R21TW012612

Using adaptive e-learning and smartphones to improve newborn and pediatric admission care outcomes in Mwanza, Tanzania - Project summary/abstract:

In sub-Saharan Africa, low quality care at health facilities contributes to over 1 million child deaths each year.

Provider knowledge is a major contributor, but conventional provider educational methods have proven limited due to fixed, universal content; limited geographical reach; and no refresher learning over time.

Our long-term goal is to develop a highly effective education strategy to increase provider proficiency with evidence-based interventions that can be scaled-up worldwide.

To this end, we have piloted a novel adaptive eLearning (Electronic media and devices that adjust to the learner’s needs) intervention called PACE.

The overall objectives of this application are to 1) determine the effect of incorporating tailored skills practice and rapid content development process into PACE and 2) finalize an implementation strategy for PACE, including measures of provider performance and patient outcomes at all facility types in Mwanza, Tanzania.

The central hypothesis is that adaptive eLearning blended with in-person skills training that is continuously contextualized to facility needs will increase the quality of care.

Our pilot studies of PACE have shown significant improvement in provider knowledge rates, providing the rationale that adaptive eLearning represents a potential solution to overcome known limitations of current educational methods to greatly increase the impact of education on provider proficiency.

The specific aims of our two phased approach will: 1) determine if the addition of tailored skills training increases refresher knowledge assignment completion >60% (R21); 2) determine whether rapid content development process using Tanzanian based personnel can disseminate content within 90 days (R21); 3) validate whether PACE implementation is feasible across all facility types (R33); and 4) establish and validate a system to derive provider specific pediatric admission quality of care (PAQC) scores for future PACE effectiveness study.

In our R21, we will recruit clinical champions to conduct tailored skills practice at health centers, recruit a local content engineer (CE) and initiate quarterly meetings with multi-level leadership to continuously contextualize PACE to facility needs.

For the R33, we will expand PACE to all facility types and explore generating provider specific PAQC scores using both electronic health record data extraction and prospective clinical auditing.

Our innovative mixed methods approach will provide a significant framework for the optimal integration of eLearning into tailored skills trainings and clinical auditing for providers in LMICs.

Development of an effective pediatric acute care provider education strategy and system to derive provider level performance and patient outcome metrics will build a foundation for a large-scale implementation study in Tanzania.

If successful, this work will improve child global health significantly and broadly advance our knowledge and understanding of provider education and quality of care worldwide.

The Leland Stanford Junior University

THE JOHN E. FOGARTY INTERNATIONAL CENTER (FIC) SUPPORTS RESEARCH AND RESEARCH TRAINING TO REDUCE DISPARITIES IN GLOBAL HEALTH AND TO FOSTER PARTNERSHIPS BETWEEN U.S. SCIENTISTS AND THEIR COUNTERPARTS ABROAD. FIC SUPPORTS BASIC BIOLOGICAL, BEHAVIORAL, AND SOCIAL SCIENCE RESEARCH, AS WELL AS RELATED RESEARCH TRAINING AND CAREER DEVELOPMENT. THE RESEARCH PORTFOLIO IS DIVIDED INTO SEVERAL PROGRAMS THAT SUPPORT A WIDE VARIETY OF FUNDING MECHANISMS TO MEET PROGRAMMATIC OBJECTIVES.

93.989 - International Research and Research Training

Fogarty International Center (FIC) [HHS - NIH]

Stanford, California 943052004 United States

Single Zip Code

Mobile Health: Technology and Outcomes in Low and Middle Income Countries (R21/R33 - Clinical Trial Optional) (PAR-23-318)

Amendment Since initial award the total obligations have increased 89% from $174,511 to $330,651.