title: Steps on a journey to TB control in Solomon Islands: a cross-sectional, mixed methods pre-post evaluation of a local language DVD.
abstract: BACKGROUND
  In Solomon Islands many people with Tuberculosis (TB) have challenges in accessing services because of socio-cultural, geographic and health service reasons, resulting in delays in TB treatment and low detection rates. The purpose of this project was to (i) develop a local language audio-visual resource (DVD) about TB (ii) share this resource with people in remote villages and (iii) evaluate the process and outcomes.
  
  
  METHODS
  The project involved the development and evaluation of a DVD in local Kwaio language. The DVD included five short videos based on the Australian Respiratory Council TB Education Flipchart. The DVD also included short videos of: traditional music/chanting (ai'imae); drama that presented an allegory of TB; and a short documentary on the redevelopment of the local TB Ward. A mixed-methods approach evaluated changes in TB knowledge and investigated the impact of the DVD.
  
  
  RESULTS
  The DVD was recorded and produced in March-June 2013 and screened in 41 villages and hamlets. The pre-post DVD survey was completed by 64% (255/400) of people who viewed the DVD in the villages. Pre-DVD survey responses showed a moderate to high knowledge about TB signs, symptoms and treatment but 76/255 (30%) stated TB was caused by sorcery and 85/255 (33%) incorrectly stated that TB medication should be stopped when a patient feels better. The post-DVD survey showed a significant increase in people in coastal villages reporting (i) a 3-week cough would trigger a medical assessment and (ii) TB is mainly spread through the air. Statements that TB is not caused by sorcery increased post-DVD in both coastal and mountain villages, however belief in sorcery in mountain villages remained high at 20/70 (29%).
  
  
  CONCLUSIONS
  The local DVD resource was developed within local cultural understandings and oral traditions of Kwaio people. Using modern but accessible DVD technology generated a lot of interest about the disease and the stories. The project evaluation indicates that current delays in seeking treatment may be more due to socio-cultural and health service factors than awareness of the disease. Therefore the development of TB services, including TB education, which are culturally sensitive, remains important.
authors: Hunter New England Population Health, 470 Peel St, Locked bag 9783, Tamworth, NEMSC, 2348, Australia. peter.massey@hnehealth.nsw.gov.au.|University of New England, Armidale, Australia. peter.massey@hnehealth.nsw.gov.au.
authors: Peter D
authors: PD
authors: Massey
authors: Atoifi Adventist Hospital, Malaita, Solomon Islands. rowenaasugeni@gmail.com.|James Cook University, Brisbane, Queensland, Australia. rowenaasugeni@gmail.com.
authors: Rowena
authors: R
authors: Asugeni
authors: East Kwaio, Malaita, Solomon Islands. jwakageni@gmail.com.
authors: John
authors: J
authors: Wakageni
authors: East Kwaio, Malaita, Solomon Islands. esaukekeubata@gmail.com.
authors: Esau
authors: E
authors: Kekeubata
authors: East Kwaio, Malaita, Solomon Islands. jmaenaadi@gmail.com.
authors: John
authors: J
authors: Maena'aadi
authors: East Kwaio, Malaita, Solomon Islands. jlaeteesafi@gmail.com.
authors: John
authors: J
authors: Laete'esafi
authors: East Kwaio, Malaita, Solomon Islands. esaukekeubata@gmail.com.
authors: Jackson
authors: J
authors: Waneagea
authors: Atoifi Adventist Hospital, Malaita, Solomon Islands. forestmanlaw@gmail.com.
authors: Vunivesi
authors: V
authors: Asugeni
authors: James Cook University, Brisbane, Queensland, Australia. david.maclaren@jcu.edu.au.
authors: David
authors: D
authors: MacLaren
authors: James Cook University, Brisbane, Queensland, Australia. rickspeare@gmail.com.|Tropical Health Solutions, Townsville, Australia. rickspeare@gmail.com.
authors: Richard
authors: R
authors: Speare
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016250:Compact Disks; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D007802:Language; D008297:Male; D008542:Melanesia; D008875:Middle Aged; D012424:Rural Population; D014376:Tuberculosis / Q000517:prevention & control*; D055815:Young Adult
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