mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention

BackgroundMore than half of the women of reproductive age (aged 15-49 years) are anemic in India. The uptake of and adherence to iron folic acid (IFA) supplements remain low despite sustained efforts to increase their use. With India’s burgeoning digital environment, mobile p...

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Main Authors: Ichhya Pant, Rajiv Rimal, Hagere Yilma, Jeffrey Bingenheimer, Erica Sedlander, Sibabrata Behera
Format: Article
Language:English
Published: JMIR Publications 2021-11-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2021/11/e26252
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author Ichhya Pant
Rajiv Rimal
Hagere Yilma
Jeffrey Bingenheimer
Erica Sedlander
Sibabrata Behera
author_facet Ichhya Pant
Rajiv Rimal
Hagere Yilma
Jeffrey Bingenheimer
Erica Sedlander
Sibabrata Behera
author_sort Ichhya Pant
collection DOAJ
description BackgroundMore than half of the women of reproductive age (aged 15-49 years) are anemic in India. The uptake of and adherence to iron folic acid (IFA) supplements remain low despite sustained efforts to increase their use. With India’s burgeoning digital environment, mobile phones offer a potential medium for increasing their uptake, especially when combined with interactive voice messages that deliver entertaining stories infused with norms-based educational messages. ObjectiveThis study aims to investigate whether a norms-based entertainment education mobile health intervention can increase self-efficacy for IFA adherence among women of reproductive age in Odisha, India. MethodsMobile reduction in anemia through normative innovations (mRANI) is a randomized 2-arm study that includes assessments before and after the intervention. All study participants will be recruited from the intervention arm of the parent reduction in anemia through normative innovations trial only. Although the usual practice is to randomize participants either to a treatment arm or a usual care control arm, we will assign the mRANI control group to another entertainment education–based treatment group that is designed to improve bystander intervention to reduce violence against women. Data collection for the mRANI study is embedded in the parent trial and will include baseline and end line assessments. The primary outcomes are self-efficacy for IFA adherence and violence against women–related bystander intervention. The inclusion criteria for the mRANI study are participation in the parent trial and phone ownership. Women (approximately n=400) who meet the mRANI inclusion criteria will be randomly assigned to the IFA arm or the bystander arm. Ordinary least squares regression with robust SEs will be conducted to assess between-group comparisons at the end line. A mediation analysis will be conducted to examine whether social norms and interactivity mediate the relationship between intervention exposure and primary outcomes in both arms. Real-time monitoring data will offer insights into intervention receptivity and audience engagement. ResultsData collection for the mRANI study is integrated within the parent trial. Household surveys were conducted between February and March of 2021. Responses on the mRANI study’s primary and secondary outcomes were collected from 381 participants. The data analysis is expected to be completed by October 2021. ConclusionsThis study will provide evidence on whether a mobile health norms–based entertainment education intervention can increase self-efficacy for IFA adherence and violence against women–related bystander intervention. International Registered Report Identifier (IRRID)PRR1-10.2196/26252
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spelling doaj.art-0d4147497871422dbc9b10258235f0122023-08-28T19:48:52ZengJMIR PublicationsJMIR Research Protocols1929-07482021-11-011011e2625210.2196/26252mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual InterventionIchhya Panthttps://orcid.org/0000-0002-2521-6292Rajiv Rimalhttps://orcid.org/0000-0003-1413-9305Hagere Yilmahttps://orcid.org/0000-0002-4042-3484Jeffrey Bingenheimerhttps://orcid.org/0000-0002-1427-0402Erica Sedlanderhttps://orcid.org/0000-0002-5128-669XSibabrata Beherahttps://orcid.org/0000-0002-2551-031X BackgroundMore than half of the women of reproductive age (aged 15-49 years) are anemic in India. The uptake of and adherence to iron folic acid (IFA) supplements remain low despite sustained efforts to increase their use. With India’s burgeoning digital environment, mobile phones offer a potential medium for increasing their uptake, especially when combined with interactive voice messages that deliver entertaining stories infused with norms-based educational messages. ObjectiveThis study aims to investigate whether a norms-based entertainment education mobile health intervention can increase self-efficacy for IFA adherence among women of reproductive age in Odisha, India. MethodsMobile reduction in anemia through normative innovations (mRANI) is a randomized 2-arm study that includes assessments before and after the intervention. All study participants will be recruited from the intervention arm of the parent reduction in anemia through normative innovations trial only. Although the usual practice is to randomize participants either to a treatment arm or a usual care control arm, we will assign the mRANI control group to another entertainment education–based treatment group that is designed to improve bystander intervention to reduce violence against women. Data collection for the mRANI study is embedded in the parent trial and will include baseline and end line assessments. The primary outcomes are self-efficacy for IFA adherence and violence against women–related bystander intervention. The inclusion criteria for the mRANI study are participation in the parent trial and phone ownership. Women (approximately n=400) who meet the mRANI inclusion criteria will be randomly assigned to the IFA arm or the bystander arm. Ordinary least squares regression with robust SEs will be conducted to assess between-group comparisons at the end line. A mediation analysis will be conducted to examine whether social norms and interactivity mediate the relationship between intervention exposure and primary outcomes in both arms. Real-time monitoring data will offer insights into intervention receptivity and audience engagement. ResultsData collection for the mRANI study is integrated within the parent trial. Household surveys were conducted between February and March of 2021. Responses on the mRANI study’s primary and secondary outcomes were collected from 381 participants. The data analysis is expected to be completed by October 2021. ConclusionsThis study will provide evidence on whether a mobile health norms–based entertainment education intervention can increase self-efficacy for IFA adherence and violence against women–related bystander intervention. International Registered Report Identifier (IRRID)PRR1-10.2196/26252https://www.researchprotocols.org/2021/11/e26252
spellingShingle Ichhya Pant
Rajiv Rimal
Hagere Yilma
Jeffrey Bingenheimer
Erica Sedlander
Sibabrata Behera
mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention
JMIR Research Protocols
title mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention
title_full mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention
title_fullStr mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention
title_full_unstemmed mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention
title_short mHealth for Anemia Reduction: Protocol for an Entertainment Education–Based Dual Intervention
title_sort mhealth for anemia reduction protocol for an entertainment education based dual intervention
url https://www.researchprotocols.org/2021/11/e26252
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