JMIR Publications

ABSTRACT

Background:

Health promotion and health education have traditionally been given to communities in the global south in the form of leaflets or orally by healthcare workers. Digital health interventions (DHIs) such as digital health messages accessed with, for example, smartphones have the potential to reach more people at a lower cost and to contribute to strengthening of the healthcare system. The DHI in this study is focused on disseminating digital health education on three disease complexes of high public health concern, i.e. HIV/AIDS, tuberculosis (TB) and Taenia solium (neuro)cysticercosis/taeniosis (TSCT), a parasitic zoonotic disease that requires a Health One approach to combat. The DHI presents the participants with animated health videos (animations) and provides access to internet hotspots in rural Tanzanian communities, with a freely accessible digital health platform containing messages about health.

Objective:

The objective of this study is to measure the effect of the DHI on health knowledge uptake and retention over time in the rural communities.

Methods:

This is a mixed-method study including a non-randomized, controlled trial and qualitative interviews, conducted in rural Tanzania, in which the DHI is being implemented. A health platform containing digital health messages to the communities was developed prior to the study. The health messages comprise text, pictures, quizzes and animations of everyday stories, aiming at disease prevention and early treatment. The baseline and immediate-after assessment was completed in Iringa, Tanzania in 2019. The participants were interviewed by enumerators and completed questionnaires with questions regarding health knowledge. Participants in the intervention group were exposed to three health animations once, on a tablet device. The participants’ health knowledge was immediately assessed again after exposure. The first follow-up survey was undertaken in August 2019. The internet hotspots with the health platform were thereafter rolled out in the intervention villages in November 2019. Qualitative interviews were undertaken in February 2020. The second follow-up was completed in June 2020.

Results:

A total of 600 participants have been enrolled in the trial. We will assess 1) the difference in knowledge scores between baseline and immediate-after in the intervention group, 2) the difference in knowledge scores between the groups on the changes from baseline to 3 and 6 months post DHI rollout. As a randomised design was not feasible, potential confounders, e.g. age, gender, education and time from exposure, may be introduced, for which results will be adjusted. Data analysis for the 35 qualitative interviews is currently ongoing, where perspectives and experiences related to use and non-use of the hotspots are being explored.

Conclusions:

This is an ongoing digital health study, aiming at evaluating the effects of a DHI based on relevant health messages, of which published results can be expected next year. Clinical Trial: ClinicalTrials.gov NCT03808597; https://clinicaltrials.gov/ct2/show/NCT03808597