Evaluation of a learner-produced photocomic in South Africa

Preventing HIV Transmission along the Trans-Africa Highway in Kenya: Using Persuasive Message Theory in Formative Education

Although HIV infection is now seen as pandemic in many parts of Africa, little is known about existing perceptions and knowledge regarding the disease or about the use of preventive measures among groups with the highest infection rates. Further, many call for theoretically-based formative evaluations and interventions, yet few appear to utilize theory to determine perceptions and knowledge and to evaluate existing campaigns. This project reports the results of a theoretically-based formative evaluation conducted with commercial sex workers, truck drivers and their assistants, and young men at three truck stops along the Trans-Africa Highway in Kenya. The theoretical basis for the project was the Extended Parallel Process Model (EPPM), a health risk message theory. Results indicate that the participants appear to have high levels of knowledge and threat, coupled with apparent low levels of efficacy. According to the theoretical perspective used, these results suggest that participants may be putting themselves at risk for HIV infection.

Evaluation of a photo-poster on nurses' perceptions of teething problems in South-western Nigeria

BACKGROUND

Health problems commonly associated with the eruption of teeth in babies continue to pose problems in Nigeria. Even nurses who should be well informed have misconceived views. In order to enlighten mothers and healthcare workers on this issue, a photo-poster was developed as a health-education tool. The objective of this study was to assess the effect of the poster, displayed in the workplace for 18 months, on the knowledge, attitude and reported practice of nurses. The study also aimed to assess the outcome of the inclusion of the photo-poster in training materials in a workshop setting.

METHODS

The study was conducted in two parts. In the first part, 542 nurses working in children's units within the city of Ibadan, South-western Nigeria were selected using a stratified sampling technique. A questionnaire was used to gather information on their perceptions of teething problems at baseline. Photo-posters were displayed in the nurses' workplaces for 18 months, and a follow-up survey was conducted using the same questionnaire. In the second part of the study, two groups of nurses (n = 21 and n = 18 nurses) working in similar healthcare facilities in Ibadan participated in two separate workshops. One workshop used the photo-poster in addition to the standard educational materials, and the other workshop did not. Percentage differences between pre- and postintervention responses to perceived health problems were calculated. Intervention effects were the differences between the percentage changes in the intervention (with poster) and comparison (without poster) groups. Statistical differences were determined by Chi-squared test or one-tailed t-test, as appropriate.

RESULTS

Five hundred and forty-two nurses (519 female and 23 male) completed the questionnaire survey at baseline and 403 (371 female and 32 male) at follow-up. Their ages ranged between 23 and 56 years, with the greatest percentage aged 25-40 years. At baseline, many respondents indicated that several of the listed health problems were a consequence of tooth eruption. After exposure to the posters at their workplace for 18 months, there were slight changes in their opinions but most were not statistically significant (P > 0.05). The use of posters in a workshop setting revealed percentage changes ranging from -11 to 61% for the different associated health problems. Many of these changes were statistically significant (P < 0.05).

CONCLUSION

Displaying photo-posters in the workplace did little to change nurses' perceptions of teething problems; the posters had more influence when they were used in an instructional, interactive atmosphere. It is recommended that the use of photo-posters in health education for such culturally entrenched health issues should be accompanied by discussion of the same subject wherever possible.

Developing Photo-Posters for Health Education on Perceived Teething Problems in Nigeria

The development of photo-posters to educate the Nigerian community on the perceived problems of teething was prompted by research findings which revealed that misconceptions about teething were widespread within the populace and in particular among some health professionals. Studies have shown that 58% of ethnic Yoruba rural dwellers in Nigeria attributed ailments to the teething process, while 70% of market women in Enugu State perceived diarrhea in their children was due to teething. In a recent survey, 61.4% of nurses believed diarrhea should accompany the teething process. Furthermore 82.1%, 35.8%, and 27.9% of them implicated fever, weight loss, and boils respectively as signs of teething. Photo-posters adopt the use of visual representation of a problem and the goal of using photo-posters is to begin to create an understanding in the minds of people that babies can be healthy in spite of their erupting teeth. It is believed that using pictures of real babies who are seen to be healthy when their teeth first emerge should go a long way to reducing some of the misconceived ideas. In its development, the participatory approach was adopted involving selected members of the target population, thus making it a culturally appropriate tool. This article describes the rationale behind the choice of the photo-posters and the process of developing them.