Community health workers’ experiences of using video teaching tools during home visits—A pilot study

Innovations in health, such as the use of tablet computers, show promise in broadening the scope of work of community health workers (CHWs), and play an important role in keeping CHWs and their clients up to date with advancements in health. While the use of mobile phones and tablets is innovative, the applicability of these technologies in different contexts remains poorly understood. Furthermore, little is known about the acceptability and feasibility of the use of video teaching tools on such devices across diverse contexts. In this study, we aimed to explore the acceptability and feasibility of using tablets with teaching videos (about HIV, alcohol, nutrition and breastfeeding) to support the health promotion efforts of 24 CHWs who work with pregnant mothers and mothers of young children in an urban township in South Africa. Between November 2015 and May 2016, we conducted focus groups and identified four key themes (with several sub-themes) that demonstrated factors related to the acceptability and feasibility of these devices and their content. Focus group transcripts were analysed thematically using qualitative data analysis software. The findings indicated that while the devices contained several supportive features (such as lightening the workload, and stimulating interest in their work), they also contained several restrictive features (safety and confidentiality). CHWs considered the video content an important tool to engage not only their clients but also family members and the community at large. Issues surrounding safety, privacy and confidentiality of using these devices require careful consideration prior to implementation in large-scale studies. Furthermore, stigma associated with household visits by CHWs and the nature of their work also need to be addressed by researchers and programme implementers. Overall, CHWs deemed the devices and the video content an acceptable and feasible means with which to provide health promotion and education among their clients.

[1]  Clara B. Aranda-Jan,et al.  Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa , 2014, BMC Public Health.

[2]  V. Braun,et al.  Using thematic analysis in psychology , 2006 .

[3]  Ian David Aronson,et al.  Optimizing educational video through comparative trials in clinical environments , 2012, Educational technology research and development : ETR & D.

[4]  N. Mahmud,et al.  A text message-based intervention to bridge the healthcare communication gap in the rural developing world. , 2010, Technology and health care : official journal of the European Society for Engineering and Medicine.

[5]  Hilary Brown,et al.  Responding to the global human resources crisis , 2004, The Lancet.

[6]  Robert Yu,et al.  The Challenges for the Adoption of M-Health , 2006, 2006 IEEE International Conference on Service Operations and Logistics, and Informatics.

[7]  Leyland F. Pitt,et al.  Deciding When to Use Tablets for Business Applications , 2011, MIS Q. Executive.

[8]  C. Worthman,et al.  Philani Plus (+): A Mentor Mother Community Health Worker Home Visiting Program to Improve Maternal and Infants’ Outcomes , 2011, Prevention Science.

[9]  G. Wright,et al.  Tablet computers for recording tuberculosis data at a community health centre in King Sabata Dalindyebo Local Municipality, Eastern Cape: a proof of concept report , 2014 .

[10]  Jiajie Zhang,et al.  Performance factors of mobile rich media job aids for community health workers , 2011, J. Am. Medical Informatics Assoc..

[11]  J. Sachs,et al.  1 million community health workers in sub-Saharan Africa by 2015 , 2013, The Lancet.

[12]  Robert W. Snow,et al.  Mobile Phone Text Messaging: Tool for Malaria Control in Africa , 2012, PLoS medicine.

[13]  B. Kirkwood,et al.  Supervising community health workers in low-income countries – a review of impact and implementation issues , 2014, Global health action.

[14]  Jennie Q. Lou,et al.  A systematic review of eHealth interventions to improve health literacy , 2016, AMIA.

[15]  Krisda H. Chaiyachati,et al.  A Pilot Study of an mHealth Application for Healthcare Workers: Poor Uptake Despite High Reported Acceptability at a Rural South African Community-Based MDR-TB Treatment Program , 2013, PloS one.

[16]  J. Blaya,et al.  E-health technologies show promise in developing countries. , 2010, Health affairs.

[17]  A. Abernethy,et al.  Feasibility and acceptability to patients of a longitudinal system for evaluating cancer-related symptoms and quality of life: pilot study of an e/Tablet data-collection system in academic oncology. , 2009, Journal of pain and symptom management.

[18]  Jonathan A. Smith,et al.  Interpretative Phenomenological Analysis: Theory, Method and Research , 2009, QMiP Bulletin.

[19]  Arul Chib,et al.  Midwives' Cell Phone Use and Health Knowledge in Rural Communities , 2011, Journal of health communication.

[20]  Jay F. Nunamaker,et al.  Instructional video in e-learning: Assessing the impact of interactive video on learning effectiveness , 2006, Inf. Manag..

[21]  John F. Canny,et al.  Mobile-izing health workers in rural India , 2010, CHI.

[22]  S. Goenka,et al.  Evaluation of the feasibility and acceptability of the ‘Care for Stroke’ intervention in India, a smartphone-enabled, carer-supported, educational intervention for management of disability following stroke , 2016, BMJ Open.

[23]  M. Merritt,et al.  Ethical Issues in mHealth Research Involving Persons Living with HIV/AIDS and Substance Abuse , 2013, AIDS research and treatment.

[24]  F. Griffiths,et al.  Healthcare workers' perceptions and experiences on using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis. , 2015, The Cochrane database of systematic reviews.

[25]  A. Haines,et al.  The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review , 2013, PLoS medicine.

[26]  Caricia Catalani,et al.  Community Health Workers and Mobile Technology: A Systematic Review of the Literature , 2013, PloS one.