The mCME Project:Delivering Continuing Medical Education for Community Health Workers Via SMS Text Messages

Study Overview
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Brief Summary
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Community health workers (CHWs) provide essential basic medical care to hundreds of millions of people across the globe. CHWs offer a myriad of services including community sanitation, breast feeding counseling, family planning, management of febrile children, and malaria control and prevention, to name but a few. In fact, CHWs are often the only source of primary health care available to some of the most disadvantaged populations in the world. However, to be effective, CHWs must be trained - and retrained - at regular intervals, and the costs for such trainings can be substantial. In the US, clinicians are required to stay current and maintain their competence through continuing medical education (CME). Increasingly, CME activities are delivered via internet-based, self-teaching modules. A typical example would be a set of topical readings followed by multiple-choice questions, with the answers, and CME credit, provided to the user upon satisfactory completion of the module. This content is typically delivered over the Internet. However, there is no intrinsic reason why this approach could not be adapted so that CME activities are delivered using standard cell phones via SMS text messaging. This would significantly expand professional training opportunities to a far greater range of CHWs than possible through computer/tablet/smart phone platforms, and would be particularly valuable in poorer countries with limited training budgets. In the mCME project, the investigators propose to test the effectiveness and cost effectiveness of a mobile phone-based CME delivery strategy among Vietnamese community-based physician assistants (CBPAs), a cadre of CHW mandated to provide primary health care to rural and disadvantaged populations. The investigators hypothesize that providing CME activities over a mobile platform will significantly improve their professional knowledge, and may also improve their job satisfaction and self-efficacy.

Official Title
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The mCME Project:Delivering Continuing Medical Education for Community Health Workers Via SMS Text Messages

Conditions
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Medical Knowledge

Intervention / Treatment
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* Behavioral: Group 2 intervention daily SMS bullet point
* Behavioral: Group 3 intervention daily SMS bullet point


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Graduated from a CBPA training program Possesses their own cell phone Phone able to send/receive text messages Aged 18 years or older Exclusion Criteria: Unwilling to sign informed consent Lives/operates in an area without cellular coverage Unwilling to be randomized Unwilling to adhere to study procedures

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Group 1<br>Weekly non-medical SMS messages | |
| Experimental: Group 2<br>Receipt of a daily SMS text message describing various aspects of clinical practice | Behavioral: Group 2 intervention daily SMS bullet point<br>* Group 2 subjects receive a daily SMS bullet point, summarizing a key clinical point pertinent to the CBPA's daily work.<br>* Other names: non interactive model CME;|
| Experimental: Group 3<br>Receipt of a daily SMS text message describing various aspects of clinical practice, but phrased as multiple choice question | Behavioral: Group 3 intervention daily SMS bullet point<br>* Group 3 subjects receive a c phrased as a multiple choice question. The content mirrors that of group 2, but is presented as a question to render it interactive<br>* Other names: Interactive model CME;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Medical knowledge (Score on medical knowledge exams) | Score on medical knowledge exams administered at baseline and at the end of six months of the intervention | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Job satisfaction (Score on likert scale) | Score on likert scale measuring job satisfaction | 6 months | 
| Self efficacy (Score in likert scale) | Score in likert scale measuring self efficacy | 6 months |