(a) Objective: To build an evidence base on effective water, sanitation, and hygiene interventions to reduce diarrheal diseases in cholera hotspots, we developed the CHoBI7 Cholera Rapid Response ...Program. (b) Methods: Once a cholera patient (confirmed by bacterial culture) is identified at a health facility, a health promoter delivers a targeted WASH intervention to the cholera hotspot (households within 20 m of a cholera patient) through both in-person visits during the first week and bi-weekly WASH mobile messages for the 3-month program period. A randomized controlled trial of the CHoBI7 Cholera Rapid Response Program was conducted with 284 participants in 15 cholera hotspots around cholera patients in urban Dhaka, Bangladesh. This program was compared to the standard message in Bangladesh on the use of oral rehydration solution for dehydration. Five-hour structured observation of handwashing with soap and diarrhea surveillance was conducted monthly. (c) Findings: Handwashing with soap at food- and stool-related events was significantly higher in the CHoBI7 Cholera Rapid Response Program arm compared to the standard message arm at all timepoints (overall 54% in the CHoBI7 arm vs. 23% in the standard arm,
< 0.05). Furthermore, there was a significant reduction in diarrheal prevalence for all participants (adults and children) (Prevalence Ratio (PR) 0.35, 95% CI: 0.14-0.85) and for children under 5 years of age (PR: 0.27, 95% CI: 0.085-0.87) during the 3-month program. (d) Conclusions: These findings demonstrate that the CHoBI7 Cholera Rapid Response Program is effective in lowering diarrhea prevalence and increasing handwashing with soap for a population at high risk of cholera.
Objective
The Cholera‐Hospital‐Based‐Intervention‐for‐7‐days (CHoBI7) is a water treatment and handwashing with soap intervention for diarrhoea patients and their household members which is initially ...delivered in a healthcare facility setting. This study evaluated the effectiveness of CHoBI7 program delivery in increasing handwashing with soap in a healthcare facility setting among diarrhoea patients and their household members.
Methods
A randomised controlled trial of the CHoBI7 program was conducted among 404 diarrhoea patients and their accompanying household members in healthcare facilities in Dhaka, Bangladesh. The ‘Standard Message’ Arm received the standard message given in Bangladesh to diarrhoea patients on the use of oral rehydration solution. The ‘Health Facility Visit + Soapy Water’ Arm received the standard message, the CHoBI7 communication module delivered bedside to the patient; and a soapy water bottle in the healthcare facility. The ‘Health Facility Visit + Handwashing Station’ Arm received this same intervention plus a small plastic handwashing station. Within 24 h of intervention delivery, three‐hour structured observation of handwashing practices at stool/vomit‐ and food‐related events (key events) was conducted in healthcare facilities of diarrhoea patients and their accompanying household members.
Results
Compared to the Standard Message Arm, there was significantly more handwashing with soap at key events in both the Health Facility Visit + Soapy Water Arm (51% vs. 25 %) (Odds Ratio: 3.02; (95% Confidence Interval (CI): 1.41, 6.45) and the Health Facility Visit + Handwashing Station Arm (58% vs. 25%) OR: 4.12; (95% CI: 1.86, 9.14).
Conclusion
These findings demonstrate that delivery of the CHoBI7 communication module and provision of a soapy water bottle to diarrhoea patients and their accompanying household members presents a promising approach to increase handwashing with soap among this high risk population in a healthcare facility setting in Bangladesh.
Objectif
Le programme (CHoBI7Cholera‐Hospital‐Based‐Intervention‐for‐7‐days) est une intervention de traitement de l'eau et de lavage des mains avec du savon pour les patients et les membres de leur famille qui est initialement administrée dans un établissement de santé. Cette étude a évalué l'efficacité du programme CHoBI7 pour augmenter le lavage des mains au savon dans les établissements de santé.
Méthodes
Un essai contrôlé randomisé du programme CHoBI7 a été mené auprès de 404 patients atteints de diarrhée et des membres de leur famille qui les accompagnent dans des établissements de santé à Dhaka, au Bangladesh. Le bras "Message standard" a reçu le message standard donné au Bangladesh aux patients atteints de diarrhée sur l'utilisation de la solution de réhydratation orale. Le bras "Visite de l'établissement de santé + eau savonneuse" a reçu le message standard, le module de communication CHoBI7 a été délivré au chevet du patient et une bouteille d'eau savonneuse dans l'établissement de santé. Le bras "Visite de l'établissement de santé + station de lavage des mains" a reçu la même intervention, ainsi qu'une petite station de lavage des mains en plastique. Dans les 24 heures suivant l'intervention, une observation structurée de trois heures des pratiques de lavage des mains lors d'événements liés aux selles/vomis et à la nourriture (événements clés) a été menée dans les établissements de santé.
Résultats
Par rapport au bras ‘Message standard’, le lavage des mains au savon était significativement plus fréquent lors des événements clés dans le bras ‘Visite de l'établissement de santé + Station de lavage des mains’ (58% contre 25%) (rapport de cotes (OR): 4,12 ; (intervalle de confiance (IC) de 95%: 1,86–9,14) et dans le bras ‘Visite de l'établissement de santé + Eau savonneuse’ (51% contre 25%) (OR: 3,02 ; (IC95% : 1,41–6,45).
Conclusion
Ces résultats démontrent que l’implémentation du module CHoBI7 constitue une approche prometteuse pour augmenter le lavage des mains au savon dans un établissement de santé au Bangladesh.
Cholera is a severe form of acute watery diarrhea that if left untreated can result in death. Globally, there are 2.9 million cholera cases annually. Individuals living in close proximity to cholera ...cases are at a higher risk for developing cholera compared to the general population. Targeted water, sanitation, and hygiene (WASH) interventions have the potential to reduce cholera transmission in cholera hotspots around cholera cases. The objective of this study was to expand the scope of the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) program, focused on cholera patient households, for delivery in cholera hotspots in urban slums in Dhaka, Bangladesh. Thirty-one semi-structured interviews were conducted in cholera hotspots around cholera patients, and three intervention planning workshops were conducted to inform modifications needed to the CHoBI7 program. After exploratory interviews, a two-phase, iterative pilot study was conducted for 9 months to test the developed CHoBI7 Cholera Rapid Response program among 180 participants to further inform modifications to intervention content and delivery. Findings from pilot participant interviews highlighted the need to adapt intervention content for delivery at the compound-rather than household-level, given an environment with multiple households sharing a water source, toilets, and kitchen facilities. This was addressed by conducting a "ring session" for intervention delivery in cholera hotspots for households to discuss how to improve their shared facilities together and encourage a compound-level commitment to promoted WASH behaviors and placement of soapy water bottles in shared spaces. Based on the low number of soapy water bottles observed in communal spaces during the first iteration of the pilot, we also added context-specific examples using the narratives of families in mobile messages to encourage WASH behavioral recommendations. Formative research identified important considerations for the modifications needed to tailor the CHoBI7 program for delivery in cholera hotspots in urban Bangladesh.
AbstractHousehold contacts of cholera patients are at a 100 times higher risk of a
infection than the general population. To examine risk factors for
infections and investigate intervention ...strategies among this population, we followed household contacts of cholera patients for the 1-week high-risk period after the index patient obtained care. This study was nested within a randomized controlled trial of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7), a handwashing with soap and water treatment intervention in Dhaka, Bangladesh. Rectal swab results were available from 320 household contacts of cholera patients at five time points over a 1-week period. Fecal and water samples were analyzed for
by bacterial culture. All analyses were stratified by study arm. Within the intervention arm, stored household drinking water with a median free chlorine concentration below 0.5 mg/L was associated with a three times higher odds of a cholera infection (odds ratio OR: 3.0; 95% confidence interval CI: 1.32, 6.63). In the control arm, having
in stored water was associated with a significantly higher odds of a symptomatic cholera infection (OR: 8.66; 95% CI: 2.11, 35.48). No association was found between observed handwashing with soap at food and stool-related events and
infections. Stored household drinking water with detectable
and chlorine concentrations below the World Health Organization guideline were found to be important risk factors for cholera infection among household contacts of cholera patients. These findings emphasize the need for water treatment interventions targeting this high risk population.
To explore the consistency in impact evaluation based on reported diarrhea, we compared diarrhea data collected through two different surveys and with observed diarrhea-associated hospitalization for ...children aged ≤ 5 years from a non-blinded cluster-randomized trial conducted over 2 years in urban Dhaka. We have previously reported that the interventions did not reduce diarrhea-associated hospitalization for children aged ≤ 5 years in this trial. We randomly allocated 90 geographic clusters comprising > 60,000 low-income households into three groups: cholera vaccine only, vaccine plus behavior change (cholera vaccine and handwashing plus drinking water chlorination promotion), and control. We calculated reported diarrhea prevalence within the last 2 days using data collected from two different survey methods. The "census" data were collected from each household every 6 months for updating household demographic information. The "monthly survey" data were collected every month from a subset of randomly selected study households for monitoring the uptake of behavior change interventions. We used binomial regression with a logarithmic link accounting for clustering to compare diarrhea prevalence across intervention and control groups separately for both census and monthly survey data. No intervention impact was detected in the census (vaccine only versus control: 2.32% versus 2.53%;
= 0.49; vaccine plus behavior change versus control: 2.44% versus 2.53%;
= 0.78) or in the vaccine only versus control in the monthly survey (3.39% versus 3.80%;
= 0.69). However, diarrhea prevalence was lower in the vaccine-plus-behavior-change group than control in the monthly survey (2.08% versus 3.80%;
= 0.02). Although the reasons for different observed treatment effects in the census and monthly survey data in this study are unclear, these findings emphasize the importance of assessing objective outcomes along with reported outcomes from non-blinded trials.
Objective
The objective of this study was to evaluate the impact of the Cholera‐Hospital‐Based‐Intervention‐for‐7‐days (CHoBI7) handwashing with soap and water treatment mobile health (mHealth) ...program on diarrhoeal disease knowledge among diarrhoea patients and their household members in urban Dhaka, Bangladesh.
Methods
A cluster‐randomised controlled trial of the CHoBI7 mHealth program was conducted among diarrhoea patient households in Dhaka, Bangladesh. Patients were randomised to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (weekly voice and text messages) (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. An open‐ended questionnaire was administered to 1468 participants 12 years of age or older on diarrhoeal disease transmission and prevention. These items were combined to form a diarrhoeal disease knowledge score measured at baseline and at a 1 week, 6 month and 12 month follow‐up.
Results
At baseline, when participants were asked to report three ways diarrhoeal diseases were spread 37% (546/1468) of participants reported by water, 13% (187/1468) by lack of handwashing and 4% (53/1468) by food not being covered properly. At baseline when asked to name three ways diarrhoeal diseases could be prevented, 35% (515/1468) of participants reported safe water, and 16% (228/1468) reported handwashing with soap. At the 12‐month follow‐up, the overall diarrhoeal disease knowledge score was significantly higher in the mHealth with no home visits arm (score coefficient: 0.69, 95% Confidence Interval: 0.36, 1.01, P < 0.0001) and the mHealth with two home visits arm (score coefficient: 1.18, 95% CI: 0.87, 1.49, P < 0.0001) compared with the standard recommendation arm.
Conclusion
The CHoBI7 mHealth program significantly increased knowledge of diarrhoeal disease transmission and prevention among diarrhoea patients and their household members 12 months after in‐person visits for program delivery were conducted.
Objectif
L'objectif de cette étude était d'évaluer l'impact du programme CHoBI7 (Cholera‐Hospital‐Based‐Intervention‐for‐7‐days) de santé mobile (mHealth) sur la connaissance sur les maladies diarrhéiques chez les patients atteints de diarrhée et les membres de leur ménage dans la ville de Dhaka, au Bangladesh.
Méthodes
Un essai contrôlé randomisé par grappes du programme mHealth CHoBI7 a été mené auprès de ménages de patients atteints de diarrhée à Dhaka, au Bangladesh. Les patients ont été randomisés dans trois groupes: recommandation standard sur l'utilisation de solutions de réhydratation orale; délivrance du programme CHoBI7 dans les services de santé plus mHealth (pas de visites à domicile); et délivrance du programme CHoBI7 dans les services de santé plus deux visites à domicile et mHealth. Un questionnaire ouvert a été administré à 1.468 participants âgés de 12 ans ou plus sur la transmission et la prévention des maladies diarrhéiques. Ces éléments ont été combinés pour former un score de connaissance sur les maladies diarrhéiques mesuré au départ et à 1 semaine, 6 mois et 12 mois.
Résultats
Au départ, lorsqu'il a été demandé aux participants d'indiquer trois modes de propagation des maladies diarrhéiques, 37% (546/1468) des participants ont indiqué que ces maladies étaient transmises par l'eau, 13% (187/1468) par le manque de lavage des mains et 4% (53/1468) par le fait que les aliments n'étaient pas correctement couverts. Au départ, lorsqu'on leur a demandé de citer trois moyens de prévention des maladies diarrhéiques, 35% (515/1468) des participants ont cité l’accès à l'eau potable et 16% (228/1468) ont cité le lavage des mains avec du savon. Lors du suivi à 12 mois, le score global de connaissance sur la diarrhée était significativement plus élevé dans le bras mHealth sans visites à domicile (coefficient de score: 0,69, intervalle de confiance à 95%: 0,36–1,01; P < 0,0001) et le volet mHealth avec deux visites à domicile (coefficient de score: 1,18; IC 95%: 0,87–1,50; P < 0,0001) par rapport au bras de recommandation standard.
Conclusion
Ces résultats suggèrent que le programme mHealth de CHoBI7 présente une approche prometteuse pour accroître les connaissances sur les maladies diarrhéiques dans les ménages de patients atteints de diarrhée.
Objective
The objective of the study was to investigate potential risk factors for growth faltering among children under 5 years of age.
Method
We conducted a prospective cohort study of 553 children ...under 5 years from diarrhoea patient households in urban Dhaka, Bangladesh. Height and weight measurements were obtained at baseline and at a 12‐month follow‐up. Caregivers of young children were administered a monthly questionnaire on household sociodemographic characteristics and hygiene practices.
Results
Children with caregiver reports of mouthing soil at the majority of household visits had a significant reduction in their height‐for‐age z‐scores (HAZ) from baseline to the 12‐month follow‐up (ΔHAZ: −0.28 (95% confidence interval (CI): −0.51, −0.05)). A significant reduction in HAZ was also observed for children in households with animals in their sleeping space (ΔHAZ: −0.37 (95% CI: −0.71, −0.04)).
Conclusion
These findings provide further evidence to support the hypothesis that child mouthing of soil and the presence of animals in the child’s sleeping space are potential risk factors for growth faltering among young children. Interventions are urgently needed to provide clean play and sleeping spaces for young children to reduce exposure to faecal pathogens through child mouthing.
Objectif
L'objectif de l'étude était d'examiner les facteurs de risque potentiels de retard de croissance chez les enfants de moins de 5 ans.
Méthode
Nous avons mené une étude de cohorte prospective sur 553 enfants de moins de 5 ans provenant de ménages avec des patients diarrhéiques dans la ville de Dhaka, au Bangladesh. Les mesures de taille et de poids ont été obtenues au départ et à 12 mois de suivi. Les personnes s’occupant de jeunes enfants (les gardiens) ont reçu un questionnaire mensuel sur les caractéristiques sociodémographiques des ménages et les pratiques d'hygiène.
Résultats
Les enfants pour lesquels les gardiens ont déclaré qu'ils mâchouillaient de la terre lors de la majorité des visites à domicile présentaient une diminution du score Z de taille pour l’âge (TAZ) de manière significative de l'âge de référence au 12 mois de suivi (ΔTAZ −0,28 (intervalle de confiance (IC) à 95%: −0,51, −0,05)). Une réduction significative des TAZ a également été observée pour les enfants des ménages ayant des animaux dans leur espace de couchage (ΔTAZ −0,37 (IC95%: −0,71, −0,04)).
Conclusion
Ces résultats apportent des données supplémentaires pour appuyer l'hypothèse selon laquelle le fait que l'enfant mâchouille de la terre et la présence d'animaux dans son espace de couchage sont des facteurs de risque potentiels de retard de croissance chez les jeunes enfants. Des interventions sont urgemment nécessaires pour fournir des espaces de jeu et de sommeil sains aux jeunes enfants afin de réduire l'exposition aux agents pathogènes fécaux par le mâchouillement des enfants.
Diarrhea is the second leading cause of death in children under 5 years of age globally. The time patients and caregivers spend at a health facility for severe diarrhea presents the opportunity to ...deliver water, sanitation, and hygiene (WASH) interventions. We recently developed Cholera-Hospital-Based Intervention for 7 days (CHoBI7), a 1-week hospital-based handwashing with soap and water treatment intervention, for household members of cholera patients. To investigate if this intervention could lead to sustained WASH practices, we conducted a follow-up evaluation of 196 intervention household members and 205 control household members enrolled in a randomized controlled trial of the CHoBI7 intervention 6 to 12 months post-intervention. Compared with the control arm, the intervention arm had four times higher odds of household members' handwashing with soap at a key time during 5-hour structured observation (odds ratio OR: 4.71, 95% confidence interval CI: 2.61, 8.49) (18% versus 50%) and a 41% reduction in households in the World Health Organization very high-risk category for stored drinking water (OR: 0.38, 95% CI: 0.15, 0.96) (58% versus 34%) 6 to 12 months post-intervention. Furthemore, 71% of observed handwashing with soap events in the intervention arm involved the preparation and use of soapy water, which was promoted during the intervention, compared to 9% of control households. These findings demonstrate that the hospital-based CHoBI7 intervention can lead to significant increases in handwashing with soap practices and improved stored drinking water quality 6 to 12 months post-intervention.
Objective
To characterise childhood mouthing and handling behaviours and to assess the association between hand‐to‐object and object‐to‐mouth contacts and diarrhoea prevalence in young children in ...urban Dhaka, Bangladesh.
Methods
A prospective cohort study was conducted among 494 children under 5 years of age in Dhaka, Bangladesh. This study was nested within the randomised controlled trial of the Cholera Hospital‐Based Intervention for 7 Days (CHoBI7) mobile health (mHealth) program. The CHoBI7 mHealth program focuses on promoting handwashing with soap and water treatment to diarrhoea patients and their household members through mobile messages and a single in person visit. Mouthing and handling of faeces and fomites among young children was measured by five‐hour structured observation and caregiver reports. Diarrhoea surveillance data was collected monthly for 12 months.
Results
Fifty five percent of caregivers reported that their child put a visibly dirty fomite (object or soil) in their mouth in the past week. Caregivers reported that 50% of children had mouthed visibly dirty objects, 26% had mouthed dirt, and 2% had mouthed faeces. Forty five percent of children were observed mouthing a visibly dirty fomite during structured observation, 40% of children were observed mouthing a visibly dirty object, 10% were observed mouthing soil, and one child (0.2%) was observed mouthing faeces. Mouthing of visibly dirty fomites was highest for children 12‐18 months of age with 69% of these children having caregiver reports and 54% having observed events. Children with caregiver reports of mouthing faeces had a significantly higher odds of diarrhoea over the subsequent month (Odds Ratio: 4.54; 95% Confidence Interval: 1.06, 19.48).
Conclusion
These findings demonstrate that mouthing of contaminated fomites among young children is frequent in urban environments in Bangladesh, and that mouthing faeces is associated with a significantly higher odds of diarrhoea. Interventions are urgently needed to protect young children from faecal pathogens in their play spaces.
Objectif
Caractériser les comportements de mâchouillement et de manipulation par les enfants et évaluer l'association entre les contacts main‐objet et objet‐bouche et la prévalence de la diarrhée chez les jeunes enfants dans la ville de Dhaka, au Bangladesh.
Méthodes
Une étude de cohorte prospective a été menée auprès de 494 enfants de moins de 5 ans à Dhaka, au Bangladesh. Cette étude s'inscrivait dans le cadre de l'essai contrôlé randomisé du programme CHoBI7 (Cholera‐Hospital‐Based‐Intervention‐for‐7‐days) de santé mobile (mHealth. Le programme de santé mobile CHoBI7 se concentre sur la promotion du traitement de l’eau et du lavage des mains avec à l'eau et au savon aux patients atteints de diarrhée et aux membres de leur foyer par le biais de messages mobiles et de visites de face à face. Le mâchouillement et la manipulation des excréments et des fomites chez les jeunes enfants ont été mesurés par des observations structurées de cinq heures et par les rapports des personnes s’occupant d’enfants (soignants). Les données de surveillance de la diarrhée ont été recueillies chaque mois pendant 12 mois.
Résultats
55% des soignants ont déclaré que leur enfant avait mis un fomite visiblement sale (objet ou terre) dans sa bouche au cours de la semaine précédente. Les soignants ont indiqué que 50% des enfants avaient mâchouillé des objets visiblement sales, 26% avaient mâchouillé de la terre et 2% avaient mâchouillé des excréments. 45% des enfants ont été observés en train de mâchouiller un fomite visiblement sale au cours d'une observation structurée. 40% des enfants ont été observés en train de mâchouiller un objet, 10% ont été observés en train de mâchouiller de la terre et un enfant (0,2%) a été observé en train de mâchouiller des excréments. Le mâchouillement de fomites visiblement sales était le plus fréquent chez les enfants de 12 à 18 mois; 69% de ces enfants ont été signalés par les soignants et 54% ont été observés en train de le faire. Les enfants dont les soignants avaient signalé un mâchouillement d’excréments présentaient un risque de diarrhée nettement plus élevé au cours du mois suivant (rapport de cotes: 4,54; intervalle de confiance à 95%: 1,06–19,48).
ConclusionCes résultats démontrent que le fait de mâchouiller des fomites contaminés chez les jeunes enfants est fréquent en milieu urbain au Bangladesh et que le fait de mâchouiller des excréments est associé à un risque de diarrhée nettement plus élevé. Des interventions sont urgemment nécessaires pour protéger les jeunes enfants des agents pathogènes fécaux dans leurs espaces de jeu.
Objective
The Cholera‐Hospital‐Based Intervention for 7‐days (CHoBI7) mobile health (mHealth) program delivers mobile messages to diarrhoea patient households promoting water treatment and ...handwashing with soap. The randomised controlled trial (RCT) of the CHoBI7 mHealth program demonstrated this intervention was effective in significantly reducing diarrhoea and stunting amoung young children. The objective of this study was to assess the implementation of the CHoBI7 mHealth program in delivering mHealth messages during this RCT.
Methods
517 diarrhoea patient households with 1777 participants received weekly text, voice and interactive voice response (IVR) messages from the CHoBI7 mHealth program over the 12‐month program period. The program process evaluation indicators were the following: the percentage of CHoBI7 mHealth messages received and fully listened to by program households (program fidelity and dose), and household members reporting receiving and sharing an mHealth message from the program in the past two weeks (program reach).
Results
Ninety two percent of text messages were received by program households. Eighty three percent of voice and 86% of IVR messages sent were fully listened to by at least one household member. Eighty one percent of IVR quiz responses from households were answered correctly. Program households reported receiving a CHoBI7 mHealth message in the past two weeks at 79% of monthly household visits during the 12‐month program. Seventy seven percent of participants reported sharing a program message with a spouse, 55% with a neighbour and 49% with a child during the program period.
Conclusion
There was high fidelity, dose and reach of mobile messages delivered for the CHoBI7 mHealth program. This study presents an approach for process evaluation that can be implemented to evaluate future mHealth programs.
Objectif
Le programme CHoBI7 (Cholera‐Hospital‐Based‐Intervention‐for‐7‐days) de santé mobile (mHealth) délivre des messages mobiles aux ménages avec patients atteints de diarrhée pour promouvoir le traitement de l'eau et le lavage des mains au savon. L'essai contrôlé randomisé (ECR) du programme mHealth CHoBI7 a démontré que cette intervention était efficace pour réduire de manière significative la diarrhée et le retard de croissance chez les jeunes enfants. L'objectif de cette étude était d'évaluer la mise en œuvre du programme CHoBI7 mHealth dans la diffusion des messages mHealth au cours de cet ECR.
Méthodes
517 ménages avec des patients atteints de diarrhée ont reçu chaque semaine des messages SMS, vocaux et de réponse vocale interactive (RVI) du programme mHealth de CHoBI7 pendant les 12 mois du programme. Les indicateurs d'évaluation du processus du programme étaient les suivants: le pourcentage de messages mHealth du programme CHoBI7 reçus (fidélité au programme et dose) et entièrement écoutés par les ménages participant au programme (fidélité au programme et dose) et les bénéficiaires déclarant avoir reçu et partagé un message mHealth du programme (portée du programme) au cours des deux dernières semaines.
Résultats
92% des SMS ont été reçus par les ménages participant au programme. 83% des messages vocaux et 86% des messages RVI envoyés ont été entièrement écoutés par au moins un membre du ménage. 81% des réponses aux quiz RVI des ménages ont été correctement répondues. Les ménages du programme ont déclaré avoir reçu un message CHoBI7 mHealth au cours des deux dernières semaines dans 79% des visites mensuelles des ménages pendant les 12 mois du programme. 77% des participants ont déclaré avoir partagé un message du programme avec un conjoint, 55% avec un voisin et 49% avec un enfant pendant la durée du programme.
Conclusion
La dose et les messages délivrés dans le cadre du programme mHealth de CHoBI7 l’ont été avec une fidélité élevée. Cette étude présente une approche d'évaluation des processus qui peut être mise en œuvre pour évaluer les futurs programmes mHealth.
PDF
