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Yorulmaz-Demir DS, Kocoglu-Tanyer D. The Effect of the Vaccine Education Program Prepared Using The Integrated Change Model on Mothers' Vaccine Advocacy and Vaccine Literacy: A Waitinglist Randomized Controlled Trial. J Pediatr Health Care 2025; 39:424-435. [PMID: 39891641 DOI: 10.1016/j.pedhc.2024.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 11/11/2024] [Accepted: 11/21/2024] [Indexed: 02/03/2025]
Abstract
INTRODUCTION The study evaluated the effect of the vaccine education program developed using the Integrated Change Model on mothers' vaccine literacy and advocacy. METHODS The study is a parallel design randomized controlled trial with a waiting-list. Seventy-four mothers were enrolled in the study. In the study, the experimental group received a four-session vaccine education program, one week apart. The study used mixed ANOVA to explore the interaction between time and group. Effect sizes were interpreted using partial eta squared. RESULTS Vaccine literacy increased significantly in the intervention group in the post-test, and the intervention had a large effect size. In addition, it was found that vaccine knowledge increased with a large effect size in the intervention group, positive changes in vaccine attitudes, and vaccine advocacy intentions increased. DISCUSSION The Integrated Change Model vaccine education program can be used to reduce maternal and community vaccine hesitancy and increase vaccine acceptance. REPORTING METHOD The CONSORT-Outcomes 2022 Extension. PROTOCOL REGISTRATION ClinicalTrials NCT05929053.
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Johnston JS, Suri P, Yan S, Chandrasekar A, Singla S, Ward VC, Murthy S. A mobile messaging service for families on postnatal knowledge and practices: a cluster randomized trial, India. Bull World Health Organ 2025; 103:255-265. [PMID: 40207245 PMCID: PMC11978415 DOI: 10.2471/blt.24.292145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 09/11/2024] [Accepted: 01/08/2025] [Indexed: 04/11/2025] Open
Abstract
Objective To evaluate the impact of a mobile messaging service that delivers World Health Organization recommendations on postnatal care to families from birth through six weeks postpartum via a messaging platform. Methods We randomized tertiary hospitals in four Indian states into two groups. In the treatment group, 15 hospitals promoted the messaging service to families in maternity wards before discharge following a recent birth. Nine control hospitals provided standard in-hospital information. From mid-March 2021 to mid-January 2022, we recruited mothers to participate in the study. Consenting mothers completed a face-to-face baseline survey before hospital discharge after birth and a follow-up phone survey roughly 6 weeks postpartum. Using logistic regression controlling for state-fixed effects and baseline covariates, we examine intent-to-treat estimates and report risk differences. Findings A total of 21 937 participants met the inclusion criteria. We observed significant positive impacts in 7 out of 11 neonatal and maternal care practices examined (P-values < 0.05). Breastfeeding increased by 3.1 percentage points, recommended cord care practices by 4.1 percentage points, skin-to-skin care with mothers by 9.2 percentage points, and skin-to-skin care by fathers by 2.2 percentage points. For recommended maternal dietary practices, we observed significant increases in adherence to guidelines advising no reduction of food intake (7.1 percentage points), no reduction of water intake (7.9 percentage points) and no restrictions on food items (10.8 percentage point; P-values < 0.01). Conclusion This study demonstrates that concise yet comprehensive digital messaging delivered to families during the postpartum period can effectively encourage recommended postnatal care practices.
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Affiliation(s)
- Jamie Sewan Johnston
- Stanford Center for Health Education, Stanford University, 408 Panama Mall, Stanford, CA94070, United States of America (USA)
| | | | | | | | - Saumya Singla
- Stanford Center for Health Education, Stanford University, 408 Panama Mall, Stanford, CA94070, United States of America (USA)
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Boynito WG, Pauwels NS, Otayto K, De Henauw S, Abbeddou S. Effects of community-based educational video interventions on nutrition, health, and use of health services in low- and middle-income countries: systematic review and meta-analysis. Nutr Rev 2025; 83:201-216. [PMID: 38341801 DOI: 10.1093/nutrit/nuae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024] Open
Abstract
CONTEXT Health education using videos has been promoted for its potential to enhance community health by improving social and behavior change communication. OBJECTIVE To provide stakeholders in maternal and child health with evidence that can inform policies and strategies integrating video education to improve maternal, newborn, and child health. DATA SOURCES Five databases (MEDLINE, Embase, Scopus, Web of Science, and CENTRAL) were searched on January 28, 2022, and November 10, 2022 (updated search). Quantitative and qualitative studies conducted in low- and middle-income countries on the effects of video-based interventions on nutrition, health, and health service use were eligible. There was no restriction on time or language. Study selection was done in 2 stages and in duplicate. DATA EXTRACTION A total of 13 710 records were imported to EndNote. Of these, 8226 records were screened by title and abstract using Rayyan, and 76 records were included for full-text evaluation. RESULTS Twenty-nine articles (n = 12 084 participants) were included in this systematic review, and 7 were included in the meta-analysis. Video interventions improved knowledge about newborn care (n = 234; odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04-1.40), colostrum feeding (n = 990; OR, 60.38; 95%CI, 18.25-199.78), continued breastfeeding (BF; n = 1914; OR, 3.79; 95%CI, 1.14-12.64), intention to use family planning (FP) (n = 814; OR, 1.57; 95%CI, 1.10-2.23), and use of FP (n = 864; OR, 6.55; 95%CI, 2.30-18.70). Video interventions did not result in reduced prelacteal feeding or improvement in early initiation of BF. The qualitative studies showed that video interventions were acceptable and feasible, with perceived impacts on communities. CONCLUSION This systematic review and meta-analysis indicated that video interventions improved knowledge of newborn care, colostrum feeding, and continuing BF, and the intention to use FP. Given the high levels of heterogeneity and inconsistency in reporting, more research with stronger designs is recommended. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022292190.
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Affiliation(s)
- Wanzahun Godana Boynito
- School of Public Health, Nutrition Unit, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nele S Pauwels
- Knowledge Center for Health Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Kusse Otayto
- School of Public Health, Nutrition Unit, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Dube E, Trottier ME, Greyson D, MacDonald NE, Meyer SB, MacDonald SE, Driedger SM, Witteman HO, Ouakki M, Gagnon D. Use of narratives to enhance childhood vaccine acceptance: Results of an online experiment among Canadian parents. Hum Vaccin Immunother 2024; 20:2379093. [PMID: 39044701 PMCID: PMC11271131 DOI: 10.1080/21645515.2024.2379093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/25/2024] Open
Abstract
Identifying effective interventions to promote children's vaccination acceptance is crucial for the health and wellbeing of communities. Many interventions can be implemented to increase parental awareness of the benefits of vaccination and positively influence their confidence in vaccines and vaccination services. One potential approach is using narratives as an intervention. This study aims to evaluate the effects of a narrative-based intervention on parents' attitudes and vaccination intentions. In a pre-post experiment, 2,000 parents of young children recruited from an online pan-Canadian panel were randomly exposed to one of the three videos presenting narratives to promote childhood vaccination or a control condition video about the importance and benefits of physical activity in children. Pre-post measures reveal a relatively modest but positive impact of the narratives on parents' attitudes and intention to vaccinate their child(ren). The results also suggest that narratives with more emotional content may be more effective in positively influencing vaccine attitudes than the more factual narrative. Using narratives to promote vaccination can positively influence parents' views and intentions toward childhood vaccines, but research is still required to identify the best components of such interventions.
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Affiliation(s)
- Eve Dube
- Department of Anthropology, Laval University, Quebec, Quebec, Canada
| | - Marie-Eve Trottier
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Devon Greyson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Noni E. MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Samantha B. Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Shannon E. MacDonald
- Faculty of Nursing, University, University of Alberta, Edmonton, Alberta, Canada
| | - S. Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Holly O. Witteman
- Department of Family Medicine, Laval University, Quebec, Quebec, Canada
| | - Manale Ouakki
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
| | - Dominique Gagnon
- Department of Biohazard, Quebec National Institute of Public Health, Quebec, Quebec, Canada
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Beleites F, Adam M, Favaretti C, Hachaturyan V, Kühn T, Bärnighausen T, Barteit S. Evaluating the impact of short animated videos on COVID-19 vaccine hesitancy: An online randomized controlled trial. Internet Interv 2024; 35:100694. [PMID: 38149090 PMCID: PMC10750063 DOI: 10.1016/j.invent.2023.100694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/15/2023] [Accepted: 11/25/2023] [Indexed: 12/28/2023] Open
Abstract
Addressing the global challenge of vaccine hesitancy, amplified during the COVID-19 pandemic due to misinformation propagated via social media, necessitates innovative health communication strategies. This investigation scrutinizes the efficacy of Short, Animated, Story-based (SAS) videos in fostering knowledge, behavioral intent, and engagement around COVID-19 vaccination. We conducted an online three-arm parallel randomized controlled trial (RCT) involving 792 adult participants (≥18 years, English-speaking) from the United States. The intervention group viewed a SAS video on COVID-19 vaccination, the attention placebo control group watched a SAS video on hope, and the control group received no intervention. Our primary objectives were to assess the influence of SAS videos on knowledge, behavioral intent, and engagement regarding COVID-19 vaccination. Participants in the intervention group displayed significantly higher mean knowledge scores (20.6, 95 % CI: 20.3-20.9) compared to both the attention placebo control (18.8, 95 % CI: 18.5-19.1, P < .001) and control groups (18.7, 95 % CI: 18.4-19.0, P < .001). However, SAS videos did not notably affect behavioral intent. Perception of COVID-19 as a significant health threat emerged as a strong predictor for engaging with the post-trial video without further incentives (OR: 0.44; 95 % CI: 0.2-0.96). The 35-44 age group exhibited the highest post-trial engagement (P = .006), whereas right-wing political inclination negatively associated with engagement (OR: 1.98; 95 % CI: 3.9-1.01). Vaccination status correlated significantly with self-efficacy (P < .001), perceived social norms (P < .001), and perceived response efficacy of the COVID-19 vaccine (P < .001), all heightened in the intervention group. These findings suggest that while SAS videos effectively amplify COVID-19 vaccination knowledge, their impact on behavioral intent is not direct. They do, however, affect determinants of vaccination status, thereby indirectly influencing vaccination behavior. The study highlights the appeal of SAS videos among younger audiences, but underscores the need for further examination of factors impeding vaccination engagement. As SAS videos closely mirror conventional social media content, they hold significant potential as a public health communication tool on these platforms. Trial Registration: Trial was registered at drks.de with the identifier DRKS00027938, on 5 January 2022.
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Affiliation(s)
- Ferdinand Beleites
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Maya Adam
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Caterina Favaretti
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Behavioral Science for Disease Prevention and Health Care, Technical University of Munich, Munich, Germany
| | - Violetta Hachaturyan
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Tilman Kühn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- University of Vienna, Department of Nutritional Sciences, Vienna, Austria
- Medical University of Vienna, Center for Public Health, Vienna, Austria
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele, KwaZulu-Natal, South Africa
- Harvard Center for Population and Development Studies, T.H. Chan School of Public Health, Cambridge, MA, United States
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Understanding COVID: Collaborative Government Campaign for Citizen Digital Health Literacy in the COVID-19 Pandemic. Life (Basel) 2023; 13:life13020589. [PMID: 36836945 PMCID: PMC9959963 DOI: 10.3390/life13020589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
The strategy "Understanding COVID" was a Public Health campaign designed in 2020 and launched in 2021 in Asturias-Spain to provide reliable and comprehensive information oriented to vulnerable populations. The campaign involved groups considered socially vulnerable and/or highly exposed to COVID-19 infection: shopkeepers and hoteliers, worship and religious event participants, school children and their families, and scattered rural populations exposed to the digital divide. The purpose of this article was to describe the design of the "Understanding COVID" strategy and the evaluation of the implementation process. The strategy included the design and use of several educational resources and communication strategies, including some hundred online training sessions based on the published studies and adapted to the language and dissemination approaches, that reached 1056 people of different ages and target groups, an accessible website, an informative video channel, posters and other pedagogical actions in education centers. It required a great coordination effort involving different public and third-sector entities to provide the intended pandemic protection and prevention information at that difficult time. A communication strategy was implemented to achieve different goals: reaching a diverse population and adapting the published studies to different ages and groups, focusing on making it comprehensible and accessible for them. In conclusion, given there is a common and sufficiently important goal, it is possible to achieve effective collaboration between different governmental bodies to develop a coordinated strategy to reach the most vulnerable populations while taking into consideration their different interests and needs.
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