"Nuestras Historias": Evaluating the Impact of Community-Created Digital Stories on Pre- and Perinatal Health Motivation in the Peruvian Amazon

Universidad Peruana Cayetano Heredia

Status: Completed

Conditions: Maternal Behavior; Health Knowledge, Attitudes, Practice

Treatments: Behavioral: "Nuestras Historias"

Study type: Interventional

Funder types: Other

Identifiers

NCT06013787

0000065203

Details and patient eligibility

About

"Nuestras Historias" curriculum is a tablet-based digital story curriculum that was created through community-based participatory methods. It uses narrative videos to teach about local prenatal health issues in the Parinari District of Peru. This study aims to assess the impact of "Nuestras Historias" on pregnant women and their partners by measuring participants' changes in prenatal health knowledge, attitudes and behavioral intentions for pregnancy and birth after exposure to the curriculum. The study uses a cluster-randomized design, in which communities were match-paired and then randomized for pregnant women/partners to receive the "Nuestras Historias" curriculum vs. standard prenatal health teaching, delivered by local community health workers.

Full description

Background and Study Setting:

Parinari is a district in the Loreto region that has 30 communities with approximately 7264 people. The communities are very dispersed and only accessible by river. Inhabitants of this district do not have access to running water, electricity or sanitation and the majority live in poverty. Our study takes place in the 13 communities of Parinari where the Mama River project operated. Mama River selects community health workers (CHWs) who are able to use smartphones in these communities and trains them on the use of smartphones to collect information of new pregnancies, deliveries, alarms signs or deaths of pregnant women or newborns. CHWs then send this information via mobile phone to local health care providers. CHWs are also all trained in the delivery of verbal MCH educational messages to pregnant women, and perform home visits and group visits throughout pregnancies.

Methods:

Twelve communities (6 intervention, 6 control) were recruited and after a final evaluation we excluded two communities, as one had no pregnant women at time of study initiation. The remaining communities were divided into 5 pairs, where the two within the pair were similar in terms of overall population, distance from a health center, and number of pregnant women. One community in each pair was randomly assigned to the intervention group received the Mama River programming along with the digital story curriculum, and the other community to the control group, which received only the standard existing program with no digital stories.

The community agents in the five communities selected for the intervention received training on how to use and show the digital stories on solar-powered tablets.

During the recruitment phase, all pregnant women identified by Mama River were recruited into the trial, with an effort to also recruit their partners. All trial participants signed an informed consent prior to participating, and then completed the pre-intervention survey instrument that measured prenatal health knowledge, attitudes, and behavioral intentions for pregnancy and birth.

Then, in the intervention communities, the participants received home visits and attended group meetings with the community agent in which the digital story curriculum was shown and discussed. In the control communities, participants also received home visits and attended group meetings, but the community agents carried on their standard of practice without the digital stories.

One month after completing the pre-survey, participants completed a post-survey. Those in the intervention group had a slightly longer survey including a short quantitative questions regarding their reactions to the digital stories.

Enrollment: 26 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All female participants had to be confirmed pregnancies, living permanently within the selected communities of the Parinari District, and age 18 or older
• All male participants had to be partners of women who were confirmed to be pregnant, living permanently within the selected communities of the Parinari District, and age 18 or older

Exclusion criteria

• Participants were excluded if not pregnant, if not living in the correct communities or likely to travel away within the study time frame, or if did not consent to the study.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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26 participants in 2 patient groups

Intervention Group

Experimental group

Description:

In the communities randomized into the intervention arm, the pregnant women who enrolled in the study received a month long prenatal health education intervention called "Nuestras Historias", a digital story curriculum. This video-based curriculum was delivered by by community health workers during their normal home visits and group visits.

Treatment:

Behavioral: "Nuestras Historias"

Control Group

No Intervention group

Description:

In the communities randomized to the control arm, the pregnant women who enrolled in study had normal visits and group visits with community health workers and received standard prenatal health education, but with no video intervention.