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

Ichhya Pant; Rajiv Rimal; Hagere Yilma; Jeffrey Bingenheimer; Erica Sedlander; Sibabrata Behera

doi:10.2196/26252

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

JMIR Res Protoc. 2021 Nov 22;10(11):e26252. doi: 10.2196/26252.

Authors

Ichhya Pant¹, Rajiv Rimal², Hagere Yilma¹, Jeffrey Bingenheimer¹, Erica Sedlander¹, Sibabrata Behera³

Affiliations

¹ Department of Prevention and Community Health, School of Public Health, George Washington University, Washington, DC, United States.
² Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
³ DCOR Inc, Bhubaneshwar, Odisha, India.

PMID: 34812735
PMCID: PMC8663628
DOI: 10.2196/26252

Abstract

Background: More 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.

Objective: This 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.

Methods: Mobile 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.

Results: Data 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.

Conclusions: This 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.

Keywords: anemia; bystander; education; entertainment; interactive; mHealth; rural; violence against women; voice response.

©Ichhya Pant, Rajiv Rimal, Hagere Yilma, Jeffrey Bingenheimer, Erica Sedlander, Sibabrata Behera. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 22.11.2021.