Effectively Targeting Perinatal Home Visiting Interventions: Estimating Heterogeneous Treatment Effects on Infant Hemoglobin, Breastfeeding, and Diet Using Sorted Effects

Speaker: Siva Balakrishnan, PhD, University of Nevada, Reno

In this paper, we explore heterogenous treatment effects (HTE) of a stage-based home counseling intervention on exclusive breastfeeding (EBF), child hemoglobin and dietary diversity (DDS). In a cluster randomized controlled trial, pregnant women and caregivers of infants <6 months of age were enrolled in intervention or control arms in rural Sichuan, China. Community health workers delivered educational modules tailored to participants’ stage of development for 12 months. A novel sorted effects method was used to estimate HTE. Individual treatment effects were modeled by regressing baseline characteristics, treatment, and interactions thereof on outcomes. Characteristics of the 20% most and 20% least affected families were compared using multiple t-tests and adjusted p-values to identify those associated with HTE. Evidence of HTE on outcomes was strong with significant individual CATE on EBF and DDS among the 20% most affected families. Mothers with higher baseline caregiving knowledge or who gave birth vaginally saw greatest increases in EBF. Mothers pregnant at baseline or with less social support saw the most benefits on hemoglobin. Mothers with lower caregiving knowledge had greatest increases in DDS. The evidence supports the use of stage-based curricula and targeting mothers from pregnancy to obtain the greatest increases in child hemoglobin. To improve overall effects on EBF, breastfeeding modules may need to adjust content for first-time mothers and those with low caregiving knowledge. Partnering with hospital staff may improve EBF, particularly after c-section. Engaging family members to strengthen maternal social support may improve infant DDS.

About the Workshops

Our Young Researcher Workshops offer emerging China scholars an opportunity to engage directly with interdisciplinary faculty and peers from across campus to discuss and receive feedback on their research. Each workshop features one or several PhD students presenting their latest empirical findings on issues related to China’s economy. Past topics have included college major selection as an obstacle to socioeconomic mobility, the effect of a cooling-off period on marriage outcomes, and factors contributing to government corruption. Faculty and senior scholars provide comments and feedback for improvement. This event series helps to build and strengthen Stanford’s community of young researchers working on China.

Workshops are held on select Fridays from 12 - 1 pm. Lunch will be provided! 

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