Supporting CHWs as Vaccine Educators: Impact of a Digital Training and Chatbot Intervention on Vaccination in Kenya

NCT06237374 | Active Not Recruiting

• 1 other identifier: 69793
• Study Type: interventional
• Target: 795
• Locations: 1 country
• Sites: 1

Brief Summary

This study seeks to understand how to support community health workers (CHWs) to improve routine vaccination rates in high-need areas by testing a two-part intervention. The first part of the intervention is a digital training provided to CHWs, which includes videos and job aids on vaccine education to support patient communication. The second part of the intervention is a patient-facing chatbot that CHWs can share with their patients. The chatbot is designed to answer patient questions about routine immunization. The intervention will be implemented in two sub-counties in Migori County Kenya (Awendo and Nyatike) that Lwala Community Health Alliance has identified as high need with respect to vaccine education. We hypothesize that the intervention will increase knowledge about routine immunization among CHWs and patients, increase vaccine acceptance, intent-to-vaccinate, and vaccination rates among patients in the treatment group.

Conditions

Vaccine Knowledge; Vaccine Hesitancy; Vaccine Refusal

Outcome Measures

Primary Outcomes (6)

• CHW vaccine knowledge

  Knowledge about routine childhood vaccines based on a set of 15 knowledge questions draw directly from the digital training

  Collected after roughly 1 month of exposure to the training content

• CHW vaccine beliefs

  Set of 5 Likert scale questions about beliefs about routine childhood vaccines regarding 1) the safety of childhood vaccines, 2) the effectiveness of childhood vaccines, 3) whether children should receive the new Malaria vaccine, 4) whether children receive too many vaccines, and 5) whether vaccination is compatible with one's personal beliefs.

  Collected after roughly 1 month of exposure to the training content

• CHW vaccine education preparedness

  Set of 5 Likert scale questions about preparedness to educate patients about routine childhood vaccines including 1) preparedness to answer patient questions, 2) preparedness to explain complex health topics including immunization to patients, 3) adequate access to information about vaccines and the diseases they prevent, 4) preparedness to explain the need for so many childhood vaccines, and 5) preparedness to alleviate patients' fears about vaccination.

  Collected after roughly 1 month of exposure to the training content

• Patient vaccine knowledge

  Knowledge about routine childhood vaccines based on a set of 15 knowledge questions draw directly from the digital training

  Collected roughly 4-6 months from CHW first exposure to the training content

• Patient vaccine beliefs

  Set of 5 Likert scale questions about beliefs about routine childhood vaccines regarding 1) the safety of childhood vaccines, 2) the effectiveness of childhood vaccines, 3) whether children should receive the new Malaria vaccine, 4) whether children receive too many vaccines, and 5) whether vaccination is compatible with one's personal beliefs.

  Collected roughly 4-6 months from CHW first exposure to the training content

• Patient vaccination uptake

  Vaccination uptake among patients of treatment CHWs measured by CHW records, patient self reports, and administrative health records (where available)

  Collected roughly 6 months from CHW first exposure to the training content

Secondary Outcomes (1)

• CHW perceptions of patient vaccine beliefs

  Collected after roughly 1 month of exposure to the training content

Study Arms (2)

Treatment

EXPERIMENTAL

Community health workers (CHWs) will receive the intervention training videos, job aids and chatbot tool to share with patients via WhatsApp in addition to standard CHW training provided by Lwala Community Health Alliance.

Behavioral: Digital Vaccine Education Training & Patient-facing Chatbot Tool; Behavioral: Standard Training

Control

ACTIVE COMPARATOR

Participants in the control group will receive standard community health worker (CHW) training provided by Lwala Community Health Alliance.

Behavioral: Standard Training

Interventions

Digital Vaccine Education Training & Patient-facing Chatbot Tool BEHAVIORAL

The first part of the intervention is a digital training provided to CHWs, which includes videos and job aids on vaccine education to support patient communication. The second part of the intervention is a patient-facing chatbot designed to provide key information about routine immunization that CHWs can share with their patients through the social media and messenger application, WhatsApp.

Treatment

Standard Training BEHAVIORAL

All CHWs in the study will receive the standard CHW training that is provided on an ongoing basis by Lwala Community Health Alliance.

Control; Treatment

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• CHWs identified by Lwala Community Health Alliance in study area
• Patients with children in the household of eligible age for routine immunization

You may not qualify if:

• \- Patients without children in the household of eligible age for routine immunization

Sponsors & Collaborators

• Stanford University: lead

Study Sites (1)

Lwala Community Health Alliance

Rongo, Kenya

Location

MeSH Terms

Conditions

Vaccination Hesitancy; Vaccination Refusal

Condition Hierarchy (Ancestors)

Treatment Refusal; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: The CHWs will be blinded to treatment assignment and informed that they are taking part in a study to understand the CHW experiences and their communication with patients.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Director, Stanford Center for Health Education

Model Details: This is a cluster randomized trial with baseline covariate adjustment and stratification. The randomization unit is the Community Health Unit (CHU), the administrative unit in which community health workers (CHWs) are organized in the study region. The randomization will be stratified by geographic unit (wards) and whether a health facility is located in the ward. The following baseline characteristics will be measured and adjusted for in the main analysis of primary outcomes to increase statistical efficiency: 1) age, 2) gender, 3) language, 4) years of work experience, 5) vaccine beliefs, and 6) self-reported preparedness to educate patients about vaccination.

Study Record Dates

• First Submitted: January 24, 2024
• First Posted: February 1, 2024
• Study Start: January 16, 2024
• Primary Completion: March 1, 2024
• Study Completion: August 1, 2024
• Last Updated: April 16, 2024

Record last verified: 2024-04

Locations

KE (1)