By guest contributors Pauline Marie P. Tiangco, Kent Tristan L. Esteban, Alfredo Lorenzo R. Sablay & Kirchelle Ann Mae E. Nodado We…
Together with guest editors Zulfiqar Bhutta, Kathryn Yount, and Quique Bassat, PLOS Medicine is pleased to publish new research articles in a special issue devoted to the theme of global child and adolescent health and development. Below, Associate Editor Caitlin Moyer interviews Maya Adam, MD, co-author of an article featured in the special issue, describing a video intervention to promote breastfeeding in South Africa.
Please tell us a little more about your background. For example, your current role, where you’re based, your current research, and your scientific interests.
I am a faculty member in the Pediatrics Department at the Stanford University School of Medicine and I also serve as the Director of Health Media Innovation. Before studying medicine, I spent 10 years as a professional ballet dancer in Germany. I think my first career shaped my current research in many ways. I’m excited by the opportunities that lie at the intersection of health communication and audience engagement. I call it “health entertainment” because we need to find innovative ways of keeping our target audiences engaged if we want our health messages to reach them and support behavior change.
What inspired your studies on the use of a mobile video intervention for promoting healthy infant feeding practices?
Health educators have struggled for decades to successfully promote healthy infant feeding practices. Especially in under-resourced communities, where science-driven health messages are urgently needed, there are significant challenges including language barriers, literacy barriers, and sometimes even misinformation that gets passed from one generation to the next. But one of the biggest challenges, which we all-too-often overlook, is the need to authentically engage our target audiences. If people are bored by our health messages (because they are delivered didactically or in a way that isn’t culturally aligned and captivating) we will almost certainly fail to promote healthier behaviors. Our study aimed to explore the use of engaging video modules to help South African community health workers more effectively engage mothers in their communities, thereby promoting healthier infant feeding practices. The videos incorporated the narratives of local community mothers and local celebrity mothers, using an entertainment-education, story-telling approach.
What were the main findings from the Philani MOVIE trial?
We found no differences between the two study arms, in terms of infant feeding practices. What’s interesting is that community health workers in the video intervention arm replaced 40% of their face-to-face counseling time with video viewing time. While their clients were watching the video series, these community health workers used that time to perform other health-related tasks for the family. They also said that incorporating tablet technology into their home visits gave credibility to their work. The mothers they support seemed more likely to listen to them and pay attention during the visit, because the tablets “gave weight” to their work.
What are the clinical and global implications of your work?
The equal outcomes between the two groups suggest that engaging video content could be as effective as face-to-face counseling for supporting new mothers, at least when it’s used to replace a portion of that counseling. Of course, community health workers form the bedrock of health promotion in their communities, but if we can lighten their workload – support their health promotion efforts – by giving them universal access to the technological tools and resources they need, that shift could have significant positive implications for the health of under-resourced communities. Additionally, in places where community health workers are lacking or in short supply, video content could form a bridge – connecting hard-to-reach target communities with local health services and life-saving health information.
What is next? What are the most exciting developments in your field?
The COVID-19 pandemic has accelerated global trends in smartphone ownership and usage. Around the world, more people are also spending more time watching video content than ever before and this is an exciting opportunity for the global health community because we can use these new pathways to reach those who urgently need high quality, science-driven messages. Finding innovative ways of designing those messages is equally important. The pathways to our target audiences are only useful if the vehicles driving down them are likely to actually reach their final destination. We need to reach our audiences – capture their attention and engage them – if we want our health messages to stick.
What are the benefits of publishing your research in an open access journal like PLOS Medicine?
One of the biggest challenges we face in academic research is how to make the findings of our work accessible to everyone. When we have opportunities to discuss our findings in readable blog posts, public interest articles or even television and radio interviews that reach the public, those are all important opportunities to broaden the reach of our work. Publishing in open access journals also enhances the reach of our work and makes science available to other researchers in a more equitable way. We are thrilled to have this paper published in PLOS Medicine. The editors have been flexible, responsive and wonderful to work with.
Image Credit: Photograph taken by Tim Dang. Used with permission.