Centre for Global Health, Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway.
J Med Internet Res. 2022 Jul 28;24(7):e37666. doi: 10.2196/37666.
Community health education is one of the most effective measures to increase health literacy worldwide and can contribute to the achievement of specific targets of the Sustainable Development Goal 3. Digitalized health education materials can improve health knowledge as a dimension of health literacy and play an important role in disease prevention in rural sub-Saharan settings.
The objective of this research is to assess the effect of a digital health education intervention on the uptake and retention of knowledge related to HIV/AIDS, tuberculosis (TB), and Taenia solium (neuro)cysticercosis and taeniosis in rural communities in Iringa, Tanzania.
We conducted a nonrandomized intervention study of participants aged 15 to 45 years, randomly selected from 4 villages in Iringa, Tanzania. The intervention consisted of 2 parts. After the baseline assessment, we showed the participants 3 animated health videos on a tablet computer. After a period of 6 months, free access to community information spots (InfoSpots) with an integrated digital health education platform was provided to the intervention villages. Participants in the control group did not receive the intervention. The primary outcome was the difference in disease knowledge between the intervention and control groups, 12 months after baseline. Data were collected using an open-ended questionnaire, with correct or incorrect answers before and after intervention.
Between April and May 2019, a total of 600 participants were recruited into the intervention (n=298, 49.7%) or control (n=302, 50.3%) groups. At baseline, no statistically significant differences in knowledge of the target diseases were observed. At 12 months after intervention, knowledge about HIV/AIDS, TB, and T. solium (neuro)cysticercosis and taeniosis was 10.2% (95% CI 5.0%-15.4%), 12% (95% CI 7.7%-16.2%), and 31.5% (95% CI 26.8%-36.2%) higher in the intervention group than in the control group, respectively. In all 4 domains (transmission, symptoms, treatment, and prevention), an increase in knowledge was observed in all the 3 diseases, albeit to varying degrees. The results were adjusted for potential confounders, and the significance of the primary results was maintained in the sensitivity analysis to assess dropouts. The participants who reported using the InfoSpots in the 12-month assessment further increased their knowledge about the target diseases by 6.8% (HIV/AIDS), 7.5% (TB), and 13.9% higher mean proportion of correct answers compared with the participants who did not use the InfoSpots.
Digital health education based on animated health videos and the use of free InfoSpots has significant potential to improve health knowledge, especially in rural areas of low- and middle-income countries.
ClinicalTrials.gov NCT03808597; https://clinicaltrials.gov/ct2/show/NCT03808597.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/25128.
社区健康教育是提高全球健康素养最有效的措施之一，有助于实现可持续发展目标 3 的具体目标。数字化健康教育材料可以提高健康知识作为健康素养的一个维度，并在撒哈拉以南农村地区的疾病预防中发挥重要作用。
本研究旨在评估数字化健康教育干预对坦桑尼亚伊林加农村社区人群对艾滋病毒/艾滋病、结核病（TB）和猪带绦虫（神经）囊尾蚴和带绦虫病相关知识的获取和保留的影响。
我们对年龄在 15 至 45 岁之间的参与者进行了非随机干预研究，这些参与者是从坦桑尼亚伊林加的 4 个村庄中随机选择的。干预措施包括 2 部分。在基线评估后，我们在平板电脑上向参与者展示了 3 个动画健康视频。在 6 个月后，为干预村庄提供了免费访问带有集成数字化健康教育平台的社区信息点（InfoSpots）。对照组的参与者未接受干预。主要结局是干预组和对照组在基线后 12 个月时疾病知识的差异。使用开放式问卷收集数据，在干预前后提供正确或错误的答案。
2019 年 4 月至 5 月期间，共有 600 名参与者被纳入干预组（n=298，49.7%）或对照组（n=302，50.3%）。基线时，目标疾病的知识没有统计学上的显著差异。干预后 12 个月，艾滋病毒/艾滋病、结核病和猪带绦虫（神经）囊尾蚴和带绦虫病的知识分别提高了 10.2%（95%CI 5.0%-15.4%）、12%（95%CI 7.7%-16.2%）和 31.5%（95%CI 26.8%-36.2%）。在所有 4 个领域（传播、症状、治疗和预防），所有 3 种疾病的知识都有所增加，尽管程度不同。在敏感性分析中，对辍学者进行了调整，结果仍保持了主要结果的显著性。在 12 个月评估中报告使用 InfoSpots 的参与者，与未使用 InfoSpots 的参与者相比，其目标疾病的知识进一步增加了 6.8%（艾滋病毒/艾滋病）、7.5%（结核病）和 13.9%的正确答案平均比例。
基于动画健康视频的数字化健康教育和免费 InfoSpots 的使用具有显著提高健康知识的潜力，特别是在低收入和中等收入国家的农村地区。
ClinicalTrials.gov NCT03808597；https://clinicaltrials.gov/ct2/show/NCT03808597。
国际注册报告标识符（IRRID）：RR2-10.2196/25128。
