Audio-visual training intervention improves knowledge, skill, confidence, and performance of barefoot nurses for screening noncommunicable disease

CONTEXT: In India, the primary health system is inadequate to screen noncommunicable diseases (NCDs) at a population level due to sub-centers being short-staffed and underequipped. Training barefoot nurses (BFNs) to screen NCD is an important strategy of task shifting. Again, there is paucity of studies exploring the effectiveness of training program using technology for training BFNs in the screening of NCDs. AIMS: The aim of the study was to assess the effectiveness of audio-visual-based training to improve knowledge, skill, confidence, and performance (number screened and completeness of data entry) of BFNs to strengthen NCD screening. SETTINGS AND DESIGN: This study was conducted at Doddaballapura taluk of Bengaluru rural district, India. A mixed-method research design was employed to assess the effectiveness of an audio-visual module for training BFNs. SUBJECTS AND METHODS: Descriptive analysis was conducted to test the effectiveness of intervention in pre- and post-intervention period. A focus group discussion was conducted to explore the facilitators and barriers to the intervention. STATISTICAL ANALYSIS USED: Statistical analysis was performed using mean knowledge score (MKS) and two-tailed t-test. Descriptive analysis was done using simple percentages. RESULTS: The MKS of BFN improved across all the six components by 15% after the introduction of the video intervention. This improvement in MKS was statistically significant. The qualitative analysis testifies the improvement in skillsets, namely, finger pricking, swab placement, blood specimen collection, and waste disposal. In addition, the BFNs experience heightened confidence in conducting these procedures. The performance of BFNs has improved the number of screening and data entry into mobile apps. CONCLUSIONS: The findings from this study suggest that audio-visual-based training of BFNs improves their knowledge, skill, confidence, and performance during the screening of NCDs. This evidence has relevance for the Indian public health system, which is struggling due to short-staffing, and is a value addition for training BFNs.