Impact of Graduation on Child Development in Uganda - Wave 2 (Ancillary/Extension)

NCT07212374 | Active Not Recruiting

• 3 other identifiers: IPA-2025-UG-Wave2NCT05531812 (IPA-2022-UG)AEARCTR-0004080
• Study Type: interventional
• Target: 2,100
• Locations: 1 country
• Sites: 1

Brief Summary

This ancillary/extension study ("Wave 2") measures child development and school readiness outcomes among children residing in households within host communities that participated in the Graduation to Resilience (G2R) randomized controlled trial in Uganda (G2R trial: AEARCTR-0004080 \[AEA RCT Registry\]; Wave 1 child assessments: NCT05531812). No new randomization or intervention assignment occurs in Wave 2; rather, we assess outcomes in children linked to households in communities previously randomized in the parent study. Wave 2 expands the eligible child age range (0-9 years) and includes age-appropriate outcomes (e.g., IDELA for school readiness; Raven's Progressive Matrices and executive function tasks for older children). We will compare children in households assigned to receive the Graduation program in the parent RCT (T1) to children in pure ("spillover") control households (C2) in host communities. Primary completion is anticipated in October 2025. Pre-analysis plans for Wave 1 and Wave 2 are posted.

Conditions

Child Development; Under Nutrition; School Readiness; Anemia

Keywords

Uganda; ultra-poor graduation; executive function; IDELA; Raven's Progressive Matrices; hemoglobin; HAZ; WHZ

Outcome Measures

Primary Outcomes (7)

• Height-for-age z-score (HAZ)

  Based on WHO Growth Standards

  6 years after the introduction of Graduation

• Anemia

  Hemoglobin levels captured using HemoCue devices and categorized according to anemia status (\<11.5 g/dL)

  6 years after the introduction of Graduation

• Forward Digit Span score

  Children are asked to repeated a sequence of numbers. Children who are successful are presented with progressively longer sequences.

  6 years after the introduction of Graduation

• Head-Toes-Knees-Shoulders-Revised (HTKS-R) score

  A self-regulation game which taps children's cognitive flexibility, memory, and self-control. Children are presented with instructions and must remember the rules of a game, which require them to: inhibit the more natural response to instructions in favor of the correct, unnatural one; flexibly shift between old and new rules to commands when given, and; regulate their behavior in accordance with all of the above.

  6 years after the introduction of Graduation

• Raven's Progressive Matrices Second Edition score

  A direct assessment of fluid intelligence. Children are presented with 36 items and for each item they are asked to identify the missing piece from a set of options that finishes the matrix/picture that is presented.

  6 years after the introduction of Graduation

• IDELA total score

  International Development and Early Learning Assessment (IDELA) total score. Direct assessment of children with items across four domains: literacy, numeracy, motor, and socio-emotional.

  6 years after the introduction of Graduation

• Caregiver-Reported Early Development Index (CREDI) overall z-score

  Caregivers report on their child's abilities in the domains of cognitive, language, motor, and social-emotional skills.

  6 years after the introduction of Graduation

Secondary Outcomes (2)

• Diet diversity

  6 years after the introduction of Graduation

• Caregiver-child interactions

  6 years after the introduction of Graduation

Other Outcomes (4)

• Stunting status

  6 years after the introduction of Graduation

• Weight-for-height z-score (WHZ)

  6 years after the introduction of Graduation

• Hemoglobin level

  6 years after the introduction of Graduation

Study Arms (2)

Pure ("Spillover") Control (C2)

NO INTERVENTION

Children aged 0-9 years living in host-community households in pure control communities (no Graduation program) from the parent RCT

Graduation (T1)

EXPERIMENTAL

Children aged 0-9 years living in host-community households assigned to receive the Graduation program in the parent RCT (no new assignment in Wave 2).

Other: Graduation

Interventions

Graduation OTHER

"Graduation" is a multifaceted approach that aims to support ultra-poor households in permanently escaping poverty traps. The standard version of Graduation tested in this study includes: a one-time asset transfer; monthly cash transfers; life skills coaching on topics like health and nutrition; technical skills training on topics like financial literacy; and access to savings services.

Graduation (T1)

Eligibility Criteria

• Age: 6 Months - 119 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Child aged 0-9 years at time of Wave 2 assessment.
• Resides in a host-community household within the G2R trial sample
• Caregiver provides informed consent; child provides assent where applicable.

You may not qualify if:

• Caregiver declines consent or child declines assent.
• Not resident in the study communities at time of assessment.

Sponsors & Collaborators

• Innovations for Poverty Action: lead

Study Sites (1)

Innovations for Poverty Action Uganda

Kampala, Uganda

Location

MeSH Terms

Conditions

Anemia

Condition Hierarchy (Ancestors)

Hematologic Diseases; Hemic and Lymphatic Diseases

Study Officials

• Lasse Brune, PhD

  Northwestern University

  PRINCIPAL INVESTIGATOR

• Nathanael Goldberg, MPA

  Innovations for Poverty Action

  PRINCIPAL INVESTIGATOR

• Dean Karlan, PhD

  Northwestern University

  PRINCIPAL INVESTIGATOR

• Christopher Udry, PhD

  Northwestern University

  PRINCIPAL INVESTIGATOR

• Peter Rockers, ScD

  Boston University

  PRINCIPAL INVESTIGATOR

• Doug Parkerson, MA

  Innovations for Poverty Action

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 1, 2025
• First Posted: October 8, 2025
• Study Start: August 20, 2025
• Primary Completion: November 1, 2025
• Study Completion: November 1, 2025
• Last Updated: October 8, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Study data will be published concurrent with the publication of the manuscript describing the study results.
• Access Criteria: All interested researchers will be able to access and download study data without restrictions.

Locations

UG (1)