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Abstract
We developed the Informed Health Choices podcast to improve people’s ability to assess claims about the effects of treatments. We evaluated the effects of the podcast in a randomised trial.
Objectives We conducted this process evaluation to assess the fidelity of the intervention, identify factors that affected the implementation and impact of the intervention and could affect scaling up, and identify potential adverse and beneficial effects.
Setting The study was conducted in central Uganda in rural, periurban and urban settings.
Participants We collected data on parents who were in the intervention arm of the Informed Health Choices study that evaluated an intervention to improve parents’ ability to assess treatment effects.
Procedures We conducted 84 semistructured interviews during the intervention, 19 in-depth interviews shortly after, two focus group discussions with parents, one focus group discussion with research assistants and two in-depth interviews with the principal investigators. We used framework analysis to manage qualitative data, assessed the certainty of the findings using the GRADE-CERQual (Grading of Recommendations, Assessment, Development and Evaluations-Confidence in the Evidence from Reviews of Qualitative Research) approach, and organised findings in a logic model.
Outcomes Proportion of participants listening to all episodes; factors influencing the implementation of the podcast; ways to scale up and any adverse and beneficial effects.
Results All participants who completed the study listened to the podcast as intended, perhaps because of the explanatory design and recruitment of parents with a positive attitude. This was also likely facilitated by the podcast being delivered by research assistants, and providing the participants with MP3 players. The podcast was reportedly clear, understandable, credible and entertaining, which motivated them to listen and eased implementation. No additional adverse effects were reported.
Conclusions Participants experienced the podcast positively and were motivated to engage with it. These findings help to explain the short-term effectiveness of the intervention, but not the decrease in effectiveness over the following year.
- process evaluation
- fidelity
- podcast
- barriers
- facilitators
- scaling-up
- adverse effects
- critical appraisal
- evidence-informed decision-making
- edutainment
- health communication
- media interventions
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Footnotes
Twitter @Dansemakula, @AllenNsangi
Contributors DS is the principal investigator. He drafted the protocol with input from all the other coauthors and was responsible for planning and data collection. DS, AN, AO, AAD, CG, SL, MK, MO, SR, AAD, AF and NS participated in the planning of the study. DS and AN collected the data and led the data analysis; CJR conducted the quantitative data analysis; AO, CG, SL, MK, MO, SR, AAD, AF and NS participated in the analyses, interpretation and organisation of findings. DS wrote the first draft of the manuscript. All of the authors reviewed and commented on earlier drafts and contributed to the final manuscript. All authors reviewed and approved the final version of the manuscript.
Funding This trial was funded by the Research Council of Norway, Project number 220603/H10.
Competing interests DS is a medical doctor, epidemiologist and health services researcher. AN is a social scientist. Having developed the intervention and interviewed participants about it, it is possible that our involvement in both processes might have in some way influenced how we asked questions or our interpretation of the responses. It is not known at this point whether indeed this occurred and the effect this might have on the participants’ responses.
Patient and public involvement statement Included within the text of the manuscript
Patient consent for publication Consent for publication of findngs in reports and or presentations was sought as part of the informed consent process for study participation. Additional consent for publication of participant-identifiable material was not required.
Ethics approval Participants who were invited to participate in the process evaluation were informed of the purpose of their participation before written permission was obtained. Participants in the trial consented for both the initial assessment and the 1-year follow-up at the beginning of the study. Only consenting participants were included. The study was approved by Makerere University Institutional Review Board and the Uganda National Council of Science and Technology as part of the Supporting Informed Healthcare Choices in Low-income Countries Project (Grant no. ES498037).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.