Economics and Business
University of Indonesia
Jl. Salemba Raya IV Gedung Ali Wardhana, RW.5, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta 10430
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Country [3]
311551
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Indonesia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310037
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Lembaga Penyelidikan Ekonomi & Masyarakat Fakultas Ekonomi dan Bisnis Universitas Indonesia
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Ethics committee address [1]
310037
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Kampus UI Salemba Jl. Salemba Raya 4, Jakarta 10430 012/ UN2.F6.D2.LPM/PPM.KEP/2021
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Ethics committee country [1]
310037
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Indonesia
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Date submitted for ethics approval [1]
310037
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Approval date [1]
310037
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06/12/2021
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Ethics approval number [1]
310037
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012/ UN2.F6.D2.LPM/PPM.KEP/2021
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Ethics committee name [2]
310047
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Monash University Human Research Ethics Committee (MUHREC)
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Ethics committee address [2]
310047
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Wellington Road Clayton 3168 VICTORIA
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Ethics committee country [2]
310047
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Australia
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Date submitted for ethics approval [2]
310047
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Approval date [2]
310047
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04/11/2021
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Ethics approval number [2]
310047
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30699
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Summary
Brief summary
Increasing COVID-19 vaccination uptake is crucial for controlling the spread of COVID-19, economic recovery, and returning to normal or near-normal daily lives. However, even when supplies are increasingly available, COVID-19 vaccine take-up rates in developed and developing countries are still low, owing to widespread vaccine hesitancy. The vaccination take-up rate in Indonesia is still far below the 70% of the target (aged 12+ receiving double dose) by the end of 2021. As of mid-November 2021—nine months after the public vaccination rollout—the take-up rate (out of target population—aged 12+) is 65% (at least one dose) and 44% (two doses). Local governments and volunteers have made creative efforts to tackle hesitancy and encourage people to get vaccinated. We will conduct a randomized experiment to address misinformation and lack-of-information problems about the COVID-19 vaccine and increase the vaccination take-up rate in rural Indonesia. Specifically, we randomly assign health care workers, local leaders (identified through nominations by fellow villagers), and laypersons as ambassadors for the COVID-19 vaccine to randomly selected villages. The main task of the ambassadors is to deliver information that can help unvaccinated villagers understand the private and social benefits of the COVID-19 vaccine and encourage them to get vaccinated. The ambassadors will carry out home visits (twice) to the household to provide an one on one information session on Covid-19 and benefits of its vaccination. Ambassadors will also provide leaflet with relevant information on Covid-19 and Covid-19 vaccination program. Two months after implementation (around May 2022), we will conduct the endline survey. This survey aims to measure the impact of our interventions on the first vaccination dose take-up. The activity in the endline survey consists of in-person interviews in which the respondents should be able to show a proof of vaccination either via a physical card or digital (if they decide to take the COVID-19 vaccine).
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Asad Islam
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Address
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Centre for Development Economics and Sustainability (CDES)
Monash University
Building H, Level 4
900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country
116270
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Australia
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Phone
116270
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+61399032783
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Fax
116270
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Email
116270
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[email protected]
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Contact person for public queries
Name
116271
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Giovanni Empel
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Address
116271
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Centre for Health Economics (CHE)
Monash University
Building H, Level 5
900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country
116271
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Australia
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Phone
116271
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+61426558932
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Fax
116271
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Email
116271
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[email protected]
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Contact person for scientific queries
Name
116272
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Asad Islam
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Address
116272
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Centre for Development Economics and Sustainability (CDES)
Monash University
Building H, Level 4
900 Dandenong Road
Caulfield East 3145
VICTORIA
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Country
116272
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Australia
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Phone
116272
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+61399032783
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Fax
116272
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Email
116272
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual data after de-identification process
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When will data be available (start and end dates)?
Data will be made available to interested researchers after we have publish the main results. This will be approximately within 1 year after the endline survey finished (around June 2022 - May 2023). The data will be available at least 5 (years) following the publication of main results (2027-2028).
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Available to whom?
Interested researchers will have to submit formal request of access to the data along with a short proposal to the Primary Investigator.
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Application should be directed to the Primary Investigator
Professor Asad Islam (
[email protected]
)
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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