Evaluation of a game-based training course to build capacity for insecticide resistance management in vector control programmes

Abstract

Across Africa, malaria control programmes are increasingly challenged with the emergence of insecticide resistance among malaria vector populations. Confronted with this challenge, vector control staff must understand insecticide resistance management, think comprehensively and react positively when confronted with new problems. However, information on the subject is often only available through written guidelines that are difficult to put into practice. Based on the successes and strengths of educational games for health, we developed and evaluated a novel game-based course to fill the gap in training resources for insecticide resistance management. The training was evaluated by analysing results of pre- and post-course knowledge tests and self-efficacy surveys, as well as post-course interviews. At the start of the training, fundamental concepts of insecticide resistance were reviewed through Resistance101, a mobile app game. Subsequently, insecticide resistance management strategies were explored using the simulation game ResistanceSim, which was introduced by mini-lectures and complemented by class discussions and group work. The game-based training was conducted and evaluated in two African countries (Ethiopia and Zambia) using a mixed-methods approach. Quantitative outcome measures included knowledge acquisition and change in self-efficacy. We completed a qualitative inductive thematic analysis of participant interviews to explore the views and experiences of participants with the games and training, and the impact of the training on professional practices and attitudes. The game-based training increased knowledge in the short-term and improved self-efficacy scores. The training increased participants' knowledge base, stimulated knowledge sharing and changed work practices. The game-based training offers scalable training opportunities that could nurture and capacitate the next generation of professionals in vector control.

Fig 1. Screenshots showing elements of Resistance101.

Screenshot taken of (A) the Resistance101 splash screen, (B) the main menu where players select which game level they want to play, and (C) a general representation of gameplay showing mosquitoes crossing an intervention zone where players must decide which intervention to deploy.

Fig 2. Distribution of results for the participant knowledge test on IRM.

The mean score (x), 1^st and 3^rd quartiles (box), and range (whiskers) of pre- and post- course knowledge tests from 44 participants.

Fig 3. Distribution of results for the participant knowledge test on IRM by pre-course test performance.

The mean score (x), 1^st and 3^rd quartiles (box), and range (whiskers) of pre- and post- course knowledge tests from 44 participants. The data was divided into 4 groups (Q1-Q4) based on scores attained in the pre-course test. Asterisks indicate significant differences at a Bonferroni adjusted alpha of 0.0125.

Fig 4. Distribution of results from participant surveys on self-efficacy in vector control and insecticide resistance management.

The mean score (x), 1^st and 3^rd quartiles (box), and range (whiskers) of self-efficacy scores before and after participation in the course (n = 40).

Fig 5. Distribution of results from participant surveys on self-efficacy in vector control and insecticide resistance management by pre-course self-efficacy.

The mean score (x), 1^st and 3^rd quartiles (box), and range (whiskers) of pre- and post- course self-efficacy scores from 40 participants. The data was divided into 4 groups (Q1-Q4) based on scores in the pre-course evaluation. Asterisks indicate significant differences at a Bonferroni adjusted alpha of 0.0125.

Fig 6. Overview of the thematic analysis.

Themes are shown in orange circles, and sub-themes are shown in turquoise circles.