Zanzibar Arts for Children's Eyesight Pilot Trial
NCT Number: NCT06469697
Acronym: ZANZI-ACEII
Status: ACTIVE_NOT_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Myopia|Conjunctivitis|Hyperopia
Interventions: BEHAVIORAL: School music broadcast|BEHAVIORAL: Community music broadcast
Sponsor: Queen's University, Belfast
Collaborators: Ministry of Health and Social Welfare, Zanzibar
Sex: ALL
Age: CHILD, ADULT, OLDER_ADULT
Enrollment: 1600
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (CARE_PROVIDER)|Primary Purpose: PREVENTION
Start Date: 2024-01-15
Completion Date: 2025-01-15
Locations: Ministry of Health, Zanzibar, Tanzania

Summary:
In Zanzibar, around 22,000 children (4% of those aged 6 to 12) need treatment for eye issues like conjunctivitis or require glasses. A 2017 study found that 42% of rural children needing glasses didn't have them. Many locals distrust Western medicine and prefer traditional remedies, rejecting public health efforts such as posters and brochures.

Globally, eye health promotion has been underfunded and overlooked. Research suggests community-designed interventions and behavior change studies are needed to promote sustainable eye health practices. Arts-based interventions using traditional storytelling and performances have been effective in Africa, improving health outcomes in areas like food hygiene and mental health. Health campaigns in schools might be less effective since parents make health decisions for their children.

This study aims to see how well using both traditional and modern music performances in an eye health education program can break down cultural barriers and increase children's use of eye health services in schools and communities. The investigators want to answer three main questions:

1. How effective is a 6-month music-based eye health education program in schools and communities at improving eye health knowledge and service use among parents and children?
2. What factors influenced the success of the 6-month music-based eye health education program?
3. What are the costs and benefits of this 6-month program in increasing eye health service use among children in schools and communities?

Primary Outcome Measures: Change in the proportion of children accessing eye health services, Proportion of children who have gone for eye treatment at the referral sites over those who failed eye health screening and referred to the referral site; measured in percentage, the higher the percentage the better the referral rate, Three months and six months after the intervention is implemented
Secondary Outcome Measures: Children spectacle compliance, Possession of glasses at school during an unannounced examination will be measured as either yes or no. A higher proportion of "yes" responses indicates better compliance., Three months and six months after the intervention is implemented|Children eye drops usage compliance, Self-reported completion of eye drop treatment will be measured as either yes or no. A higher proportion of "yes" responses indicates better compliance., Three months and six months after the intervention is implemented|Cost-benefit analysis, Costs will be measured by the program expenses, while benefits will be assessed by the proportion of children who voluntarily seek eye treatment at referral sites compared to those who failed the eye health screening and were referred. A higher proportion of treated children per US dollar spent indicates a higher cost-benefit ratio., Through study completion, 6 months after the intervention is implemented.|Parents knowledge and attitude, A 27-item questionnaire will be used for measurement. Each question requires a yes or no response. A higher number of "yes" answers indicates better knowledge and attitude., Three months and six months after the intervention is implemented|Children's knowledge and attitude, A 27-item questionnaire will be used for measurement. Each question requires a yes or no response. A higher number of "yes" answers indicates better knowledge and attitude., Three months and six months after the intervention is implemented|Cost effectiveness analysis, Cost will be measured by the program expenses, while effectiveness will be assessed using the Visual Analogue Scale (EQ-5Q-Y questionnaire). A higher score per US dollar indicates greater cost-effectiveness., Through study completion, 6 months after the intervention is implemented.