Leveraging Community Health Workers to Combat COVID-19 and Mental Health Misinformation in Haiti, Malawi, and Rwanda
- Conditions
- MisinformationMental HealthCOVID-19
- Interventions
- Behavioral: Card-Sorting Activity (Pre-intervention design)Behavioral: SMS Crafting (Pre-intervention design)Behavioral: SMS Messaging
- Registration Number
- NCT05997511
- Lead Sponsor
- Harvard Medical School (HMS and HSDM)
- Brief Summary
Partners In Health (PIH), in collaboration with Harvard Medical School, aims to develop and evaluate an SMS-based intervention for Community Health Workers (CHWs) to combat COVID-19 and mental health-related misinformation in Haiti, Rwanda, and Malawi. The study involves three aims: identifying locally relevant misinformation through a card-sorting exercise with CHWs, developing targeted messages through cognitive interviewing, and evaluating the effectiveness of SMS-based educational message dissemination via a randomized controlled trial. The evaluation will assess the impact on public health practices, knowledge and attitudes among CHWs, and knowledge and attitudes among community members.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 5109
- CHWs affiliated with PIH Rwanda, Malawi, or Haiti
- 18+ years of age.
- Less than 18 years old.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description COVID-19 Card-Sorting Activity (Pre-intervention design) Behavioral (SMS) Intervention Mental Health SMS Messaging Behavorial (SMS) Intervention COVID-19 SMS Crafting (Pre-intervention design) Behavioral (SMS) Intervention COVID-19 SMS Messaging Behavioral (SMS) Intervention Mental Health Card-Sorting Activity (Pre-intervention design) Behavorial (SMS) Intervention Mental Health SMS Crafting (Pre-intervention design) Behavorial (SMS) Intervention
- Primary Outcome Measures
Name Time Method Number of Mental Health Visits/ Consultations Completed Monthly at Health Facilities 24 months Mental health service utilization will be measured using routinely collected data measured monthly at the health facility level
Number of COVID-19 Vaccine Doses Administered Monthly at Health Facilities (if available) 24 months COVID-19 Vaccine administration will be measured using routinely collected data measured monthly at the health facility level
Number of Patients who Sought Care from Mental Health Services Monthly at Health Facilities 24 months Mental health service utilization will be measured using routinely collected data measured monthly at the health facility level
- Secondary Outcome Measures
Name Time Method Qualitative Interviews Before, after 6 months of the intervention, and after 12 months of the intervention (only in Rwanda & Haiti) In-depth qualitative interviews will occur before, during, and after the dissemination of messages. Prior to the message dissemination we will contact between 10-15 randomly selected CHWs per country and provide them with draft messages. Although the content of all messages will be determined by the results of the card sorting exercise, the style of the messages will vary. We will use cognitive interviewing techniques to understand how CHWs interpret each message and ask them to provide their preferences on messaging style. During subsequent qualitative sessions at midline and endline, we will ask up to ten CHWs to provide feedback on the messages that they actually received during the intervention.
Cross-Sectional Survey Before the intervention and after 12 months of the intervention (only in Rwanda & Haiti) a repeated cross-sectional survey of community members
Longitudinal Cohort Surveys Before, after 6 months of the intervention, and after 12 months of the intervention (only in Rwanda & Haiti) In each country, we will also select a random sample of 175 CHWs to participate in in a longitudinal cohort consisting of a quantitative questionnaire administered before, during, and after the intervention. During our survey, we will assess both COVID-19 related outcomes (CHWs' knowledge about COVID-19, vaccination status, and intention to vaccinate) and mental health-related outcomes (CHWs' knowledge about and stigmatization of mental illness). After the start of the intervention, we will also ask CHWs to self-report whether they have received our messages or used our helpline, and we will seek to verify this information by direct observation of text messages or outgoing calls on their phone.
Trial Locations
- Locations (3)
Partners in Health- Malawi
🇲🇼Neno, Malawi
Zanmi Lasante
ðŸ‡ðŸ‡¹Cange, Haiti
Partners in Health- Rwanda
🇷🇼Kigali, Rwanda