Influence of Spaced Repetition Intervention on Knowledge Retention among Community Health Promoters
DOI:
https://doi.org/10.47672/ejhs.2643Abstract
Purpose: To establish knowledge retention (KR) baseline levels from the entry training community health promoters (CHPs) received in diverse years since 2006 in Nyandarua County, Kenya. Moreover, to determine the influence of spaced repetition (SR) intervention on knowledge retention.
Materials and Methods: Quasi experimental design through pre and post intervention tests were used and the sample (n=348) was calculated through Yamane (1967) formula at 95% confidence interval. Tests’ measured KR and the use of mobile phone short message service (SMS) happened to the respondents once per week in 12 weeks after the pre intervention and before the post intervention test. The 4 key messages from the CHP training manual were relayed interchangeably, each 3 times in total. Both tests used competence based curriculum (CBC) rubrics; exceeding expectation (EE), approaching expectation (AE), meeting expectation (ME) and below expectation (BE).
Findings: With a response rate of 92% (n= 320), at pre intervention 82.2% (n=263) had BE KR which is 0-49% score and only 0.6% (n=2) had EE with a mean of 1.21 (30.25%) out of scale of 4. At post intervention the mean was 2.49 (62.25%), an improvement ratio of 2.1. The BE fell to 35.3% (n=113) and EE increased to 33.4% (n=107) at post intervention. SR was statistically significant on knowledge retention according to the Wilcoxon signed rank test results (Z = -11.919, p = 0.000).
Implications to Theory, Practice and Policy: Results confirmed the multi-store memory theory that some knowledge ‘decays’ before entering the long term memory but on several reminders knowledge can resurface; a further confirmation of the forgetting curve that information is forgotten over time if not reviewed. Results mean that training CHPs once without subsequent knowledge reinforcement may have less significant effects. Going forward, county government of Nyandarua should organize periodical training refreshment programs for CHPs.
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Agarwal, S., Kirk, K., Sripad, P., Bellows, B., Abuya, T., and Warren C. (2019).
Ameh, C., Kerr, R., Madaj, B., Mdegela, M., Kana, T., Jones, S., Lambert, J., White,
Amref. (2016). Amref Health Africa unveils revolutionary mobile solution for
An Overview. https://www.grin.com/document/510047 and delivering e-learning solutions from the FAO elearning Academy, second edition. Rome. https://doi.org/10.4060/i2516e https://www.fao.org/3/i2516e/i2516e.pdf
Ballard, M., Bonds, M., Burey, J., Foth, J., Fiori, K., Holeman, I., Johnson, A.,
Bastawrous, A. and Armstrong, M. (2019). Mobile health use in low- and high-income
Bridge, A.022). 10 Facts & Stats about Learning Retention You’ll Want to Remember.
Brooks, A. (2019). What Is Community Health and Why Is It Important? Rasmussen
Brown, A. and Nieminen, M. (2017). How Kenyans are embracing mobile technology
Colman, H. (2020). Learning Retention – How to Make Information Stick.
Competency retention among health workers one year after completing helping babies breathe training in South Sudan. Pan African Medical Journal. 2019;33: 175. doi:10.11604/pamj.2019.33.175.17560. http://www.panafrican-med-journal.com/content/article/33/175/full/ Pan African Medical Journal – ISSN: 1937- 8688 (www.panafrican-med-journal.com) Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net)
Countries: an overview of the peer-reviewed literature. Journal of the royal society of Medicine. v.106 (4); 2013 Apr.
Deliberately making and correcting errors boosts learning. https://www.psychologytoday.com/gb/blog/finding-new-home/202203/learn-better-make-mistakes
Dewah, P., and Mutula, S. (2020). Knowledge retention strategies in public sector doi: 10.1177/0141076812472620.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618170/
Draiko, C., Yamarat, K., Panza, A., & Draleru, J. (2019). Knowledge, skills and
EdApp Microlearning. (2022).https://www.edapp.com/blog/how-spaced-repetition-
Emamzadeh, A. (2022). To Learn Better, Make Mistakes. New findings suggest
FAO. (2021). E-learning methodologies and good practices: A guide for designing
Fiorini, V. (2022). Knowledge retention: How to capture and preserve knowledge at for residents. The Star. Edited by S. Kanyara. https://www.the- star.co.ke/counties/central/2021-07-29-nyandarua-launches-free-wi-fi-points-for-residents/
Harvard Medical School. (2020). 7 Ways of to Keep Your Memory Sharp at Any Age.
Haseeb M., Roy, A. (2021). Assessment of knowledge retention of healthcare staff through Telephonic interview after training for rotavirus vaccine introduction in India. Doi: https://doi.org/10.1101/2021.10.26.21265523.
Health Care workers at health facility, trends in the retention of knowledge and correlates at 3rd year following training of health care workers on the prevention of mother-to-child transmission (PMTCT) of HIV–National Assessment. Published online 2019 Jan 29. Doi: 10.1186/s12913-019-3925-4. BMC Health Serv Res. 2019; 19: 78. PMID: 30696489. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352341/
Implementation of knowledge into health practice: study protocol for the validation and redevelopment of the Knowledge Uptake and Utilization Tool. Health Research Policy and Systems . Article number: 105 (2019). Published: 27 December 2019. https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-019-0503-5 in the Training Support of Community Health Workers in India. CHI ’21, May 8–13, 2021, Yokohama, Japan. ACM ISBN 978-1-4503-8096-6/21/05. Pg 1. https://doi.org/10.1145/3411764.3445111. https://dl.acm.org/doi/pdf/10.1145/3411764.3445111
Kibuacha, F. (2021). Mobile Penetration and Growth in Kenya.
Kuehn, P. (2022). Function and Importance of Pre and Post-Tests.
Kufe, N., Metekoua, C., Nelly, M., Tumasang, F., and Mbu, E. (2019). Retention of
Lavery, T. (2023). Definition. Serial position effect.
Learning. https://www.readingrockets.org/article/making-it-stick-memorable-strategies-enhance-learning
Malaba, S., Palazuelos, D., Raghavan, M., Rogers, A., Schwarz, R., Furth, R., Lyons, J., Dini, H., Zambruni, J., Jacobs, T., and Kureshy, N. (2018). Community Health Worker Assessment and Improvement Matrix (CHW AIM) Updated Program Functionality Matrix for Optimizing Community Health Programs.
McLeod, S. (2021). Multi-Store Model of Memory. Simply Psychology.
Meltzer, R. (2021). What Is the Serial Position Effect?
Mobile Phones. https://mksujournals.mksu.ac.ke/improving-health-care-delivery-by-community-health-workers-through-mobile-phones/
MoH. (2018). Community Health Volunteers (Chvs). Basic Modules Handbook.
Momanyi, G., Adoyo, M., Mwangi, E., & Mokua, D. (2015). Value of training on
Moses, S. (2019). Theories of Human Memory and Their Application in Education.
Motivation Among health workers in Narok County, Kenya. Pan African Medical Journal. 2016; 23:261 [doi: 10. 11604/ pamj.23.261.8414] https://www.panafrican-med-journal.com/content/article/23/261/full/
Namunwa, K. (2019). Kenya leads Africa in Smartphone usage.
Nandasamba, K. (2024). Improving Health Care Delivery by Community Health Workers Through
Nyambura, G. and Sabuni, A., (2021). Nyandarua launches free Wi-Fi points
Nyandigisi, A. (2018). Ownership and use of mobile phones among health workers, caregivers of sick children and adult patients in Kenya: Cross-sectional national survey. Globalization and Health, May 2013 9(1):20. DOI: 10.1186/1744-8603-9-20. https://www.researchgate.net/publication/236835440_
Organizations: Current status in sub-Saharan Africa. ResearchGate. Information Development 32(3) DOI:10.1177/0266666914551070.
Plowright, A., Taylor, C., Davies, D., Sartori, J., Hundit, G., and Lilford, R.
Quadri, S. Kaur, A., Ray, A., Koshal S., Shersiya M., Haldar, P., Kapur S.,
Richards, R. (2022). Making It Stick: Memorable Strategies to Enhance
S., Dickson, F., Broek, N. (2016). Knowledge and Skills of Healthcare Providers in Sub-Saharan Africa and Asia before and after Competency-Based Training in Emergency Obstetric and Early Newborn Care. PLoS One, 2016; 11(12): e0167270. Published online 2016 Dec 22. Doi: 10.1371/journal.pone.0167270. PLoS One. PMC5179026
Setting the global research agenda for community health systems: literature and consultative review. Human Resources for Health volume 17, Article number: 22 (2019). https://doi.org/10.1186/s12960-019-0362-8. https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-019-0362-8#citeas
Shankar, S., Skinner, K., Nimomiya, M., and Bhawra, J. (2019). Fostering
Sonowski, J. (2018). Types of grading systems.
Stack, J. (2021). Likendin. Why knowledge retention is a competitive
Surprising ways to Retain Sharp Memory Using Brain Games that Strengthen Mental Functioning. Harvard Health Publishing. https://www.health.harvard.edu/healthbeat/7-ways-to-keep-your-memory-sharp-at-any-age to Access healthcare. https://www.businesscalltoaction.org/news/how-kenyans-are-embracing-mobile-technology-to-access-healthcare
Training community health workers. https://amref.org/news/amref-health-africa-unveils- Revolutionary-mobile-solution-for-training-community-health-workers/
University. https://www.rasmussen.edu/degrees/health-sciences/blog/what-is-community-health/
Wong, E. (2020). Serial Position Effect: How to Create Better User Interfaces. work. Bloomfire.
Yadav, D., Dabas, K., Malik, P. & Singh, P. (2021). Illustrating the Gaps and Needs
Zurovac, D., Otieno, G., Samuel, K., Mbithi, A., Muturi, A., Snow, R.
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