649 - Effectiveness of Interactive Voice Response for Health Worker Training in Low Resource Settings: Experimental Evidence from the Democratic Republic of the Congo (DRC)

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 649
Publication Number: 649.316

Victoria Ward, Stanford University, San Francisco, CA, United States

Presenting Author(s)

Victoria Ward, MD

Clinical Associate Professor
Stanford University
San Francisco, California, United States

Background: The COVID-19 pandemic intensified the need for providing critical and rapidly evolving health information to healthcare workers (HCWs), particularly in low-bandwidth areas with limited information access. Interactive voice response (IVR) interventions create opportunities to provide just-in-time training and clinical recommendations for those who are most vulnerable to misinformation and education gaps.

Objective: In collaboration with the Congolese Ministry of Health and the Global Vaccine Alliance (GAVI), we developed a 5-module IVR training on administration of the COVID-19 vaccine, inclusive of mitigation of misinformation inhibiting vaccine uptake, in effort to increase COVID vaccination nationally.

Design/Methods:
We conducted an RCT to measure the effects of the IVR-based training curriculum on HCWs' COVID-19 vaccine knowledge, beliefs, and preparedness in the DRC. Stratifying on geographic region and profession, we randomized participants into either a treatment arm that received the training immediately versus a control arm that would receive the training after data collection. Surveys were collected from participants via IVR-based assessments and follow-up phone surveys. We also conducted in-depth interviews with a purposive sample of treatment HCWs to better understand learners’ experiences of the IVR training for vaccine-related information.

Results:
Government HCWs were contacted for enrollment (n=8,959). Of those, 66% enrolled to participate in the training (treatment n=3,318; control n=2,604). While the rate of module completion was low (between 32-56% among those who started a course module), preliminary intention-to-treat results demonstrated a significant impact on vaccine acceptance and knowledge. For instance, those in the treatment group were significantly less likely to report vaccine hesitancy following the training curriculum compared to the control (7% vs 10%, p< 0.01) and were more likely to have accurate knowledge about vaccine administration using a 7-point knowledge test (5.01 vs 4.88, p< 0.05). Follow up phone surveys were completed amongst 1,250 enrollees (treatment n=625; control n=625) demonstrating that HCWs found the curriculum both important and useful for both their understanding of the vaccine, as well as their communication with patients and families.

Conclusion(s): Our data suggest that HCWs in very low resource areas significantly benefited from IVR-based curriculum accessible via mobile phones, particularly as it relates to mitigation of vaccine hesitancy and misinformation.