Five prerequisites for high quality mHealth content

Five prerequisites for high quality mHealth content

June 14, 2017 | mHealth | Sub-Saharan Africa | Peris Kagotho

This is the first of a four part blog series focusing on techniques and learnings for effective and impactful content development that achieves its intended outcomes, resulting in behavioural change.

In Sub-Saharan Africa, the need for innovative approaches that increase the access to quality healthcare is unparalleled due to the mismatch between healthcare supply and demand. This has led to a growing health information gap which mobile technology can be used to reduce. The ubiquity of mobile technology across the economic divides means that there is an ever increasing equity in access to health information. Due to this we have seen the rise of mHealth services in Sub-Saharan Africa with documented evidence of reaching those who were previously unreached using the conventional healthcare delivery methods.

The focus is today shifting from availability of health information content to its credibility.
Creating a content team, which comprises of a project manager, a dedicated content specialist, a subject matter specialist (who doubles as an approver) and a copy writer (who acts as an editor) goes a long way in easing this process. To build credible content, this team will need to ensure that content delivered to the target groups (end users) is accurate, impactful and of high quality. This will indirectly contribute to building trust and therefore to behaviour change.

Building trust and changing behaviour

There are several general definitions of quality. ISO defines quality as “The totality of features and characteristics of a product or service that bear on its ability to satisfy stated or implied needs”. From this definition, good quality implies proof that it is ‘fit for purpose’. Quality in the context of developing content for mobile-based services can be classified under the following domains:

 

  • Accuracy;
  • Relevance;
  • Timeliness;
  • Appropriateness;
  • Accessibility;
  • Clarity;
  • Interpretability;
  • Coherence;
  • Credibility;
  • Reliability; and
  • Integrity.

 

These qualities are discussed in more detail in the next blog (Five quality principles of behaviour change messaging).

To ensure this quality is achieved, you first need to clearly identify:

1. The scope and purpose of the content

Scope is defined as the extent of the area or subject matter that something deals with or to which it is relevant. The content developed should achieve the intended purpose for the intended target group. To achieve this, the message should contain a full thought process i.e. be independently complete, be clearly described and recommend concrete action points. A clear group should be targeted by the message and this should also be clearly seen in the message content. This goes a long way in ensuring clarity and relevance of the message is achieved.

2. Stakeholder involvement

Three main groups of stakeholders are relevant in the content development and review stages. These include the subject matter experts or professionals, relevant Government/private sector representatives, and the end users or beneficiaries. Most content has been traditionally produced by health experts in offices, behind closed doors and/or in workshops. This content comes out as having followed all the policies and guidelines set by the World Health Organisation and the country specific ministries of health, and with it, very medically accurate.

However, in majority of the cases, for the end user, this content is usually difficult to understand. What may sound as a very basic or straightforward message to a technical expert, may contain technical terms and concepts that are not understood by the end user. Use of plain language with simple terms that the local target audience of all education levels can understand is essential in order to lead toward successful behaviour change.

As the content team, involving all three groups of stakeholders in the production of the content ensures the content is accurate, relevant, answers the right questions and is produced in a way that is easy to understand for the end users or beneficiaries. It also ensures that the recommendations given are available in the local context, culturally acceptable and appropriate, actionable and economically accessible by the target audience.

3. Precision and accuracy of evidence base, information and sources

The content developed should be based on the best evidence available. It is good practice for the message pathway to provide the evidence for their advice and include the pros and cons. You should endeavour to document a list of sources/references associated with the message/content. Due diligence is also important to ensure the sources or references used are reliable, up-to-date (less than 10 years old) and likely to reflect the best local practice.

In cases where the strength of the supporting evidence is weak, or non-existent, one should clearly state this and check if the advice and facts suggested fit with the local consensus. For example, instructions on how to do something (like a recipe, or a technique) that is practiced locally and evidence is not needed.

4. Editorial independence

Information and recommendations in the health message should not be influenced by any commercial or other aims of the organisation that paid for the content to be developed. A good example is developing content that markets specific drugs of a pharmaceutical or medical company. The health message should be unbiased, and written independently of external influences. In the cases where the development of the content was funded by an organisation or NGO, the source of funding for the resource should be clearly identified and a statement regarding the role of the funder included, stating there has been no influence on content.

5. Quality assurance and quality control processes

These processes need to be set up prior to the actual content development. Quality assurance are the activities and processes that as the content developer you undertake to ensure sources and messages are of acceptable standards. Quality control on the other hand is the set of routine activities undertaken by managers on a sample of developer’s sources and messages to identify deficiencies (gaps or errors) or non-adherence (inconsistency) in quality assurance processes.

The quality assurance and quality control processes will inevitably identify the fundamental failings, such as incomplete or unclear scope, inappropriate evidence base, and undue influence from the funder.

Once the content has completed the Quality Assurance and Quality Control process, it is recommended that these messages go for validation before they go live. In the case of health messages, content needs to go through the Ministry of Health for the experts to assess the degree to which this content aligned with the accumulated evidence and policies of that particular country. Issues such as clarity, style and presentation could be addressed editorially by the content development team and stakeholders.

Once all these pre-requisites are accurately set and implemented, the health content you have developed should be:

 

  • Up-to-date;
  • Accurate and balanced;
  • Accessible and understandable by the target audience;
  • Relevant and useful;
  • Created by a documented process;
  • Created with the involvement of stakeholders and end-users; and
  • Be independently complete.

 

In the next blog, ‘Five Quality principles of behaviour change messaging’, I will expand more on the domains under which quality in the context of developing content for mobile-based services can be classified. These qualities, when employed in the content developed, help us to create very credible content that is likely to cause behaviour change.

 

This project was funded with UK aid from the British people.

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