Date Published: May 8, 2019
Publisher: Public Library of Science
Author(s): Laura Prieto-Pinto, María Fernanda Lara-Díaz, Nathaly Garzón-Orjuela, Dayanne Herrera, Carol Páez-Canro, Jorge Humberto Reyes, Lina González-Gordon, Viviana Jiménez-Murcia, Javier Eslava-Schmalbach, Thach Duc Tran.
Audiovisual educational material has been used effectively as a knowledge translation strategy in patient education. Given the need to impact maternal mortality rates, 12 video clips related to maternal and neonatal health information were designed based on the results of a previous systematic review (SR). The content was formulated based on clinical practice guideline recommendations and validated following a formal consensus methodology. This study evaluated the effectiveness of knowledge transfer from the 12 video clips in terms of attention, emotional response, and recall by using neuroscience tools. In a randomized cross-over trial, 155 subjects (pregnant women, non-pregnant women, and men) received random sequences of 13 video clips, including a control video clip. Participants’ attention levels were evaluated through eye tracking, their emotional reactions were monitored by electrodermal activity and pupillary diameter, and their recall was tested via a questionnaire. An analysis was performed to evaluate differences in the groups and between the video clips and the control clip using variance analysis models that considered period, sequence, and carry-over effects. Results revealed that fixation length was greater in women than in men, while the greatest emotional effects occurred in men. All three groups had good recall results, without any significant differences between them. Although the sequencing did influence attentional processes, no carry-over effect was demonstrated. However, a differential effect was noted among video clips in all three outcomes, that is, when adjusted for group, level of education, and having had children. The control clip generated less attention, emotional reaction, and recall than the experimental video clips. The video clips about maternal and neonatal health were shown to be effective in the transference and comprehension of information. Therefore, cognitive neuroscience techniques are useful in evaluating knowledge translation strategies through audiovisual formats.
Improving maternal health and reducing maternal mortality are priorities in public health. At the global level, the importance of intensifying the efforts of national action plans in this regard is reinforced through the prioritization of the health of women and children . In Colombia, the maternal mortality rate in 2017 was 51.4 deaths per 100,000 live births (LV). Maternal mortality is higher among the poorest population groups and four times higher in the departments where the highest Multidimensional Poverty Index rates have been reported (Vichada and Chocó) .
The protocol for this trial and supporting CONSORT checklist are available as supporting information; see S1 Checklist and S1 File.
The final sample consisted of 161 subjects, with an average age of 27 years, and with a similar distribution among the three groups. The proportion of subjects by level of education was similar among groups, with a higher number of participants at the high school and undergraduate levels (77%) (Table 1).
This study is one of the first to implement a neuromarketing strategy to evaluate an audiovisual KT tool in maternal and neonatal health. The study was done as a crossover trial, which also included within its development the implementation of research in epidemiology, cognitive neuroscience, and other disciplines. This study identifies methods to reduce the gap between formulating evidence and applying it in order to benefit patients [6,10,47]. It has become vital to design educational strategies that guarantee an effective learning process. Educational materials presented in an audiovisual format has already been used effectively in the education of patients [24,48,49].
The tools of cognitive neuroscience (neuromarketing) could become useful in the evaluation of attention, emotional response and memory in scenarios of educational strategies in health and public health interventions, which have the purpose of improving outcomes through the social acceptance of knowledge. Video clips of knowledge about maternal and neonatal health demonstrated greater effectiveness in the acquisition of knowledge, in terms of attention, emotional reaction and recall, compared with the control video. Audiovisual educational material must be clear, have short messages, and should not have distracting or redundant elements in order to reach a bigger proportion of the population.