Ghanaian Female Adolescents Perceived Changes in Nutritional Behaviors and Social Environment After Creating Participatory Videos: A Most Significant Change Evaluation

Abstract

Background Understanding the influence of participatory video-making on the nutrition-related behavior of video creators may help shape nutrition education interventions. Objective This study assessed the perceived value and influence of a participatory video intervention among participants and stakeholders. Methods A 2018–2019 cluster randomized controlled trial (clinicaltrials.gov NCT03704649) selected 20 schools (10 intervention, n = 181; 10 control, n = 170) in one Ghanaian rural district, enrolled adolescent girls 13–16 years old, and provided a nutrition curriculum. Each intervention school also participated in two series of activities designed to help adolescents plan, film, and screen two nutrition-related videos. The Most Significant Change method involved intervention participants and local stakeholders to assess the value and influence of the intervention – a secondary outcome of the trial. Project staff collected 116 stories of change from the adolescents. Stories described shifts in four domains: participant, peer, and family behavior, and structural changes in the school. Project team used a selection rubric to identify 14 stories that reflected heightened nutrition literacy. Staff conducted interviews with the 14 adolescents whose stories were selected to elaborate on details and perceived resonance. Finally, local stakeholders assessed the stories to identify the four most significant changes of the intervention – one per domain. A separate thematic analysis identified emerging patterns of motivation and action across the 14 interviews. Results The chosen Most Significant Change stories revealed how adolescents found creative solutions to acquire iron-rich foods, encouraged neighbors to eat iron-rich foods, taught their family new agricultural practices, and promoted change in their school canteen. Local stakeholders valued stories that addressed common community nutrition issues in a creative and sustainable way, whereas adolescents prioritized stories that showed a change in health outcomes. Conclusion Stories of change revealed that the intervention promoted a transformative influence; participants modified their eating habits, lifestyle, and their environment.

Fuzzy cognitive mapping in participatory research and decision making: a practice review

“…Researchers reported their practice in three different FCM applications. Most cases mapped stakeholder knowledge in the context of participatory research [ 26 , 32 – 38 39 ]. They also described using FCM to contextualise mixed-methods literature reviews in stakeholder perspectives [ 5 , 40 , 41 , 42 ] and to conduct secondary quantitative analysis of surveys [ 43 – 45 ].…”

“…Culturally safe attitudes in a medical education trial in Colombia [ 44 , 45 ] A secondary analysis of a randomised controlled trial with medical students modelled intermediate results between knowing about cultural safety and behavioural change Colombia, 2019 Two maps stratified by intervention status, 347 participants 3. Synthesis of a scoping review on maternal health in Indigenous communities with traditional midwives [ 39 , 40 ] Fuzzy cognitive maps summarised the results of a scoping review and allowed a comparison between the literature and stakeholder maps The Americas, 2020 One literature map summarised 87 studies 4. Evacuation of Inuit mothers from Nunavik Literature maps showing factors contributing to and resulting from medical evacuation for maternal health among Inuit women in Nunavik Canada, 2019 One literature map summarised 61 studies 5.…”

“…Two maps stratified by intervention status, 347 participants 3. Synthesis of a scoping review on maternal health in Indigenous communities with traditional midwives [39,40] Fuzzy cognitive maps summarised the results of a scoping review and allowed a comparison between the literature and stakeholder maps The Americas, 2020 One literature map summarised 87 studies…”