Influence of Spaced Repetition Intervention on Knowledge Retention among Community Health Promoters

Purpose: To establish knowledge retention (KR) baseline levels from the entry training community health promoters (CHPs) received in diverse years since 2006 in Nyandarua County, Kenya. Moreover, to determine the influence of spaced repetition (SR) intervention on knowledge retention. Materials and Methods: Quasi experimental design through pre and post intervention tests were used and the sample (n=348) was calculated through Yamane (1967) formula at 95% confidence interval. Tests’ measured KR and the use of mobile phone short message service (SMS) happened to the respondents once per week in 12 weeks after the pre intervention and before the post intervention test. The 4 key messages from the CHP training manual were relayed interchangeably, each 3 times in total. Both tests used competence based curriculum (CBC) rubrics; exceeding expectation (EE), approaching expectation (AE), meeting expectation (ME) and below expectation (BE). Findings: With a response rate of 92% (n= 320), at pre intervention 82.2% (n=263) had BE KR which is 0-49% score and only 0.6% (n=2) had EE with a mean of 1.21 (30.25%) out of scale of 4. At post intervention the mean was 2.49 (62.25%), an improvement ratio of 2.1. The BE fell to 35.3% (n=113) and EE increased to 33.4% (n=107) at post intervention. SR was statistically significant on knowledge retention according to the Wilcoxon signed rank test results (Z = -11.919, p = 0.000). Implications to Theory, Practice and Policy: Results confirmed the multi-store memory theory that some knowledge ‘decays’ before entering the long term memory but on several reminders knowledge can resurface; a further confirmation of the forgetting curve that information is forgotten over time if not reviewed. Results mean that training CHPs once without subsequent knowledge reinforcement may have less significant effects. Going forward, county government of Nyandarua should organize periodical training refreshment programs for CHPs.