Impact of conditional mobile data credits on caregivers use of an early childhood digital health intervention: a nested cluster-randomized controlled trial in Andean Peru

As internet and mobile phone access increases, digital health interventions are increasingly used to support remote and low-resource populations. In many settings, the health impact of digital interventions is constrained by limited or short-lived engagement. We tested if conditional mobile data credit incentives increase digital intervention engagement within a digital intervention trial. This nested cluster randomized controlled trial was conducted with caregivers of children 3-9 months at baseline. Of 72 neighborhood clusters from the treatment arm of the parent trial (evaluating a digital early childhood development intervention), 20 were randomly assigned to treatment and 52 as controls. Eligible participants had a phone provider through which mobile data credits could be most affordably administered. Treated participants received around 250 MB mobile data credits every two weeks, conditional upon using the digital intervention at least once in the same period. Credits were digitally administered via a third-party service. Digital intervention engagement (primary outcome) was monitored continuously until endline data collection approximately 2 years after assignment. Secondary outcomes included caregivers views, behaviors, and early childhood development. We used intent-to-treat analyses to assess all outcomes. This trial was registered as NCT05202106 at clinicaltrials.gov and was completed in 2025. Participants were recruited between September 2021 and March 2023 (N Treatment = 147; N Control = 333). Conditional mobile data credits extended engagement with the digital early childhood development intervention by 6.50 weeks on average (treatment mean = 26.19 weeks, control mean = 19.69; p=0.011). No significant impacts were identified on secondary outcomes. As such, mobile data credits may be a cost-effective way for increasing caregiver engagement with digital health intervention in low resource settings.