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“Shared correct knowledge”: a measure to assess the influence of community health workers on mothers' knowledge acquisition in a behavior change communication program in rural Haiti
Author(s) -
Mbuya Mduduzi NN,
Me Purnima,
Habicht JeanPierre,
Pelto Gretel,
Frongillo Edward A,
Ruel Marie T
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a161
Subject(s) - concordance , context (archaeology) , community health workers , psychology , nursing , medicine , gerontology , environmental health , geography , health services , population , archaeology
Evaluations of the effectiveness of behavior change communication (BCC) often assess community health worker (CHW) competencies but do not use integrative measures linking CHW and client competencies. Therefore, the potential influence of differences among the CHWs who implement such programs is rarely addressed. Using data on 954 mothers (M) and 40 CHWs paired in M‐CHW dyads, we examined the correspondence of responses to identical knowledge test questions on child health & nutrition asked to CHWs & mothers. Based on the concordance/discordance of correct responses within M‐CHW dyads, we defined an effectiveness measure, “shared correct knowledge” (SCK), as the probability that a mother correctly answers a question given that the CHW also answers correctly. There was large variability in SCK among M‐CHW dyads (range: 0.29–1.00) and 14% of the true total variation in SCK was due to CHW differences. The variability in SCK due to CHWs is substantial despite overall high CHW knowledge (93% correct responses, SD = 5.6%) and suggests that CHW competencies other than technical knowledge are important. Although it needs further validation, this measure captures the role of CHW competencies in the context of a BCC program and thus provides a means of examining features of program delivery related to CHW‐ mother interactions to use in both process and outcome evaluations. [Support: USAID, through FANTA & IFPRI; World Vision]