A study to assess the efficacy of print and digital health communication media tools (HCMT) in rural and urban communities.

Rationale

The study will compare and analyze the performance of print and digital health communication media in both rural and urban communities, considering a range of relevant aspects like user engagement, beliefs, and behavioral change to gain comprehensive insights into their efficacy across sociodemographic variables. Understanding the capabilities of media tools in specific contexts can be helpful in the selection and utilization of appropriate media channels to maximize the reach and impact of health messages, bridge the gap in health communication and contribute to reducing health disparities and developing tailored communication strategies.

Aim

The purpose of this research paper is to assess the effectiveness of print and digital media as health communication tools in urban and rural communities.

Objectives

Study design

A community-based cross-sectional study will be conducted during a 6-month survey from March 2023 to November 2023. A face-to-face interview will be conducted using a semi-structured, pre-tested questionnaire regarding how various media are used for health-related reasons, their reliability and accessibility, and changes in rural and urban populations’ health behavior using the mobile app ONA data kit. A minimum of 6-7 visits will be required to collect all the data, with each subject receiving a 10-minute survey and sign a consent form.

Study settings

The current study will be conducted in the field practice area of the community medicine department under the Datta Meghe Institute of Higher Education and Research (DMIHER) for the rural population and urban population in the Wardha district.

Participants

The study participants will be a population of age 21- to 60-year-olds with minimum qualification of matriculation in urban and rural areas of Wardha.

Eligibility criteria

Individuals who have agreed to engage in the study will make up the study’s participants. A person will be excluded if they have a history of neuropsychiatric disorders, are physically challenged, have less education than a high school graduate (matric), and refuse to give their consent. After the initial visit, if a particular property is found to be locked, and after two additional attempts to contact the eligible residents, they will be eliminated from the study.

Data sources

Variables

Dependent variables

Efficacy of health communication media tools (print and digital)

Independent variables

Data collection tools and procedure

Data tool (Ona.io): Validated structured questionnaire will be created in ona.io (Odk- questionnaire).

To ascertain the effectiveness of print and digital health communication tools on members of rural and urban communities, the tool consists of a structured interview questionnaire that is semi-structured and close-ended. We modified a previously validated questionnaire^6,9–11 and prepared self-made questionnaire to compile both- print and digital media users about their viewpoints on capabilities of providing health information via both media as communication tool. The second author, a public health expert, evaluated and approved the final questionnaires.

The questionnaire consists of 17 multiple-choice questions divided over 4 sections (Table 2)²: Sociodemographic information,¹ Media Usage/Media consumption habit,³ Perceptions of Health Communication Media Tools and⁴ Effect of Health Communication Media Tools on Health Behavior. The questionnaire will include questions in English. For Marathi regional language speakers, a translator will be present during survey time for explaining questions to participants. A pilot study with a sample size of 33 participants was completed using the final set of questionnaires, and the full sample size was calculated because the standard data for sample size computation for both print and digital media together, were not readily available.

Data sources are presented in Table 1.

Data analysis plan

The study will be conducted using simple random sampling. A list of all rural areas under the field practice area of the community medicine department under the Datta Meghe Institute of Higher Education and Research (DMIHER) will be prepared and will be numbered using a random number generator, created in an Excel spreadsheet using the formula =RAND (). Once the list will be randomly sorted, the first two or three rural areas will be selected. The same process of selection will be performed for urban areas. The data will be entered into MS Excel, and descriptive statistics, including frequency and percentages, will be presented using a table and graph. Chi-square test will be performed to determine the association between category variables.

Bias

Recall bias: Participants may have difficulty in accurately recalling their exposure to print and digital health communication media tools or their health-related behaviors. Shorter recall periods will be used to address the bias, meaning that instead of asking participants to recollect events over a long period of time, researchers can utilize shorter recall periods to reduce memory errors.

Response bias: Participants’ responses to the questionnaire may be influenced by social desirability bias, where they provide answers, they believe are socially acceptable or expected. In order to counteract this bias, an anonymity and secrecy approach will be used. Through this method, we can guarantee participants’ anonymity and confidentiality and provide a secure setting in which they can respond honestly without worrying about criticism or social ramifications.

Selection bias: There could be a risk of selection bias if the participants in the study are not representative of the larger population in rural and urban communities. Random sampling techniques will be used to help eliminate selection bias by guaranteeing that every member of the population has an equal chance of being included in the study.

Study size

The sample size was decided after calculating the pilot study on 33 samples.

The estimated proportion with absolute precision: $n\ge \frac{Z^{2}1-\alpha /2\times p\left(1-p\right)}{d^2}$

Alpha (α): 0.05

Estimation error (p): 0.666

Estimation error (d): 0.05

The minimum sample size needed: 342

Statistical method

Data will be entered into MS Excel software and analyzed using SPSS version 22 (RRID:SCR_002865). The descriptive statistics (frequencies and percentages) for sociodemographic information, popular media, frequency of media consumption, accessibility, credibility, influence of media in health-related decisions, and information-sharing tendencies of health information related data will be used. Chi-square will be employed to measure the association between sociodemographic variables and their choice of health communication media tool.

Expected outcomes

Media preference: The study may reveal that digital media tools are more frequently used and preferred by individuals in both rural and urban communities compared to print media tools.

Reach and accessibility: The research may demonstrate that digital media tools have a broader reach and higher accessibility compared to print media tools in both rural and urban communities. Digital platforms may provide a more convenient and readily available source of health information for individuals in diverse locations.

Perceived credibility: The study may reveal that print media are more trustworthy for health information as compared to dispersed digital information.

Influence on decision-making: The study could reveal that both print and digital media tools have a significant influence on individuals’ health-related decision-making processes in a positive way.

Behavior change: The findings may indicate that individuals exposed to print and digital media tools are more likely to engage in positive health behaviors like adopting healthier lifestyles, seeking preventive healthcare measures, or adhering to recommended treatment plans.

Demographic differences: The findings may reveal that younger individuals and those with higher educational backgrounds are more likely to utilize digital media tools and exhibit greater behavior changes compared to older individuals and those with lower educational backgrounds.

Key results

The findings can be used to determine the preferred media tool (print or digital) and levels of interaction of print and digital media among people in urban and rural locations, based on factors like accessibility and perceived legitimacy. This might entail ideas for combining print and digital media tools, tailoring messages for audiences, utilizing preferred media platforms, or removing obstacles to media access. Thus, the study can help policymakers, public health organizations, and healthcare practitioners establish policies and standards for successful health communication projects and use media channels cost-effectively.

Limitations

One limitation of the study is that it will not accurately provide information about the frequent health topics covered in the media and accuracy of these health information. People with qualifications below matriculation are omitted, thus their familiarity with health information is not examined. A further omission from the study is any discussion of the effectiveness of various types of print media (such as newspapers, posters, books, etc.) and digital media (such as social media and the internet) in rural and urban populations.

Dissemination

The results will be published in relevant indexed journals.

Study status

The piloting of the data collection tool was done. Recruitment of final study participants is scheduled in the coming months.

Ethical consideration

With the written consent of the head of the relevant institution, data collection will happen at a time that is convenient for instructors and rural and urban community members. The institutional ethics committee of the Datta Meghe Institute of Higher Education and Research (DMIHER) has approved the research proposal with the approval number DMIHER (DU)/IEC/2023/623. Before beginning our study, we will also obtain written informed consent and notify the participants of its purpose. We will make sure the interviewee has privacy and feels comfortable throughout the interview.