This cluster randomized controlled trial (RCT) aims to assess the feasibility and
efficacy of an educational toolkit co-developed with local stakeholders to enhance
confidence in measles, mumps, rubella (MMR) and polio vaccines in the Philippines. The
toolkit contains information and messages about the following four aspects of MMR and
polio vaccines: 1) comprehensive introduction of MMR and polio; 2) vaccines safety and
efficacy; 3) MMR and polio vaccination guidelines with vaccination schedules and
locations; and 4) myths and misconceptions. The educational toolkit will be presented
using a 10-minute translated video converted from PowerPoint slides in one session.
Reminder messages regarding vaccination will then be delivered in following sessions by
health educators. The educational toolkit, as well as the adapted PowerPoint slide deck
and accompanying script, was collaboratively developed with health educators from
International Care Ministries (ICM). Professional translators have translated the
finalized English version of the slide deck and script into the local dialects.
Subsequently, ICM produced a video featuring a health worker presenting the toolkit,
synchronized with the voiceover and PowerPoint slides.
Our toolkit will be embedded in a RCT called the Soap Opera Trial, which is designed and
run by the ICM leveraging their community-based Transform Program. The standard Transform
Program consists of 15 weeks of education sessions delivered by local health educators
through traditional lectures in each community. The trial aims to evaluate the impact of
a variation to their standard Transform Program, which uses aspirational videos to
deliver education about food security, livelihood, and health. The soap opera to be shown
in the video is entitled "First Light" and is produced by ICM's own internal media team.
It includes drama and plot twists similar to a typical television show but highlights
lessons about income creation, health care, and resilience, which are key behaviors and
outcomes that can help the poor lift themselves out of poverty. The ICM will conduct this
cluster RCT to assess the impact of these soap opera videos on outcomes such as
aspirations about the future, investments on children's education, social capital,
health, hope, and economic outcomes. A 'cluster' is defined as a community participating
in the Transform Program. Each community consists of 30 participants, forming the basic
unit for our intervention and analysis. Randomization will be performed at the community
level by the ICM, and the 180 communities participating in the Transform program will be
randomly assigned to one of the two arms (intervention and control). In the intervention
arm, the participants will receive our vaccine toolkit intervention (including
educational video and reminding messages about MMR and polio vaccines) and 15 soap opera
videos alongside standard Transform Program, while participants in the control arm will
receive the standard Transform Program, in which the education sessions are delivered
through lectures.
The effectiveness of the toolkit will be evaluated by 1) the rate of measles, mumps,
rubella (MMR) and polio vaccination among children of the Transform Program participants
and 2) knowledge and attitudes towards these vaccines among the participants. Differences
in the two outcomes will be compared between the intervention and control arms using
appropriate statistical analysis. Additionally, the relevance, applicability, and
feasibility of the toolkit will be assessed using qualitative research methods. The
investigators will purposively select 30 end-users to conduct semi-structured interviews,
which aim to understand the accuracy and appropriateness of the toolkit content, user
perception of the toolkit's relevance, and overall satisfaction with the toolkit.
Finally, the investigators will conduct a cost-effectiveness analysis to compare the
cost, participants' attitude towards MMR and polio vaccines, and the immunization rates
of children in the immediate families of participants associated with our intervention
versus no intervention over the entire intervention time horizon.