Anticipated acceptability of blended learning among lay health care workers in Malawi: A qualitative analysis guided by the Technology Acceptance Model (Preprint)

Abstract

BACKGROUND HIV index case testing (ICT) aims to identify people living with HIV (PLWH) and their contacts, engage them in HIV testing services, and link them to care. ICT implementation has faced challenges in Malawi due to limited counselling capacity among lay health care workers (HCWs). Enhancing capacity through centralized face-to-face training is logistically complex and expensive. A decentralized blended learning approach to HCW capacity-building, combining face-to-face and digital modalities, may be an acceptable way to address this challenge. This analysis describes factors influencing HCW anticipated acceptability of blended learning. OBJECTIVE The objective of this analysis is to describe factors influencing HCW anticipated acceptability of blended learning. METHODS This formative qualitative study involved conducting twenty-six in-depth interviews (IDIs) with HCWs involved in the ICT program across 14 facilities in Machinga and Balaka, Malawi (November-December 2021). Results were analyzed thematically using the Technology Acceptance Model (TAM). Themes were grouped into factors affecting the two sets of TAM constructs: perceived usefulness and perceived ease of use. RESULTS Factors influencing perceived usefulness included the opportunity for self-guided learning through digital portions and the opportunity for social exchange through face-to-face interactions. Factors influencing perceived ease of use included need for orientation to the digital technology, accessibility of devices, communication around training schedules, support for logistical arrangements to avoid work interruptions; and monetary compensation to motivate learning. CONCLUSIONS A decentralized blended learning approach may be an acceptable method of enhancing ICT knowledge and skills among HCWs in Malawi, although factors influencing acceptance of technology use need to be considered. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1136/bmjopen-2023-077706