Role of digital media campaigns in improving TB health literacy at the community level.

Tuberculosis (TB) is a significant health issue in the world, and lack of health literacy has resulted in delayed care-seeking practices, non-compliance with treatment regimens, and subsequent stigma in communities with the infection. The objective of the study was to determine whether multi-platform digital media campaigns enhance health literacy of the community on TB. The study involved a cluster-randomized controlled trial with sixteen communities in four districts in twelve months with intervention communities (n = 8) having targeted digital media campaigns and control communities (n = 8) having regular health education materials. Digital intervention consisted of orchestrated content dissemination via social media, short video messages, interactive mobile applications, and community WhatsApp groups to contact an approximated number of 47,832 people. Primary endpoint was TB knowledge score; attitudes, stigma perception, and care-seeking intention were prespecified key secondary outcomes. Analyses used mixed-effects models accounting for community-level clustering (ICC assumed 0.05. TB knowledge scores, attitude indices, stigma perceptions and care-seeking intentions were assessed by using validated instruments at pre- and post-intervention using a 2156 population (1084 with intervention and 1072 with control). The outcomes showed that the post-intervention TB knowledge scores were significantly higher in intervention communities (74.8 ± 12.3 vs. 52.4 ± 15.7, p < 0.001), the positive attitude toward the TB patients were also better (68.2% vs. 41.6%, p < 0.001), the scores on stigma perception were lower (2.3 ± 0.9 vs. 4.1 ± 1.2, p < 0.001), and the intentions to seek care were more favorable The metrics of digital content engagement showed that 78.3% of the messages were recalled and 2.4 million videos have been viewed in total. These results indicate that carefully planned digital media campaigns have a great impact on increasing the level of TB health literacy, which is a scalable and cost-effective method of health communication at the community level.