Performance factors of mobile rich media job aids for community health workers.

Authors: Florez-Arango JF, Iyengar MS, Dunn K, Zhang J.

In developing countries, where the density of trained physicians and nurses is low, community health workers (CHWs) are typically the primary and sometimes sole providers of healthcare to millions. However, studies have shown that even well motivated CHWs using paper-based job aids demonstrate less-than-desirable rates of treatment and diagnosis errors, and low protocol compliance. Due to decreasing costs, rich-media capabilities, high portability, and local data storage, smart phones can potentially prove extremely useful in assisting CHWs by providing point-of-care clinical information and decision support.

In this paper, it describe a prospective, randomized controlled study among CHWs in Colombia where clinical guidelines were presented on cell phones in a structured interactive workflow using rich media (text, audio/voice, images/video). This intervention was compared to traditional paper-based job aids using several metrics including error rates, measures of guideline compliance, case completion time, usability measures, and six dimensions of workload.