Leveraging Community Health Workers to Combat COVID-19 and Mental Health Misinformation in Haiti, Malawi, and Rwanda

NCT05997511 | Active Not Recruiting

• 1 other identifier: IRB22-1339
• Study Type: interventional
• Target: 5,109
• Locations: 3 countries
• Sites: 3

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.

Conditions

Mental Health; COVID-19; Misinformation

Keywords

COVID-19; Mental Health; Misconception; Community Health Workers (CHWs)

Outcome Measures

Primary Outcomes (3)

• Number of Mental Health Visits/ Consultations Completed Monthly at Health Facilities

  Mental health service utilization will be measured using routinely collected data measured monthly at the health facility level

  24 months

• Number of Patients who Sought Care from Mental Health Services Monthly at Health Facilities

  Mental health service utilization will be measured using routinely collected data measured monthly at the health facility level

  24 months

• Number of COVID-19 Vaccine Doses Administered Monthly at Health Facilities (if available)

  COVID-19 Vaccine administration will be measured using routinely collected data measured monthly at the health facility level

  24 months

Secondary Outcomes (3)

• Qualitative Interviews

  Before, after 6 months of the intervention, and after 12 months of the intervention (only in Rwanda & Haiti)

• Longitudinal Cohort Surveys

  Before, after 6 months of the intervention, and after 12 months of the intervention (only in Rwanda & Haiti)

• Cross-Sectional Survey

  Before the intervention and after 12 months of the intervention (only in Rwanda & Haiti)

Study Arms (2)

COVID-19

OTHER

Behavioral (SMS) Intervention

Behavioral: Card-Sorting Activity (Pre-intervention design); Behavioral: SMS Crafting (Pre-intervention design); Behavioral: SMS Messaging

Mental Health

OTHER

Behavorial (SMS) Intervention

Behavioral: Card-Sorting Activity (Pre-intervention design); Behavioral: SMS Crafting (Pre-intervention design); Behavioral: SMS Messaging

Interventions

Card-Sorting Activity (Pre-intervention design) BEHAVIORAL

Study team members within each country will free list misinformation or misconceptions that they commonly encounter in clinical practice or daily life. Each item will be used to create paired cards - one containing the misinformation and a second containing the corresponding correct information. During qualitative interviews, we will ask CHWs to participate in a series of card sorting activities, which is a participatory research method that can inform the design of health interventions.

COVID-19; Mental Health

SMS Crafting (Pre-intervention design) BEHAVIORAL

A two-person team consisting of one local communication expert and one clinician will draft clinically correct, easy-to-understand SMS messages designed to counter identified misinformation. We will draft messages that use various styles and use cognitive interviewing with CHWs to assess their understanding of and responses to each style. The final messages used in our intervention will be determined by CHW preference.

COVID-19; Mental Health

SMS Messaging BEHAVIORAL

Final messages will be sent via SMS to all CHWs working in our study area. CHWs will also be provided with contact information for a helpline staffed by a local team member who can answer follow-up questions in the local language.

Also known as: text messaging

COVID-19; Mental Health

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• CHWs affiliated with PIH Rwanda, Malawi, or Haiti
• + years of age.

You may not qualify if:

• \- Less than 18 years old.

Sponsors & Collaborators

• Harvard Medical School (HMS and HSDM): lead
• Partners in Health: collaborator

Study Sites (3)

Zanmi Lasante

Cangé, Haiti

Location

Partners in Health- Malawi

Neno, Malawi

Location

Partners in Health- Rwanda

Kigali, Rwanda

Location

MeSH Terms

Conditions

Psychological Well-Being; COVID-19; Communication

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior; Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Our study will use a cluster- randomized design with two active arms - one arm targeting COVID-19-related misinformation and a second arm targeting misinformation related to mental health.

Study Record Dates

• First Submitted: July 22, 2023
• First Posted: August 18, 2023
• Study Start: November 27, 2023
• Primary Completion: January 31, 2025
• Study Completion: January 31, 2025
• Last Updated: June 24, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will not share

Locations

MA (1); RW (1); HA (1)