Telemedicine Clinical Trial
Official title:
Using mHealth Tools to Deliver Integrated Community Case Management (ICCM) to Village Health Team (VHT) Volunteers in Uganda.
This study compares the traditional, didactic method of training Ugandan community health workers with training using tablets in pneumonia management, a common, life-threatening illness in children in rural areas.
Current ICCM (Integrated Community Case Management) training in Uganda involves CHWs
physically attending a five-day workshop, which is both expensive, time consuming and
requires trainer's to be physically present to deliver training materials. The investigators
hypothesize that use of a low-cost android tablet, with pre-loaded instructional educational
videos will improve the baseline knowledge and retention of knowledge of CHWs as well as
lower the direct and indirect costs of ICCM training.
The investigators will conduct a randomized controlled trial in two sub-counties in Mukono
district among CHWs to test these two hypotheses. In this study, the investigators will
focus solely on the pneumonia component of ICCM training, instead of testing the full
week-long training course including malaria, pneumonia, and diarrhea. (The investigators
plan a later trial encompassing the entire week-long training vs the same uploaded into the
tablets.) The investigators will enroll 200 CHWs in the study, with 100 in a control group
who will receive a one day in-person training session focusing on pneumonia, similar to
traditional ICCM training and 100 in an intervention group who will receive tablets with
instructional training videos. The investigators will administer a written test prior to the
training in both groups, then administer the same written test one week later. Additionally,
the investigators will test both groups with clinical case scenarios that give these
community health workers realistic clinical cases and challenge them to diagnose pneumonia,
state whether patient should be treated in the home or brought to hospital, and how to
initiate and complete management if patients are to be referred or kept home, respectively.
The sample sizes will enable the investigators carry out independent t-tests and a paired
two-sample t-test to determine the significance of pre- and post-test scores for the control
and intervention groups. If training delivered via low-cost android tablets proves to be
both effective and acceptable, this option may represent a viable, scalable and
cost-effective alternative to the traditional training model used throughout Uganda.
Furthermore, the MoH could institute an incentive policy that allows tablets to be
distributed and retained by health workers provided that they maintain a quarterly flow of
information back to the MoH regarding home visits, patients referred, or other community
actions. Should the learning and cost efficacy prove viable, the investigators can envision
tablets throughout Mukono District, allowing the more direct transfer of information,
disease patterns, index cases of pathogens like Ebola, tracking of data for the Ministry,
regular dissemination of training materials, and opportunities for CHWs gain employment in
the health sector.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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