# Effectiveness of Interactive Audiovisual Training on Breastfeeding Knowledge Among Primary Healthcare Workers in Eastern India: A Quasi-experimental Study

## TL;DR

A one-day interactive training improved breastfeeding knowledge among Indian healthcare workers, with bigger gains for those with more education or prior training.

## Contribution

Demonstrates the effectiveness of interactive audiovisual training in improving breastfeeding knowledge among ASHAs in rural India.

## Key findings

- Participants showed significant knowledge improvement with a large effect size (Cohen’s d = 2.0).
- Those with higher education or prior training gained more from the intervention.
- Scheduled Castes/Tribes participants showed less improvement compared to others.

## Abstract

Background

Accredited Social Health Activists (ASHAs) are vital in promoting breastfeeding in rural areas. However, their understanding and misconceptions regarding this vital lifesaving intervention remain largely unexplored. The study sought to measure the effectiveness of a one-day interactive, audiovisual training on breastfeeding knowledge among ASHAs of a rural block of Deoghar, Jharkhand, India.

Methods

Utilizing a quasi-experimental design featuring a single intervention group, this study engaged 46 ASHAs from a rural block in Deoghar, Jharkhand, India, coinciding with World Breastfeeding Week in August 2023. The evaluation encompassed a broad range of sociodemographic variables along with an in-depth exploration of breastfeeding knowledge, spanning techniques, benefits, and common misconceptions.

Results

The study participants, with an average age of 39.3 years and a mean service duration of 15.6 years, included a majority (71.7%) who had received prior breastfeeding training. Analysis of pre- and post-intervention data revealed significant knowledge improvements, with an effect size (Cohen’s d) of 2.0, ranging between 1.5 and 2.5. Notably, participants with higher educational levels (correlation coefficient, r = 0.360, p = 0.014) and those with previous training (r = 0.535, p < 0.001) experienced substantial gains. In contrast, the improvements were less marked (r = -0.317, p = 0.032) among ASHAs from Scheduled Castes or Scheduled Tribes.

Conclusions

The effectiveness of interactive, audiovisual training highlights the importance of regular, context-specific education for ASHAs, enabling them to effectively support and advocate for breastfeeding in their communities.