Effectiveness of the training material on COPD for community health workers in rural western India: a quasi-experiment design

Abstract

Background: Amidst the need for a national program on the control of Chronic Obstructive Pulmonary Disease (COPD) in India, we developed and validated the training material (TM) to upskill the community health workers (CHWs) on prevention, control and screening of COPD in primary healthcare. Aim: To test the effectiveness of TM as to knowledge change, Peak Expiratory Flow Rate (PEFR) performance and constructive feedback from CHWs. Methods: A one-group quasi-experiment was conducted using universal sampling of all CHWs (n=23) working in the villages of Mulashi block, Pune district India in Aug’2018 with set of questions comprising knowledge about respiratory system, risk factors, prevention and presentations of COPD, a checklist for PEFR measurement and feedback using Likert scale. Results: The mean knowledge about COPD increased significantly among the CHWs immediately after self-reading of TM from 15.7% (SD±24.7%) to 73.1% (SD±27.2%) [p≤0.001] (fig.1). All CHWs reported strong agreement [6.7 on a 7-pointer Likert scale (range 6.3-7.0)] as regards to better understanding of COPD and PEFR (fig.2). CHWs performed all must-to-do steps of PEFR correctly (fig.3). Conclusion: TM is effective to educate CHWs who can disseminate the acquired knowledge among community and undertake screening for COPD. Further research could warrant its integration into CHW induction program in India.