Partners In Health (PIH), in collaboration with Harvard Medical School, aims to developand evaluate an SMS-based intervention for Community Health Workers (CHWs) to combatCOVID-19 and mental health-related misinformation in Haiti, Rwanda, and Malawi. The studyinvolves three aims: identifying locally relevant misinformation through a card-sortingexercise with CHWs, developing targeted messages through cognitive interviewing, andevaluating the effectiveness of SMS-based educational message dissemination via arandomized controlled trial. The evaluation will assess the impact on public healthpractices, knowledge and attitudes among CHWs, and knowledge and attitudes amongcommunity members.
The intervention will involve sending SMS messages to randomized CHWs, addressing either
COVID-19 or mental health misinformation. CHWs will have access to a helpline for further
support and can provide feedback to refine the messaging. The evaluation will use a time
series analysis to measure changes in COVID-19 vaccine administration, mental health
service utilization, CHWs' knowledge and attitudes, and community members' knowledge and
attitudes. The study aims to empower CHWs with accurate information, improve public
health practices, and ultimately contribute to better health outcomes in the communities
served by PIH. Rwanda and Haiti CHWs will receive the messages for 12 months, but Malawi
CHWs will receive the messages for 6 months due to a CHW transition in country.
Behavioral: Card-Sorting Activity (Pre-intervention design)
Study team members within each country will free list misinformation or misconceptions
that they commonly encounter in clinical practice or daily life. Each item will be used
to create paired cards - one containing the misinformation and a second containing the
corresponding correct information. During qualitative interviews, we will ask CHWs to
participate in a series of card sorting activities, which is a participatory research
method that can inform the design of health interventions.
Behavioral: SMS Crafting (Pre-intervention design)
A two-person team consisting of one local communication expert and one clinician will
draft clinically correct, easy-to-understand SMS messages designed to counter identified
misinformation. We will draft messages that use various styles and use cognitive
interviewing with CHWs to assess their understanding of and responses to each style. The
final messages used in our intervention will be determined by CHW preference.
Behavioral: SMS Messaging
Final messages will be sent via SMS to all CHWs working in our study area. CHWs will also
be provided with contact information for a helpline staffed by a local team member who
can answer follow-up questions in the local language.
Other Name: text messaging
The intervention will be assigned at the unit of the CHWs. These individuals will also be
eligible for the CHW longitudinal cohort.
Inclusion Criteria:
- CHWs affiliated with PIH Rwanda, Malawi, or Haiti
- 18+ years of age.
Exclusion Criteria:
- Less than 18 years old.
Zanmi Lasante
Cange, Haiti
Partners in Health- Malawi
Neno, Malawi
Partners in Health- Rwanda
Kigali, Rwanda
Not Provided