Background Helping Babies Breathe (HBB) is a life-saving program that has helped reduce neonatal morbidity and mortality, but knowledge and skills retention after training remains a significant challenge for sustainability of impact. User-centred design (UCD) can be used to develop solutions to target knowledge and skills maintenance. Methods We applied a process of UCD beginning with understanding the facilitators of, and barriers to, learning and retaining HBB knowledge and skills. HBB Master Trainers and frontline HBB providers participated in a series of focus group discussions (FGDs) to uncover the processes of skills acquisition and maintenance to develop a mobile application called “HBB Prompt”. Themes derived from each FGD were identified and implications for development of the HBB Prompt app were explored, including feasibility of incorporating strategies into the format of an app. Data analysis took place after each iteration in Phase 1 to incorporate feedback and improve subsequent versions of HBB Prompt. Results Six HBB trainers and seven frontline HBB providers participated in a series of FGDs in Phase 1 of this study. Common themes included lack of motivation to practise, improving confidence in ventilation skills, ability to achieve the Golden Minute, fear of forgetting knowledge or skills, importance of feedback, and peer-to-peer learning. Themes identified that were not feasible to address pertained to health system challenges. Feedback about HBB Prompt was generally positive. Based on initial and iterative feedback, HBB Prompt was created with four primary functions: Training Mode, Simulation Mode, Quizzes, and Dashboard/Scoreboard. Conclusions Developing HBB Prompt with UCD to help improve knowledge and skills retention was feasible and revealed key concepts, including drivers for successes and challenges faced for learning and maintaining HBB skills. HBB Prompt will be piloted in Phase 2 of this study, where knowledge and skills retention after HBB training will be compared between an intervention group with HBB Prompt and a control group without the app. Trial registration Clinicaltrials.gov (NCT03577054). Retrospectively registered July 5, 2018, https://clinicaltrials.gov/ct2/show/study/NCT03577054.
IntroductionOver 600 000 newborns die each year of intrapartum-related events, many of which are preventable in the presence of skilled birth attendants. Helping Babies Breathe (HBB) is a neonatal resuscitation training programme designed for low-resource settings that can reduce both early neonatal mortality and stillbirths. However, as in other similar educational programmes, knowledge and skill retention deteriorate over time. This trend may be counteracted by strategies such as regular simulated exercises. In this study, a mobile application (app) ‘HBB Prompt’ will be developed to assist providers in retaining HBB knowledge and skills.Methods and analysisThis is a comparative study in Uganda with two phases: an app development phase and an assessment phase. In the first phase, HBB trainers and providers will explore barriers and facilitators to enhance learning and maintenance of HBB skills and knowledge through focus group discussions (FGDs). The FGDs are designed with a human factors perspective, enabling collection of relevant data for the prototype version of HBB Prompt. The app will then undergo usability and feasibility testing through FGDs and simulations. In the second phase, a minimum of 10 healthcare workers from two district hospitals will receive HBB training. Only the intervention hospital will have access to HBB Prompt. All participants will be asked to practise HBB skills every shift and record this in a logbook. In the intervention site, app usage data will also be collected. The primary outcome will be comparing skills retention 12 months after training, as determined by Objective Structured Clinical Examination B scores.Ethics and disseminationThis study received ethics approval from The Hospital for Sick Children and Mbarara University of Science and Technology. The authors plan to publish all relevant findings from this study in peer-reviewed journals.Trial registration numberNCT03577054
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