It’s all in the When.

Improving online engagement of COVID-19 self-assessments

By Franciscah Nzanga (1), Tabitha Mberi (1), Stephen Odindo (1), Isaac Mwangi (1), Beatrice Wasunna (2) and Nengapate Kuria (3).

Illustration by Anthony Mogaka

Imagine for a moment, what life would have been like in the early 1900s if emoticons were available. Instead of having to write out a message to share that your prematurely born child was out of danger, all you had to do was draw confetti, baby and blue ribbon icons, attach it to the leg of a pigeon, wait a day or two, and the father knew he had a bouncing baby boy. Sounds ridiculous, nonetheless, it brings into startling contrast how communication has evolved. The manner in which we talk to each other has changed drastically over the years, even so, the need for it to be understood to garner impact has not.

Initially, the hurdle was how to communicate over long distances, getting the message across to the recipient in the shortest period of time and safely – weather and the possibility of interception being the main concern. With the advent of technology and the digital age, distance is no longer an issue. We are no longer tethered by the weight a carrier bird can hold, the elements or ensuring that both horse and messenger are well fed to withstand the journey from one point to another. The challenge has become how to quickly and effectively talk to each other with multiple different platforms and channels being developed to make communication better and faster. However, with all of this, one key element is sometimes overlooked: 

When. 

Timing and its significance cannot be overstated, especially in behavior change communication during a health crisis. With the technological advances made to create greater linkages and flow of information, people are now overloaded and bombarded by messages and offers. In this environment, overcoming attention deficits and message fatigue has become as important as the service itself.

This is the reason that though many technology-based solutions have been developed to bring remote populations into the fold and overcome last-mile delivery challenges especially in health, the impact has not been completely positive. As such, the question of when rings especially loud during a global pandemic. COVID-19 has shown just how reliant we are on information, more so, timely, relevant, clear and reliable communication that empowers us to make the right decision. Question is, how do you get people to listen, understand and take action?

The Innovation Network’s (IN) self-assessment platform grappled with this challenge, and developed a self-triage platform that empowers households to take charge of their health by allowing users to assess themselves for a given illness. In addition, it linked them  with a Community Health Worker or health facility for further assistance as needed.  

To enhance the solution, IN used its Virtual Design Lab or vLab to run an experiment in Busia and Thika, both major towns within Kenya, on a sample size of 3345 people. The objective was to increase uptake of the self-assessment platform through variations in messaging structure and timing to understand what incentivizes and motivates users to utilize online healthcare tools during COVID-19. To do so, vLab created different variations of the message prompts, by making small changes to the day and time of interaction, the language of messages, as well as, using visual aids to better understand audience needs thus making the tool more effective.

The results showed that people’s use of the platform was dependent on reaching them at the right time with a call to action. Varying the timings and days of messages showed that timing was key to getting a response. In this particular study, the best time to engage CIHA audiences was afternoons or evenings, especially on Wednesdays and Fridays.

Technological solutions have great merits, and their potential is endless, however, as this project highlights, there is a need for developers to take on a more user-centered approach in order to create accessible, usable and effective responses to a challenge. Point of note to keep in mind if doing so is that, one of the keys to nudging users towards action lies in knowing when to reach them. 

Gain a more in-depth understanding of our vLab study by reading the case study here.

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(1) Living Goods

(2) Medic

(3) Busara Center for Behavioral Economics

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