Journal Article

The Chinese government has long been suspected of hiring as many as 2,000,000 people to surreptitiously insert huge numbers of pseudonymous and other deceptive writings into the stream of real social media posts, as if they were the genuine opinions of ordinary people. Many academics, and most journalists and activists, claim that these so-called ``50c party'' posts vociferously argue for the government's side in political and policy debates. As we show, this is also true of the vast majority of posts openly accused on social media of being 50c. Yet, almost no systematic empirical evidence exists for this claim, or, more importantly, for the Chinese regime's strategic objective in pursuing this activity. In the first large scale empirical analysis of this operation, we show how to identify the secretive authors of these posts, the posts written by them, and their content. We estimate that the government fabricates and posts about 448 million social media comments a year. In contrast to prior claims, we show that the Chinese regime's strategy is to avoid arguing with skeptics of the party and the government, and to not even discuss controversial issues. We show that the goal of this massive secretive operation is instead to distract the public and change the subject, as most of the these posts involve cheerleading for China, the revolutionary history of the Communist Party, or other symbols of the regime. We discuss how these results fit with what is known about the Chinese censorship program, and suggest how they may change our broader theoretical understanding of ``common knowledge'' and information control in authoritarian regimes.

This paper is related to our articles in Science, “Reverse-Engineering Censorship In China: Randomized Experimentation And Participant Observation”, and the American Political Science Review, “How Censorship In China Allows Government Criticism But Silences Collective Expression”.

We extend a unified and easy-to-use approach to measurement error and missing data. In our companion article, Blackwell, Honaker, and King give an intuitive overview of the new technique, along with practical suggestions and empirical applications. Here, we offer more precise technical details, more sophisticated measurement error model specifications and estimation procedures, and analyses to assess the approach’s robustness to correlated measurement errors and to errors in categorical variables. These results support using the technique to reduce bias and increase efficiency in a wide variety of empirical research.

A recent article by the Open Science Collaboration (a group of 270 coauthors) gained considerable academic and public attention due to its sensational conclusion that the replicability of psychological science is surprisingly low. Science magazine lauded this article as one of the top 10 scientific breakthroughs of the year across all fields of science, reports of which appeared on the front pages of newspapers worldwide. We show that OSC's article contains three major statistical errors and, when corrected, provides no evidence of a replication crisis. Indeed, the evidence is consistent with the opposite conclusion -- that the reproducibility of psychological science is quite high and, in fact, statistically indistinguishable from 100%. (Of course, that doesn't mean that the replicability is 100%, only that the evidence is insufficient to reliably estimate replicability.) The moral of the story is that meta-science must follow the rules of science.

Replication data is available in this dataverse archive. See also the full web site for this article and related materials, and one of the news articles written about it.

Background: Effective, scalable strategies to improve maternal, fetal, and newborn health and reduce preventable morbidity and mortality are urgently needed in low- and middle-income countries. Building on the successes of previous checklist-based programs, the World Health Organization (WHO) and partners led the development of the Safe Childbirth Checklist (SCC), a 28-item list of evidence-based practices linked with improved maternal and newborn outcomes. Pilot-testing of the Checklist in Southern India demonstrated dramatic improvements in adherence by health workers to essential childbirth-related practices (EBPs). The BetterBirth Trial seeks to measure the effectiveness of SCC impact on EBPs, deaths, and complications at a larger scale.

Methods: This matched-pair, cluster-randomized controlled, adaptive trial will be conducted in 120 facilities across 24 districts in Uttar Pradesh, India. Study sites, identified according to predefined eligibility criteria, were matched by measured covariates before randomization. The intervention, the SCC embedded in a quality improvement program, consists of leadership engagement, a 2-day educational launch of the SCC, and support through placement of a trained peer “coach” to provide supportive supervision and real-time data feedback over an 8-month period with decreasing intensity. A facility-based childbirth quality coordinator is trained and supported to drive sustained behavior change after the BetterBirth team leaves the facility. Study participants are birth attendants and women and their newborns who present to the study facilities for childbirth at 60 intervention and 60 control sites. The primary outcome is a composite measure including maternal death, maternal severe morbidity, stillbirth, and newborn death, occurring within 7 days after birth. The sample size (n = 171,964) was calculated to detect a 15% reduction in the primary outcome. Adherence by health workers to EBPs will be measured in a subset of births (n = 6000). The trial will be conducted in close collaboration with key partners including the Governments of India and Uttar Pradesh, the World Health Organization, an expert Scientific Advisory Committee, an experienced local implementing organization (Population Services International, PSI), and frontline facility leaders and workers

Discussion: If effective, the WHO Safe Childbirth Checklist program could be a powerful health facilitystrengthening intervention to improve quality of care and reduce preventable harm to women and newborns, with millions of potential beneficiaries.

Trial registration: BetterBirth Study Protocol dated: 13 February 2014; ClinicalTrials.gov: NCT02148952; Universal Trial Number: U1111-1131-5647.