Diarrheal Disease Knowledge among Household Members of Diarrhea Patients: Findings from the Randomized Controlled Trial of the Cholera-Hospital-Based-Intervention-for-7 Days (CHoBI7) Mobile Health Program

The objective of this study was to evaluate the impact of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) handwashing with soap and water treatment mobile health (mHealth) program on diarrheal disease knowledge among diarrhea patients and their household members in urban Dhaka, Bangladesh. A cluster-randomized controlled trial of the CHoBI7 mHealth program was conducted among diarrhea patient households in Dhaka, Bangladesh. Patients were randomized to three arms: standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. An open ended questionnaire was administered to 1468 participants 12 years of age or older on diarrheal disease transmission and prevention. These items were combined to form a diarrheal disease knowledge score measured at baseline and 1 week, 6 months, and 12 months. At baseline, when participants were asked to report three ways diarrheal diseases were spread 37% (546/1468) of participants reported by water, 13% (187/1468) reported by lack of handwashing, and 4% (53/1468) by food not being covered properly. At baseline when asked to name three ways diarrheal diseases could be prevented, 35% (515/1468) of participants reported safe water, and 16% (228/1468) reported handwashing with soap. At the 12 month follow-up, the overall diarrhea knowledge score was significantly higher in mHealth with no home visits arm (score coefficient: 0.69, 95% Confidence Interval: 0.36, 1.01, p