Abstract
In India, community healthcare workers are the primary touchpoints between the state and the beneficiaries, such as pregnant mothers and children. Their healthcare knowledge directly impacts the quality of care they provide through home visits and community activities. Classroom in-person or traditional ways of training are found ineffective in imparting knowledge and render poor knowledge retention, which needs reinforcements through short, frequent revisions. Smartphone games on healthcare topics could be a promising solution as a refresher, as they can be scaled and tailored as per players’ requirements. This study aims to check the differences in knowledge gain, pre and post-intervention, and, secondly, to check knowledge retention after six months. 270 CHWs or participants were recruited to evaluate different modes of refresher training and assigned into three equal groups of 90 each. The control group (CG) (n = 90) was trained using the standard classroom method, which is usually followed. Intervention Group-1 (IG1) (n = 90) was trained in a physical card game format, and Intervention Group-2 (IG2)(n = 90) was trained in a smartphone game format. 4 sets of questionnaires were made by shuffling 45 questions based on immunization of equal weightage. The questionnaires were filled out by CHWs by hand and collected, evaluated, and analyzed. Paired t-tests were conducted to compare pre-post knowledge increments and repeated measure ANOVA to check for differences in knowledge retention. Results suggest a significant difference in scores in all three groups. A significant difference was observed between the physical and digital gameplay modes. Pre-post knowledge increment was higher in the digital mode (p < 0.05), but knowledge retained was not significantly different (p = .4) in digital and physical card versions. Card games confirm their effectiveness in gaining knowledge when compared to classroom training. Through this research, we found that the gamified way of learning has an improved retention rate compared to the traditional training method.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bag, S., Datta, M.: Evaluation of mother and child protection card entries in a rural area of West Bengal. Int. J. Commun. Med. Public Health 4(7), 2604 (2017). https://doi.org/10.18203/2394-6040.ijcmph20172867
Bashingwa, J.J.H., et al.: Examining the reach and exposure of a mobile phone-based training programme for frontline health workers (ASHAs) in 13 states across India, August 2021. https://doi.org/10.1136/bmjgh-2021-005299
Burger, O., et al.: Facilitating behavioral change: a comparative assessment of ASHA efficacy in rural Bihar. PLOS Global Public Health 2(8), e0000756 (2022). https://doi.org/10.1371/journal.pgph.0000756
Farah, N.F., Mohan, R., Kiruba, S.V., Aditi, K., Ananthkumar, S.R., Prem, K.M.: Assessment of ‘Accredited Social Health Activists’-A National Community Health Volunteer Scheme in Karnataka State, India (2015). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438657/
Faul, F., Erdfelder, E., Lang, A.G., Buchner, A.: G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. In: Behavior Research Methods, vol. 39 (2007). https://doi.org/10.3758/BF03193146
Gopalan, S.S., Varatharajan, D.: Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in India. Technical report (2012). http://www.biomedcentral.com/1472-6963/12/319
Harris, A.D., et al.: The use and interpretation of quasi-experimental studies in medical informatics. J. Am. Med. Inform. Assoc. 13(1), 16–23 (2006). https://doi.org/10.1197/jamia.M1749
Haynie, W.J.: Effects of multiple-choice and short-answer tests on delayed retention learning. Technical Report 1 (1994)
IIT Bombay: Institutional Review Board, IIT Bombay, India, May 2020. https://rnd.iitb.ac.in/institute_review_board
Indian Institute Population Sciences and Ministry of Health and Family Welfare: National Family Health Survey-4 India Fact Sheet. Indian Institute Population Sciences and Ministry of Health and Family Welfare (2016). http://rchiips.org/NFHS/NFHS-4Reports/India.pdf
Indian Institute Population Sciences and Ministry of Health and Family Welfare: National Family Health Survey-5 India Fact Sheet. Indian Institute Population Sciences and Ministry of Health and Family Welfare (2021). http://rchiips.org/nfhs/factsheet_NFHS-5.shtml
Javaid, M., Fatima, B., Batool, A.: Bridging the knowledge gaps in lady health visitors through video based learning tool. In: ACM International Conference Proceeding Series, vol. Part F1320 (2017). https://doi.org/10.1145/3136560.3136603
Kasi, S.G., et.al.: Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2020–2021) and update on immunization for children aged 0 through 18 years. Indian Pediatrics 58(1), 44–53 (2021). https://doi.org/10.1007/s13312-021-2096-7
Kizhatil, A., Reshma, Hariharan, H.C., John, A., Thomas, A.M., Padmanabhan, G.: Assessment of immunization coverage and associated factors among children in Paravur Taluk of Ernakulam district, Kerala. Int. J. Commun. Med. Public Health 6(8), 3594 (2019). https://doi.org/10.18203/2394-6040.ijcmph20193494
Kumar, N., Anderson, R.: Mobile phones for maternal health in rural India. In: Conference on Human Factors in Computing Systems - Proceedings, April 2015, pp. 427–436 (2015). https://doi.org/10.1145/2702123.2702258
Kumar, N., et al.: Projecting health: community-led video education for maternal health. In: ACM International Conference Proceeding Series, vol. 15 (2015). https://doi.org/10.1145/2737856.2738023
Kumar, N., Rangaswamy, N.: The mobile media actor-network in urban India. In: Conference on Human Factors in Computing Systems - Proceedings, pp. 1989–1998 (2013). https://doi.org/10.1145/2470654.2466263
Majhi, A., Agnihotri, S., Mondal, A.: Physical and augmented reality based playful activities for refresher training of ASHA workers in India. In: Conference on Human Factors in Computing Systems - Proceedings (2022). https://doi.org/10.1145/3516492.3558788
Majhi, A., Joshi, A., Agnihotri, S.B., Mondal, A.: Refresher training through Quiz App for capacity building of Community Healthcare Workers or Anganwadi Workers in India. In: 5th Asian CHI Symposium 2021 (2021). https://doi.org/10.1145/3429360.3468186
Nungester, R.J., Duchastel, P.C.: Testing versus review: effects on retention. J. Educ. Psychol. 74(1), 18–22 (1982). https://doi.org/10.1037//0022-0663.74.1.18
Ramachandran, D., Canny, J., Das, P.D., Cutrell, E.: Mobile-izing health workers in rural India. In: Conference on Human Factors in Computing Systems - Proceedings, vol. 3, pp. 1889–1898 (2010). https://doi.org/10.1145/1753326.1753610
Shah, M.P., Kamble, P.A., Agnihotri, S.B.: Tackling child malnutrition: an innovative approach for training health workers using ICT: a pilot study. In: IEEE Region 10 Humanitarian Technology Conference 2016, R10-HTC 2016 - Proceedings (2017). https://doi.org/10.1109/R10-HTC.2016.7906811
Telecom Regulatory Authority of India: TRAI Press Release No. 03/2024. Technical report (2024). https://www.trai.gov.in/sites/default/files/PR_No.03of2024_0.pdf
Tulaskar, R.: Study of instructional illustrations on ICTs: considering persona of low-literate users from India. In: ACM International Conference Proceeding Series, pp. 53–56 (2020). https://doi.org/10.1145/3391203.3391217
Verdezoto, N., et al.: The invisible work of maintenance in community health: challenges and opportunities for digital health to support frontline health workers in Karnataka, South India. Proc. ACM Hum. Comput. Interact. 5(CSCW1), 1–31 (2021). https://doi.org/10.1145/3449165
Ward, V.C., et al.: Impact of Mhealth interventions for reproductive, maternal, newborn and child health and nutrition at scale: BBC Media Action and The Ananya Program in Bihar, India. J. Global Health 10(2), 021005 (2020). https://doi.org/10.7189/jogh.10.021005
World Medical Association: WMA Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. Technical report (2013). https://www.med.or.jp/dl-med/wma/helsinki2013e.pdf
Yadav, D., Bhandari, A., Singh, P.: LEAP: scaffolding collaborative learning of community health workers in India. Proc. ACM Hum. Comput. Interact. 3(CSCW), 1–27 (2019). https://doi.org/10.1145/3359271
Yadav, D., et al.: Sangoshthi: empowering community health workers through peer learning in rural India. In: 26th International World Wide Web Conference, WWW 2017 (2017). https://doi.org/10.1145/3038912.3052624
Yadav, D., et al.: FeedPal: understanding opportunities for chatbots in breastfeeding education of women in India. Proc. ACM Hum.-Comput. Interact. 3(CSCW), 1–30 (2019). https://doi.org/10.1145/3359272
Acknowledgments
This study was jointly funded by SERB, FICCI, and UNICEF India. We thank all the Community Healthcare Workers (Accredited Social Health Activists and Anganwadi Workers) and their supervisors who actively participated in this study. We also thank the anonymous reviewers for providing feedback.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Ethics declarations
Disclosure of Interests
The authors have no conflicts of interest.
Rights and permissions
Copyright information
© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Majhi, A., Mondal, A., Agnihotri, S.B. (2024). Replay, Revise, and Refresh: Smartphone-Based Refresher Training for Community Healthcare Workers in India. In: Stephanidis, C., Antona, M., Ntoa, S., Salvendy, G. (eds) HCI International 2024 Posters. HCII 2024. Communications in Computer and Information Science, vol 2119. Springer, Cham. https://doi.org/10.1007/978-3-031-61966-3_34
Download citation
DOI: https://doi.org/10.1007/978-3-031-61966-3_34
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-61965-6
Online ISBN: 978-3-031-61966-3
eBook Packages: Computer ScienceComputer Science (R0)