Effect of a mass radio campaign on family behaviours and child survival in Burkina Faso: a repeated cross-sectional, cluster-randomised trial

BACKGROUND

Media campaigns can potentially reach a large audience at relatively low cost but, to our knowledge, no randomised controlled trials have assessed their effect on a health outcome in a low-income country. We aimed to assess the effect of a radio campaign addressing family behaviours on all-cause post-neonatal under-5 child mortality in rural Burkina Faso.

METHODS

In this repeated cross-sectional, cluster randomised trial, clusters (distinct geographical areas in rural Burkina Faso with at least 40 000 inhabitants) were selected by Development Media International based on their high radio listenership (>60% of women listening to the radio in the past week) and minimum distances between radio stations to exclude population-level contamination. Clusters were randomly allocated to receive the intervention (a comprehensive radio campaign) or control group (no radio media campaign). Household surveys were performed at baseline (from December, 2011, to February, 2012), midline (in November, 2013, and after 20 months of campaigning), and endline (from November, 2014, to March, 2015, after 32 months of campaigning). Primary analyses were done on an intention-to-treat basis, based on cluster-level summaries and adjusted for imbalances between groups at baseline. The primary outcome was all-cause post-neonatal under-5 child mortality. The trial was designed to detect a 20% reduction in the primary outcome with a power of 80%. Routine data from health facilities were also analysed for evidence of changes in use and these data had high statistical power. The indicators measured were new antenatal care attendances, facility deliveries, and under-5 consultations. This trial is registered with ClinicalTrial.gov, number NCT01517230.

FINDINGS

The intervention ran from March, 2012, to January, 2015. 14 clusters were selected and randomly assigned to the intervention group (n=7) or the control group (n=7). The average number of villages included per cluster was 34 in the control group and 29 in the intervention group. 2269 (82%) of 2784 women in the intervention group reported recognising the campaign's radio spots at endline. Post-neonatal under-5 child mortality decreased from 93·3 to 58·5 per 1000 livebirths in the control group and from 125·1 to 85·1 per 1000 livebirths in the intervention group. There was no evidence of an intervention effect (risk ratio 1·00, 95% CI 0·82-1·22; p>0·999). In the first year of the intervention, under-5 consultations increased from 68 681 to 83 022 in the control group and from 79 852 to 111 758 in the intervention group. The intervention effect using interrupted time-series analysis was 35% (95% CI 20-51; p<0·0001). New antenatal care attendances decreased from 13 129 to 12 997 in the control group and increased from 19 658 to 20 202 in the intervention group in the first year (intervention effect 6%, 95% CI 2-10; p=0·004). Deliveries in health facilities decreased from 10 598 to 10 533 in the control group and increased from 12 155 to 12 902 in the intervention group in the first year (intervention effect 7%, 95% CI 2-11; p=0·004).

INTERPRETATION

A comprehensive radio campaign had no detectable effect on child mortality. Substantial decreases in child mortality were observed in both groups over the intervention period, reducing our ability to detect an effect. This, nevertheless, represents the first randomised controlled trial to show that mass media alone can change health-seeking behaviours.

FUNDING

Wellcome Trust and Planet Wheeler Foundation.

Radio Gaga? Intra-team communication of Australian Rules Football umpires - effect of radio communication on content, structure and frequency

Intra-team communication plays an important role in team effectiveness in various domains including sport. As such, it is a key consideration when introducing new tools within systems that utilise teams. The difference in intra-team communication of Australian Rules Football (AFL) umpiring teams was studied when umpiring with or without radio communications technology. A cross-sectional observational study was conducted to analyse the verbal communication of seven umpiring teams (20 participants) grouped according to their experience with radio communication. The results identified that radio communication technology increased the frequency and altered the structure of intra-team communication. Examination of the content of the intra-team communication identified impacts on the 'Big Five' teamwork behaviours and associated coordinating mechanisms. Analysis revealed that the communications utilised did not align with the closed-loop form of communication described in the Big Five model. Implications for teamwork models, coaching and training of AFL umpires are discussed. Practitioner Summary: Assessing the impact of technology on performance is of interest to ergonomics practitioners. The impact of radio communications on teamwork is explored in the highly dynamic domain of AFL umpiring. When given radio technology, intra-team communication increased which supported teamwork behaviours, such as backup behaviour and mutual performance monitoring.

How safe is tuning a radio?: using the radio tuning task as a benchmark for distracted driving

Drivers engage in non-driving tasks while driving, such as interactions entertainment systems. Studies have identified glance patterns related to such interactions, and manual radio tuning has been used as a reference task to set an upper bound on the acceptable demand of interactions. Consequently, some view the risk associated with radio tuning as defining the upper limit of glance measures associated with visual-manual in-vehicle activities. However, we have little knowledge about the actual degree of crash risk that radio tuning poses and, by extension, the risk of tasks that have similar glance patterns as the radio tuning task. In the current study, we use counterfactual simulation to take the glance patterns for manual radio tuning tasks from an on-road experiment and apply these patterns to lead-vehicle events observed in naturalistic driving studies. We then quantify how often the glance patterns from radio tuning are associated with rear-end crashes, compared to driving only situations. We used the pre-crash kinematics from 34 crash events from the SHRP2 naturalistic driving study to investigate the effect of radio tuning in crash-imminent situations, and we also investigated the effect of radio tuning on 2,475 routine braking events from the Safety Pilot project. The counterfactual simulation showed that off-road glances transform some near-crashes that could have been avoided into crashes, and glance patterns observed in on-road radio tuning experiment produced 2.85-5.00 times more crashes than baseline driving.

Three Perspectives on Mental Health Told through StoryCorps' "Liza Long and 'Michael'"

By examining mental illness through the lens of intimate firsthand accounts of caregivers and patients, including caregiver blogposts and a conversation between Liza Long and her son as recorded by StoryCorps, we demonstrate how new media can be leveraged to shift societal perceptions of those with mental illness from blameworthy potential perpetrators of terror to vulnerable persons in need of compassion and support. Exploring patient, caregiver, and societal roles through a close reading of new media firsthand accounts, we argue for shared responsibility in caring for those with mental illness and, in particular, for physicians to leverage their unique knowledge of the patient experience by promoting media coverage of stories of mental illness recovery.

Radiofrequency Exposures of Workers on Low-Power FM Radio Transmitters

Low-power radio transmitters are one of the most common radio frequency sources and the exposure limit values (ELVs) for occupational exposure may be exceeded close to them. Therefore, a detailed analysis and assessment of occupational exposure in their vicinity is presented in the paper. For 20 different exposure scenarios, electric field strength and specific absorption rate (SAR) values were computed to determine whether the action levels (ALs) and ELVs of the European directive 2013/35/EU are exceeded for different 500 W radio transmitters. The results show that the ALs are very conservative for such exposure situations. Even when the ALs are greatly exceeded, the SAR values are not necessarily above the limit. However, in some situations, the ELVs were also exceeded. The local 10 g averaged value of the SAR can be exceeded if the worker is grounded (in direct contact with the steel structure), while the whole body ELVs can be exceeded for exposures at distances of <1 m from the transmitting dipole array antennas.

Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial

In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59), or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A) word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16), B) radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7), or C) word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75). The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3-110.4) where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1-20.1) in control communities (rate ratio 5.9, 95% CI 2.6-13.0, p<0.0001). Attendance was also improved in women who had previously seen a traditional healer (13.0, 95% CI 5.4-31.2) compared to control (1.5, 95% CI 0.5-5.0, rate ratio 8.7, 95% CI 2.0-38.1, p = 0.004). By advertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can be motivated to attend antenatal care when offered the concrete incentive of seeing their baby.

[Occupational burnout syndrome in workers of radio and television broadcasting center.]

Occupational burnout syndrome - an important health risk factor - is seen not only in social occupations, but also in "subject-object" occupation professionals. Complex study of work conditions and health used V.V. Boiko test for assessment of emotional burnout level in radio and television broadcasting center personnel. Considerable share (53,3%) of main occupations workers in radio and television broadcasting center demonstrates high level of occupational burnout (exhaustion phase has developed or is being developed). Median total points of occupational burnout syndrome equalled 123 (74,0; is5,0) that is higher than the similar parameter for many "subject-object" occupations. Emotional defence is manifested by withdrawal from emotional show at work, increased distance in communication with colleagues, at home with relatives, avoidance of work demanding emotional charge. Longer length of service is connected with less open emotions not only in occupational sphere, but outside profession with relatives, friends. The results obtained point to predisposition for lower performance and health disturbances, necessitate consideration of this factor in complex evaluation of work conditions and health of personnel engaged in radio and television communications.

Short-term effects of announcing revised lower risk national drinking guidelines on related awareness and knowledge: a trend analysis of monthly survey data in England

OBJECTIVES

To evaluate short-term effects of publishing revised lower risk national drinking guidelines on related awareness and knowledge. To examine where drinkers heard about guidelines over the same period.

DESIGN

Trend analysis of the Alcohol Toolkit Study, a monthly repeat cross-sectional national survey.

SETTING

England, November 2015 to May 2016.

PARTICIPANTS

A total of 11 845 adults (18+) living in private households in England.

INTERVENTION

Publication of revised national drinking guidelines in January 2016 which reduced the male guideline by approximately one-third to 14 units per week.

MEASUREMENTS

Whether drinkers (1) had heard of drinking guidelines (awareness), (2) stated the guideline was above, exactly or below 14 units (knowledge) and (3) reported seeing the stated guideline number of units in the last month in each of 11 locations (exposure). Sociodemographics: sex, age (18-34, 35-64, 65+), social grade (AB, C1C2, DE). Alcohol consumption derived from graduated frequency questions: low risk (<14 units/week), increasing/high risk (14+ units/week).

RESULTS

Following publication of the guidelines, the proportion of drinkers aware of guidelines did not increase from its baseline level of 85.1% (CI 82.7% to 87.1%). However, the proportion of male drinkers saying the guideline was 14 units or less increased from 22.6% (CI 18.9% to 26.7%) in December to 43.3% (CI 38.9% to 47.8%) in January and was at 35.6% (CI 31.6% to 39.9%) in May. Last month exposure to the guidelines was below 25% in all locations except television/radio where exposure increased from 33% (CI 28.8% to 36.2%) in December to 65% (CI 61.2% to 68.3%) in January. Awareness and knowledge of guidelines was lowest in social grade DE and this gap remained after publication.

CONCLUSIONS

Publication of new or revised lower risk drinking guidelines can improve drinkers' knowledge of these guidelines within all sociodemographic groups; however, in the absence of sustained promotional activity, positive effects may not be maintained and social inequalities in awareness and knowledge of guidelines are likely to persist.

gr-MRI: A software package for magnetic resonance imaging using software defined radios

The goal of this work is to develop software that enables the rapid implementation of custom MRI spectrometers using commercially-available software defined radios (SDRs). The developed gr-MRI software package comprises a set of Python scripts, flowgraphs, and signal generation and recording blocks for GNU Radio, an open-source SDR software package that is widely used in communications research. gr-MRI implements basic event sequencing functionality, and tools for system calibrations, multi-radio synchronization, and MR signal processing and image reconstruction. It includes four pulse sequences: a single-pulse sequence to record free induction signals, a gradient-recalled echo imaging sequence, a spin echo imaging sequence, and an inversion recovery spin echo imaging sequence. The sequences were used to perform phantom imaging scans with a 0.5Tesla tabletop MRI scanner and two commercially-available SDRs. One SDR was used for RF excitation and reception, and the other for gradient pulse generation. The total SDR hardware cost was approximately $2000. The frequency of radio desynchronization events and the frequency with which the software recovered from those events was also measured, and the SDR's ability to generate frequency-swept RF waveforms was validated and compared to the scanner's commercial spectrometer. The spin echo images geometrically matched those acquired using the commercial spectrometer, with no unexpected distortions. Desynchronization events were more likely to occur at the very beginning of an imaging scan, but were nearly eliminated if the user invoked the sequence for a short period before beginning data recording. The SDR produced a 500kHz bandwidth frequency-swept pulse with high fidelity, while the commercial spectrometer produced a waveform with large frequency spike errors. In conclusion, the developed gr-MRI software can be used to develop high-fidelity, low-cost custom MRI spectrometers using commercially-available SDRs.

Symptoms in Swiss adolescents in relation to exposure from fixed site transmitters: a prospective cohort study

BACKGROUND

There is public concern regarding potential health effects of radiofrequency electromagnetic fields (RF-EMF) emitted by fixed site transmitters. We therefore investigated whether self-reported general well-being in adolescents is affected by RF-EMF exposure from mobile phone base stations (downlink) and broadcast transmitters (TV and radio).

METHODS

In a prospective cohort study, 439 study participants aged 12-17 years, completed questionnaires about their self-reported well-being and possible confounding factors at baseline and one year later. Exposure from fixed site transmitters at home and school was calculated by using a geospatial propagation model. Data were analysed using a mixed-logistic cross-sectional model of a combined dataset consisting of baseline and follow-up data and a longitudinal approach where we investigated whether exposure at baseline (cohort analysis) or changes in exposure between baseline and follow-up (change analysis) were related to a new onset of a symptom between baseline and follow-up. All analyses were adjusted for relevant confounders.

RESULTS

Mean exposure (median; 75(th)) for broadcast transmitters, downlink and total exposure at baseline were 1.9 μW/m(2) (1.0 μW/m(2); 2.8 μW/m(2)), 14.4 μW/m(2) (3.8 μW/m(2); 11.0 μW/m(2)) and 16.3 μW/m(2) (5.8 μW/m(2); 13.4 μW/m(2)), respectively. In cross-sectional analyses no associations were observed between any symptom and RF-EMF exposure from fixed site transmitters. In the cohort and change analyses only a few significant associations were observed including an increased OR for tiredness (2.94, 95%CI: 1.43 to 6.05) for participants in the top 25(th) percentile of total RF-EMF exposure from fixed site transmitters at baseline, in comparison to participants exposed below the median and a decreased OR for exhaustibility (0.50, 95%CI: 0.27 to 0.93) for participants with an exposure increase between baseline and follow-up.

CONCLUSIONS

In this cohort study, using a geospatial propagation model, RF-EMF exposure from fixed site transmitters was not consistently associated with self-reported symptoms in Swiss adolescents. The few observed associations have to be interpreted with caution and might represent chance findings.

What drives technology-based distractions? A structural equation model on social-psychological factors of technology-based driver distraction engagement

BACKGROUND

With the proliferation of new mobile and in-vehicle technologies, understanding the motivations behind a driver's voluntary engagement with such technologies is crucial from a safety perspective, yet is complex. Previous literature either surveyed a large number of distractions that may be diverse, or too focuses on one particular activity, such as cell phone use. Further, earlier studies about social-psychological factors underlying driver distraction tend to focus on one or two factors in-depth, and those that examine a more comprehensive set of factors are often limited in their analyses methods.

OBJECTIVE

The present work considers a wide array of social-psychological factors within a structural equation model to predict their influence on a focused set of technology-based distractions. A better understanding of these facilitators can enhance the design of distraction mitigation strategies.

METHOD

We analysed survey responses about three technology-based driver distractions: holding phone conversations, manually interacting with cell phones, and adjusting the settings of in-vehicle technology, as well as responses on five social-psychological factors: attitude, descriptive norm, injunctive norm, technology inclination, and a risk/sensation seeking personality. Using data collected from 525 drivers (ages: 18-80), a structural equation model was built to analyse these social-psychological factors as latent variables influencing self-reported engagement in these three technology-based distractions.

RESULTS

Self-reported engagement in technology-based distractions was found to be largely influenced by attitudes about the distractions. Personality and social norms also played a significant role, but technology inclination did not. A closer look at two age groups (18-30 and 30+) showed that the effect of social norms, especially of injunctive norm (i.e., perceived approvals), was less prominent in the 30+ age group, while personality remained a significant predictor for the 30+ age group but marginally significant for the younger group.

CONCLUSION

Findings from this work provide insights into the social-psychological factors behind intentional engagement in technology-based distractions and in particular suggesting that these factors may be sensitive to demographic differences.

Driving behaviour responses to a moose encounter, automatic speed camera, wildlife warning sign and radio message determined in a factorial simulator study

In a driving simulator study, driving behaviour responses (speed and deceleration) to encountering a moose, automatic speed camera, wildlife warning sign and radio message, with or without a wildlife fence and in dense forest or open landscape, were analysed. The study consisted of a factorial experiment that examined responses to factors singly and in combination over 9-km road stretches driven eight times by 25 participants (10 men, 15 women). The aims were to: determine the most effective animal-vehicle collision (AVC) countermeasures in reducing vehicle speed and test whether these are more effective in combination for reducing vehicle speed; identify the most effective countermeasures on encountering moose; and determine whether the driving responses to AVC countermeasures are affected by the presence of wildlife fences and landscape characteristics. The AVC countermeasures that proved most effective in reducing vehicle speed were a wildlife warning sign and radio message, while automatic speed cameras had a speed-increasing effect. There were no statistically significant interactions between different countermeasures and moose encounters. However, there was a tendency for a stronger speed-reducing effect from the radio message warning and from a combination of a radio message and wildlife warning sign in velocity profiles covering longer driving distances than the statistical tests. Encountering a moose during the drive had the overall strongest speed-reducing effect and gave the strongest deceleration, indicating that moose decoys or moose artwork might be useful as speed-reducing countermeasures. Furthermore, drivers reduced speed earlier on encountering a moose in open landscape and had lower velocity when driving past it. The presence of a wildlife fence on encountering the moose resulted in smaller deceleration.

Behavior Change After 20 Months of a Radio Campaign Addressing Key Lifesaving Family Behaviors for Child Survival: Midline Results From a Cluster Randomized Trial in Rural Burkina Faso

BACKGROUND

In Burkina Faso, a comprehensive 35-month radio campaign addressed key, multiple family behaviors for improving under-5 child survival and was evaluated using a repeated cross-sectional, cluster randomized design. The primary outcome of the trial was postneonatal under-5 child mortality. This paper reports on behavior change achieved at midline.

METHOD

Fourteen community radio stations in 14 geographic areas were selected based on their high listenership. Seven areas were randomly allocated to receive the intervention while the other 7 areas served as controls. The campaign was launched in March 2012. Cross-sectional surveys of about 5,000 mothers of under-5 children, living in villages close to the radio stations, were conducted at baseline (from December 2011 to February 2012) and at midline (in November 2013), after 20 months of campaigning. Statistical analyses were based on cluster-level summaries using a difference-in-difference (DiD) approach and adjusted for imbalances between arms at baseline. In addition, routine health facility data were analyzed for evidence of changes in health facility utilization.

RESULTS

At midline, 75% of women in the intervention arm reported recognizing radio spots from the campaign. There was some evidence of the campaign having positive effects on care seeking for diarrhea (adjusted DiD, 17.5 percentage points; 95% confidence interval [CI], 2.5 to 32.5; P= .03), antibiotic treatment for fast/difficult breathing (adjusted DiD, 29.6 percentage points; 95% CI, 3.5 to 55.7; P= .03), and saving money during pregnancy (adjusted DiD, 12.8 percentage points; 95% CI, 1.4 to 24.2; P= .03). For other target behaviors, there was little or no evidence of an impact of the campaign after adjustment for baseline imbalances and confounding factors. There was weak evidence of a positive correlation between the intensity of broadcasting of messages and reported changes in target behaviors. Routine health facility data were consistent with a greater increase in the intervention arm than in the control arm in all-cause under-5 consultations (33% versus 17%, respectively), but the difference was not statistically significant (P= .40).

CONCLUSION

The radio campaign reached a high proportion of the primary target population, but the evidence for an impact on key child survival-related behaviors at midline was mixed.

Media Influence on Sexual Activity and Contraceptive Use: A Cross Sectional Survey among Young Women in Urban Nigeria

This study assessed the relationship between recent exposure to family planning (FP) messages in the media (newspaper, radio, television, and mobile phones) and use of modern contraceptive methods among women aged 15-24 years living in six cities in Nigeria. Logistic regression models were used to predict recent media exposure to FP messages and its association with sexual experience and modern contraceptive method use. About 45% of our sample had ever had sex with only a quarter of them using a modern contraceptive method at the time of survey. Approximately 71% of our sample was exposed to FP messages in the media within the three months preceding the survey. The main sources of media exposure were mobile phones (48%), radio (37%), and television (29%). Controlling for relevant factors, recent media exposure to FP messages predicted both sexual experience and use of modern contraceptive methods, although there were city-level differences.

Using wearable UWB radios to measure foot clearance during walking

Foot clearance above ground is a key factor for a better understanding of the complicated relationship between falls and gait. This paper proposes a wearable system using UWB transceivers to monitor the vertical heel/toe clearance during walking. First, a pair of very small and light antennas is placed on a point approximating to the heel/toe of the foot, acting as a transmitter and receiver. Then, the reflected signal from ground is captured and propagation delay is detected using noise suppressed Modified-Phase-Only-Correlator (MPOC). The performance of the UWB-based system was compared with an ultrasound system for stationary movements. The experimental results show that an overall mean difference between these two systems is about 0.634mm with correlation coefficient value of 0.9604. The UWB-based system is then used to measure foot clearance during walking which shows promising results for gait events detection.