![[ Visit Client Website ]](images/banner.gif)
Theoretical Background and research questions/hypothesis:In resource-poor countries, the burden for delivery of public health interventions for prevention and control of the leading causes of illness, death and disability often falls upon local health staff, such as health promoters, and community health educators who typically rely on one-way health communication approaches that often fail to take into account the contextual factors of people’s lives. There is a need to strengthen the communication and community engagement skills of these local health staff, recognizing that the skills for teaching biomedical information are different from those for facilitating the decision making needed to adopt protective behaviors among community members. The objectives of this presentation is to describe the implementation and evaluation of a theory-based, interpersonal communication and community engagement model, Education through Listening (ETL), for improving knowledge, confidence, and skills of community-level health promoters to engage others in health behavior change activities in rural Kenya.
Methods: Five participatory workshops were conducted with 122 participants from 5 organizations and agencies that promote community-level health initiatives throughout Kenya. Evaluation of the training included mid-course and post course questionnaires; 20 key informant interviews and 2 focus groups of participants 6 months post training; community feedback on a community engagement session using ETL; and a community-level, 11-village evaluation of the impact of ETL-trained vs. non-ETL-trained health promoters on the sale and installation of improved cook stoves designed to reduce indoor air pollution.
Results: Participants reported an increase in knowledge of how people change behaviors; confidence in new skills to engage the community; translation of new skills to other health behaviors; increased job satisfaction using the new methods; and increased adoption of desired behaviors by community members. An evaluation of a pilot program to train health promoters to sell and install improved stoves showed that, in villages where health promoters received ETL training, 185 (77%) of 241 households purchased improved stoves, compared to 67 (46%) of 146 households in villages where ETL was not used (p<0.001). Coverage with improved cookstove was <1% among the villages before the ETL and promotional activities began.
Conclusions: These results show that community-level health promoters in rural Kenya who attended an Education through Listening training exhibited increased confidence and improved communication skills, and were able to successfully engage community members to adopt desired health technologies and behavior. Implications for research and/or practice: