Smartphones: A Catalyst for Tobacco Control Training in India

Eve M. Nagler; Priyanka Ghosh; Smita P. Warke; Chuck Sigmund; Paromita Mehta; Leah C.  Jones; Samhita Kalidindi; Mangesh Pednekar

doi:10.34190/ecel.23.1.3065

Authors

Eve M. Nagler Harvard T.H. Chan School of Public Health and Dana-Farber Cancer Institute, Boston, USA https://orcid.org/0000-0002-8661-178X
Priyanka Ghosh Healis Sekhsaria Institute for Public Health, Navi Mumbai, India https://orcid.org/0000-0001-6546-9342
Smita P. Warke Dana-Farber Cancer Institute, Boston, USA https://orcid.org/0009-0005-1944-9240
Chuck Sigmund ProMobile BI, San Diego, USA https://orcid.org/0009-0001-2055-8162
Paromita Mehta ProMobile BI, San Diego, USA https://orcid.org/0009-0007-0031-4682
Leah C. Jones Dana-Farber Cancer Institute, Boston, USA
Samhita Kalidindi Dana-Farber Cancer Institute, Boston, USA https://orcid.org/0009-0000-7459-265X
Mangesh Pednekar Healis Sekhsaria Institute for Public Health, Navi Mumbai, India https://orcid.org/0000-0001-6266-5356

DOI:

https://doi.org/10.34190/ecel.23.1.3065

Keywords:

smartphones, training, tobacco control, gamification, schools, mobile learning

Abstract

The tobacco crisis confronting low- and middle-income countries (LMICs) requires scale-up of effective tobacco control programs, such as Tobacco Free Teachers-Tobacco Free Society (TFT-TFS). We previously demonstrated the efficacy of TFT-TFS in increasing tobacco use cessation among teachers and schools’ adoption of tobacco control policies in Bihar, India. To scale TFT-TFS, we are now pioneering a smartphone-based mobile learning strategy to train principals (or their designees) in Madhya Pradesh to implement and monitor TFT-TFS in schools. Research underscores the transformative potential of mobile learning: a flexible, scalable, and cost-effective alternative to in-person training methods. Our study is a unique opportunity to test a training approach that could have implications for wider and more efficient delivery of other public health programs. The strategic use of gamification and digital storytelling enhances the TFT-TFS mobile training app. Gamification mechanics—including points, leaderboards, and digital badging—foster a dynamic learning environment to enhance learning outcomes. This approach propels continuous participant engagement toward understanding and implementation of TFT-TFS’s six monthly themes and four program components. The TFT-TFS smartphone training program weaves in elements of Indian culture, notably the symbolic use of colors and kites. The Indian kite festival celebrates communal harmony through healthy competition. Similarly, the app employs the idea of school kites, which are divided into six blank segments corresponding to the TFT-TFS monthly themes. Participants navigate each module, engaging with animated videos, digital assessments, and interactive activities. Upon a principal’s successful completion of each monthly theme’s program components, the school’s kite receives a new color, unlocking the subsequent theme. The TFT-TFS smartphone training showcases a unique interactive mobile learning application that integrates gamification and tests how to scale up an effective tobacco control program in schools in India and other LMICs. The TFT-TFS smartphone-based training app may also have relevance to other public health-related training efforts in resource-constrained areas.

Author Biographies

Eve M. Nagler, Harvard T.H. Chan School of Public Health and Dana-Farber Cancer Institute, Boston, USA

Dr. Eve Nagler is an implementation scientist at the Harvard Chan School of Public Health and Dana-Farber Cancer Institute. Her research focuses on designing, testing, and implementing theory-driven interventions that optimize the local context. For over 30 years, she has translated research into practice in India, Africa, and the USA.

Priyanka Ghosh, Healis Sekhsaria Institute for Public Health, Navi Mumbai, India

Priyanka Ghosh is an anthropologist working at the Healis Sekhsaria Institute for Public Health as a Research Scientist. She conducted pre- and post-implementation qualitative research, capacity building, and monitoring of the evidence-based “Tobacco-Free Teachers, Tobacco-Free Society” intervention for schoolteachers in selected districts of Madhya Pradesh, India.

Smita P. Warke, Dana-Farber Cancer Institute, Boston, USA

Smita Warke, BS, MBA, MPA is a Program Manager II at the Dana-Farber Cancer Institute who helped research and develop an evidence-based smartphone training app in India. With 12 years of experience in the pharmaceutical and healthcare sectors across the USA and India, she brings valuable expertise to her role.

Chuck Sigmund, ProMobile BI, San Diego, USA

Chuck Sigmund, M.S., M.A.Ed, is the President of ProMobile BI, a multinational technology and L&D company. His research focuses heavily on evaluating the impact and ROI of programs and large-scale initiatives. Throughout his career, he has been at the forefront of designing innovative programs to solve difficult business problems.

Paromita Mehta, ProMobile BI, San Diego, USA

Paromita Mehta has over 22 years of corporate experience and describes herself as a curious learner who crafts creative learning journeys. She has led multiple learning and design projects globally for multinational companies in industries such as risk, data processing for AI, banking, and construction.

Leah C. Jones, Dana-Farber Cancer Institute, Boston, USA

Leah Caroline Jones, MA, is a public health and education writer/editor who has worked with development partners, health and education institutions, researchers, and community organizations in the USA, Southern Africa, and India. Leah has taught adult education and chaired the City of Beverly, MA Human Rights Committee for four years.

Samhita Kalidindi, Dana-Farber Cancer Institute, Boston, USA

Samhita Kalidindi recently received her undergraduate degree in Economics and works as a research assistant for the India Smartphone Study at the Center for Community-Based Research within the Dana-Farber Cancer Institute.

Mangesh Pednekar, Healis Sekhsaria Institute for Public Health, Navi Mumbai, India

Dr. Mangesh S. Pednekar is an epidemiologist and the Director of the Healis Sekhsaria Institute for Public Health. His core research involves designing and testing health interventions mainly related to tobacco control, diet, physical activity, and nutrition, as well as communicable and non-communicable disease epidemiology.