Tutorial videos are as effective as in-person training for improving community volunteers' knowledge for implementing emotional demonstrations on breastfeeding practices

Summary:

Since 2018, Global Alliance for Improved Nutrition supports the Government of Indonesia in scaling-up the implementation of emotional demonstrations (emo-demo) to improve breastfeeding and complementary feeding practices. Emo-demos are short, interactive sessions which intend to create habits by triggering association of drivers, emotions, or interests with specific behaviours. Emo-demos intend to reach 448,000 caregivers by 2021; however, in-person trainings of health volunteers (cadres) in charge of their implementation are costly and limit scale-up. The objective of this study is to compare the effectiveness of tutorial videos vs in-persons training in improving knowledge of cadres on breastfeeding emo-demos. GAIN developed 5-minute tutorial videos; each explaining how to implement a specific emo-demo. We then defined 4 different training groups: G1 viewed tutorial videos once; G2 twice and G3 thrice. G4 received an in-person training with practice sessions and were not exposed to any videos. All groups received the same printed materials. We found that cadres who watched the tutorial videos twice or thrice (G2,G3) had significantly higher knowledge on all 3 emo-demos than those who participated in the in-person training (G4). In addition, cadres who received training by watching tutorials 2 or 3 times (G2 and G3) had consistently higher knowledge on all emo-demos compared to those who watched the tutorials once. In contexts where technological resources and skills have been assessed and are available, virtual trainings can be an effective way of improving knowledge of health volunteers.

Background/Objectives:

Since 2018, Global Alliance for Improved Nutrition supports Government of Indonesia in scaling up implementation of emotional demonstrations (emo-demo) to improve breastfeeding and complementary feeding practices. Emo-demos are short, interactive sessions aiming to create habits by triggering association of drivers, emotions, or interests with specific behaviours. Community volunteers (cadres) conduct these sessions during growth monitoring sessions. Emo-demos intend to reach 448,000 caregivers by 2021; however, in-person trainings are costly and limit scale-up. This study aims to compare the effectiveness of tutorial videos vs in-persons training in improving knowledge of cadres on breastfeeding emo-demos.

Description of Intervention and/or Methods/Design:

GAIN developed eleven 5-minute tutorial videos; each explaining how to implement a specific emo-demo. We then defined 4 different training groups: G1 viewed the tutorial videos once; G2 twice and G3 thrice. G4 received a one-day, in-person training with practice sessions and were not exposed to any videos. All groups received the same printed materials. We conducted post-tests to assess cadre's knowledge on 3 breastfeeding emo-demos for each group. Each post-test had 10 question about process of conducting the emo-demo and the key messages to promote during each session, with total knowledge score ranging from to 10. Kruskal Wallis and Mann-Whitney U tests were conducted to examine difference on cadre's knowledge related to all 3 emo-demos among the 4 training groups. In addition, we examined if there were differences in knowledge related to frequency of tutorial views (G1-G3).

Results/Lessons Learned:

Cadres who watched the tutorial videos twice or thrice (G2,G3) had significantly higher knowledge on all 3 emo-demos than those who participated in the in-person training (G4) (8.51 1.31 for G2, 8.60 1.37 for G3 vs 8.31 1.30 for G4, p< 0.002). Cadres who watched the videos once had similar knowledge to those who attended the in-person training (8.27 1.57 vs 8.31 1.30, p=0.514). When examining whether there were differences in knowledge by frequency of views (G1 vs G2 vs G3), we found that cadres who received training by watching tutorials 2 or 3 times (G2 and G3) had consistently higher knowledge on all emo-demos compared to those who watched the tutorials once (G1) (p< 0.016).

Discussion/Implications for the Field:

Tutorial videos are as effective as in-person training for improving cadres' knowledge on breastfeeding emo-demos. Despite being preliminary, un-adjusted results, these are promising for the adoption and use of virtual or blended training methods for the scale-up of emo-demos in Indonesia. Next steps will be to conduct adjusted analysis and explore the effects of the different training modalities on skills for implementing the emo-demos. In contexts where technological resources and skills have been assessed and are available, virtual trainings can be an effective way of improving knowledge of health volunteers.

Abstract submitted by:

Agnes Mallipu - The Global Alliance for Improved Nutrition (GAIN)
Ardhiani Dyah Priamsari - GAIN
Nindya Putri Pamungkas - GAIN
Vitria Dewi - GAIN
Wendy Gonzalez - GAIN