Validation of Health Education Material for Youth: A Step to Ensure Implementation Fidelity in Community-Based Interventions

Development and Validation of Rabies Health Education Module (RaHEM) for Dog Owners in Kelantan, Malaysia: An ADDIE Model

BACKGROUND

Rabies is a preventable yet deadly public health threat. Despite the availability of effective vaccines for both humans and animals, the persistence of rabies-related fatalities underscores the need for enhanced public education strategies. This study aimed to develop and validate a Rabies Health Education Module delivered via a Massive Open Online Course, targeting adult dog owners in Kelantan, Malaysia.

METHODS

The development of RaHEM followed the ADDIE framework. A comprehensive analysis was conducted through literature reviews, cross-sectional surveys, and stakeholder interviews. The module's content was designed and developed based on the Modified Health Belief Model and Mayer's Cognitive Theory of Multimedia Learning. Validation was performed by a panel of six experts and ten dog owners through content and face validity indices, respectively.

RESULTS

The module was organized into five core topics, each addressing specific aspects of rabies prevention. Content validity indices for all topics exceeded the acceptable threshold of 0.83, with an overall module CVI of 0.91 for relevance and 0.88 for clarity. Face validity indices also surpassed the 0.83 threshold, with overall module FVI scores of 1.00 for understandability and 0.99 for clarity.

CONCLUSION

The RaHEM MOOC was successfully developed and thoroughly validated, ensuring it met its intended objectives and was suitable for the target audience. This educational module offers a promising approach to enhancing rabies prevention through accessible and engaging online education, potentially contributing to reduced rabies transmission and fatalities. Further studies are recommended to evaluate the module's effectiveness in improving rabies knowledge and attitudes.

Quality of patient-oriented online information on treatment of dementia: A comparative assessment of web pages in English and Hindi language

Background

Management of dementia involves a multidisciplinary approach which also requires active participation from family members and caregivers. Thus, having easy access to information about dementia care is pertinent. Internet-based information is an emerging method for the same.

Aim

To perform a comparative assessment of patient-oriented online information available on treatment of dementia over web pages in English and Hindi language.

Methods

Observational study was conducted online through a general internet search engine (www.google.com). Web pages containing patient-oriented online information on treatment of dementia in English and Hindi were reviewed to assess their content and quality, esthetics, and interactivity. Appropriate descriptive and inferential statistics were conducted using the Statistical Package for the Social Sciences.

Results

A total of 70 web pages met the eligibility criteria. Content quality assessed using the DISCERN score was significantly higher for English web pages compared to Hindi web pages (P < 0.01). About 72.4% (21/29) of English and only 9.8% (4/41) of Hindi web pages had a total DISCERN score of 40 or above, indicating good quality. For esthetics, the median score for English pages was significantly higher than for Hindi web pages (P < 0.01). The web pages with Health On Net (HON) certification had significantly better content quality.

Conclusion

Our study revealed a scarcity of good quality online information about dementia and its treatment, especially in the Hindi language. English language websites showed better content quality than Hindi websites. HON Code label might be used as an indicator of better content quality for online resources informing on dementia treatment by lay people.

Compliance of Adolescent Friendly Health Clinics with National and International Standards: Quantitative findings from the i-Saathiya study

OBJECTIVE

Indian adolescents experience several health challenges requiring acceptable, equitable, appropriate and effective healthcare services. Our objective was to assess the compliance of Adolescent Friendly Health Clinics (AFHCs) in two of India's largest states, using both national benchmarks (under Rashtriya Kishor Swasthya Karyakram-RKSK) and global standards (by WHO).

DESIGN

Cross-sectional study comprising structured observations and interactions (November 2021 to June 2022).

SETTING

Fourteen AFHCs across all levels of health system were included from two districts of Maharashtra (n=8) and Madhya Pradesh (n=6). These AFHCs were observed using checklist, and few items of checklist were verified by interactions with AFHC's health workers (medical officers/auxillary nurse midwives/counsellors) handlings adolescents. The developed checklist included 57 items based on adapted global standards and 25 items using national benchmarks.

RESULT

High compliance of AFHCs with RKSK's benchmarks was attributed to various items including the accessibility through local transport (n=14, 100%), clean surroundings (n=11, 78.5%), presence of signage (n=10, 71.4%), convenient operating days and time (n=11, 78.5%), and secure storage of records (n=13, 92.9%). Concurrently, items that showed low compliance encompassed, the availability of Information, Education and communication (IEC) resources, which were deficient in 57.1% of AFHCs (n=8). Similarly, designated areas for clinical services (n=10, 71.4%) and commodity disbursement (n=9, 64.3%) lacked in more than half of the recruited AFHCs. Additionally, lack of guidelines for referrals (n=13, 92.9%), as well as standard operating procedures to ensure equity, non-judgemental attitude, competence, confidentiality and referral as per WHO standards.

CONCLUSION

Evidence spotlights the strengths and gaps in AFHCs, aligning with, government's priorities on adolescent health. Addressing the identified gaps is crucial to creating healthcare facilities that are adolescent-friendly, easily accessible and effectively navigate adolescent health challenges. This concerted effort would contribute to their development and transformation, playing a pivotal role in India's progress.

Validation of Mobile Messages for an mHealth Intervention for Smokeless Tobacco Cessation in India

BACKGROUND

With the growth in use of mobile messages for behaviour change, the need to incorporate personal needs and cultural characteristics of target users has been promoted. The study aimed to describe the findings of content validation of mobile messages designed to promote smokeless tobacco cessation in primary care.

METHODS

This study used a concurrent mixed-method approach with 13 patients who were tobacco users at urban primary care clinics. The clarity and appeal of 32 messages were rated on a Likert scale from 1 to 10. A mean clarity and appeal score per message was generated. A 5-item discussion guide was used for in-depth interviews and data was analysed using framework analysis.

RESULTS

Participants found the content of the messages useful, and preferred shorter and audio formatted messages. The clarity scores for the messages ranged from 7.9 to 9.4 with an average score of 8.7 (SD 0.5). The appeal scores ranged from 7.3 to 9.2, with an average score of 8.5 (SD 0.6).

CONCLUSIONS

Twenty-six from a total of 32 messages were found appropriate and finalised for use. This methodology can be used when developing contextually relevant mobile message interventions in other low resource settings.

Development and Validation of a Comic Tool: An Innovative Approach to Raise Awareness about Tobacco Control among School Teachers

Background

National legislation (COTPA) in India has focused on school children with dedicated section (6a and 6b) for tobacco control at Educational Institutions. Innovative mediums like Comic offer unique and engaging medium for dissemination of health information. However, its true potential remains unexplored in tobacco control. The study was conducted to develop and validate Comic for promotion of tobacco control laws in school settings.

Materials and Methods

The present cross-sectional study was conducted among school teachers in Delhi in three phases: (1) need assessment, (2) development of Comic, and (3) validation (face/content validity by experts in public health/tobacco control, and construct validity by school teachers). Ethical clearance was obtained from Institutional Ethical Review Board. Prevalidated, structured, close-ended, and self-administered Questionnaire was used for the data collection. SPSS version 21 was used for descriptive and inferential results.

Results

Phase 1 showed, out of 150 school teachers, 121 participated (80.66%). Mean age and teaching experience was 41.85 ± 9.76 years and 10.35 ± 6.53 years, respectively. Overall awareness about COTPA was 47.9% (n = 58) and COTPA sections 4 and 6 were 37.2% (n = 45). Majority 59.5% (n = 72) reported lack of access to training material. Phase 2 and 3 showed overall content validity index (CVI) score of 0.84. Construct validity evaluation from pre-postintervention yield mean ± SD scores of 3.94 ± 0.99 and 7.97 ± 1.17, respectively, (P < 0.001).

Conclusion

Comic was developed on sound theoretical basis with satisfactory face, content and construct validity, to raise awareness about tobacco control among school children, and teachers to promote tobacco-free school.

Dietary Patterns and Determinants of Pregnant and Lactating Women From Marginalized Communities in India: A Community-Based Cross-Sectional Study

Objective: Dietary pattern analysis has emerged as a balanced and realistic approach that reflects how the food is consumed in real life. However, previous studies have overlooked the two important phases in women's life, pregnancy, and lactation. We aimed to explore dietary patterns and their determinants among pregnant and lactating women from marginalized families in rural areas and urban slums of India. Methods: It was a community-based cross-sectional study conducted across four districts of India, one from each region (North, West, East, and South). We used a structured questionnaire to collect data on socio-demographic characteristics and access to nutrition services. The dietary data were collected using a qualitative food frequency questionnaire having 204 food items, which were clubbed into 16 major food groups. The principal component analysis method was employed to identify dietary patterns (prefixed at 4). We used multinomial logistic regression to explore associations of socio-demographic and access to nutrition services' variables with identified dietary patterns. Results: The data of 476 pregnant and 446 lactating women were assessed. Four patterns explained for 54% of the variation in their food intake. The patterns identified were low-mixed vegetarian (19%), non-vegetarian (15%), high-mixed vegetarian (11%), and calorie-rich (9%). The low-mixed diet was rich in rice, roots and tubers, green leafy vegetables, and other vegetables. The non-vegetarian diet was characterized by high loadings for nuts or seeds, chicken, meat or fish, eggs, beverages (milk-based), and snacks. The high-mixed vegetarian diet was rich in cereals other than rice and wheat, pulses, and fruits. The calorie-rich diet had high factor loadings for wheat, butter and oil, sweets, and milk and milk products. Hindus and women who lived in rural areas had higher odds of consuming a low-mixed vegetarian diet and lower odds of a high-mixed vegetarian diet. Working women and those who received nutrition advice during pregnancy or lactation had 2-3 times higher odds of consuming a high-mixed vegetarian diet. Conclusions: A high prevalence of a low-mixed vegetarian diet among women can have adverse pregnancy and birth outcomes. Healthy dietary patterns during pregnancy and lactation are required to meet the increased micro- and macronutrient requirements for improved maternal and child health.