Designing and evaluating a novel mobile application for Helping Babies Breathe skills retention in Uganda: comparative study protocol

Abstract

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

Implementation of the Helping Babies Breathe Training Program: A Systematic Review

“…86 In a 3-year study on HBB program implementation in 15 regions in Tanzania, an assessment of the program's impact on neonatal mortality proved to be challenging because of the poor availability of historical, preintervention data. 25 88 Recent uses of technology to cut costs and ease logistic burden of implementation include training via video conferencing 61 and mobile apps 41 as well as the use of a highfidelity mannequin that provides feedback based on resuscitation performance. 58 HBB implementation translates into meaningfully improved skills and knowledge as demonstrated through multiple studies in which authors cite improved average OSCE scores and pass rates on knowledge assessments.…”

Development of a novel mobile application, HBB Prompt, with human factors and user-centred design for Helping Babies Breathe skills retention in Uganda

“…This article describes Phase 1, the development of HBB Prompt. More details regarding the entire study can be found in the protocol paper [ 37 ]. Further details including the focus group discussion (FGD) guides for Phase 1 can be found in Additional file 1 and Additional file 2 .…”

“…Apps targeted towards newborn health [28][29][30][31][32][33][34] have been created and evaluated previously, some employing UCD, but none have informed their design by exploring the cognitive processes of learning newborn resuscitation skills. Understanding the underlying preferences, perceptions, facilitators and barriers that drive behaviours can help tailor the development of features and functions of apps [25,35,36]. Applying UCD and assessing human factors during the development of a mobile app can enhance user experience and increase the effectiveness of the tool.…”

Digital Health Innovations, Tools, and Resources to Support Helping Babies Survive Programs

“…102,103 A number of trials are currently underway. 98,104 If shown to be effective, and if adopted and scaled, particularly as integrated interventions, 105 digital tools and platforms may have the potential to address some of the gaps and barriers that have been identified in the dissemination and implementation cascade for HBS. Overcoming these challenges might, in turn, augment global progress toward better policies, outcomes, and clinical care for newborns in LMICs.…”