Introduction Radio-based health communication is widely used to promote preventive behaviours and care-seeking in low- and middle-income countries, yet evidence on programme reach, perceived relevance, trust, and self-reported behavioural influence across differing local contexts remains limited. We evaluated the ReBUILD for Resilience health-talk programme in Kailahun, a largely rural district in eastern Sierra Leone, and Moyamba, an urban/peri-urban district in southern Sierra Leone, to assess programme exposure, perceptions, trust ecology, self-attributed behaviour change, and alternative information channels. Methods We conducted a cross-sectional, community-based survey using a two-stage stratified cluster sampling design to obtain district-representative samples (Kailahun <InlineEquation ID="IEq1"> <EquationSource Format="TEX">\(\:n=211\)</EquationSource> </InlineEquation>; Moyamba <InlineEquation ID="IEq2"> <EquationSource Format="TEX">\(\:n=191\)</EquationSource> </InlineEquation>). Adults aged 18 years and older completed a structured questionnaire covering socio-demographics, exposure to ReBUILD for Resilience, perceptions of programme content, trust in local stakeholders, self-attributed behaviour changes among listeners, comfort communicating with providers, community engagement, barriers to acting on messages, and other health information sources. Analyses accounted for the complex survey design and were conducted in R version 4.3.1. Results Programme exposure was substantial overall and higher in Kailahun than in Moyamba (68% vs. 47%, <InlineEquation ID="IEq3"> <EquationSource Format="TEX">\(\:p<0.001\)</EquationSource> </InlineEquation>). Among listeners, perceptions were highly favourable in both districts, with mean scores of 4.6–4.8 out of 5 for ease of understanding, relevance, usefulness, and trust, although perceived relevance and trust were modestly lower in Moyamba. Self-attributed behaviour change was widely reported among listeners in both settings (98% in Kailahun and 94% in Moyamba; <InlineEquation ID="IEq4"> <EquationSource Format="TEX">\(\:p=0.11\)</EquationSource> </InlineEquation>), with commonly cited changes including greater bed-net use, more routine health-facility visits, and improved hygiene practices. Trust in health workers was high in both districts, while trust in religious leaders, chiefs, and youth representatives was higher in Kailahun. Among non-listeners, alternative health information channels also differed by context, with greater reliance on health-facility staff in Moyamba and on community meetings and local leaders in Kailahun. Conclusion The ReBUILD for Resilience health-talk programme achieved meaningful reach and was perceived as useful and trustworthy in two distinct settings in Sierra Leone. Respondents frequently attributed positive health-related actions to the programme, although causal inference is limited by the cross-sectional design and self-reported outcomes. Differences in engagement and trust patterns suggest that radio health communication may be strengthened by context-specific delivery strategies, multilingual programming, improved device access, and integration with health-facility counselling and community-based communication channels.

Impact of radio health talks on engagement, trust, and self-reported behaviour change in rural and peri-urban Sierra Leone

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2026年5月5日

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Augustus Osborne,
Michael Munu,
Halimatu Kamara,
Tamba Morris,
Karin Diaconu,
Ayesha Idriss

摘要

Introduction

Radio-based health communication is widely used to promote preventive behaviours and care-seeking in low- and middle-income countries, yet evidence on programme reach, perceived relevance, trust, and self-reported behavioural influence across differing local contexts remains limited. We evaluated the ReBUILD for Resilience health-talk programme in Kailahun, a largely rural district in eastern Sierra Leone, and Moyamba, an urban/peri-urban district in southern Sierra Leone, to assess programme exposure, perceptions, trust ecology, self-attributed behaviour change, and alternative information channels.

Methods

We conducted a cross-sectional, community-based survey using a two-stage stratified cluster sampling design to obtain district-representative samples (Kailahun \(\:n=211\) ; Moyamba \(\:n=191\) ). Adults aged 18 years and older completed a structured questionnaire covering socio-demographics, exposure to ReBUILD for Resilience, perceptions of programme content, trust in local stakeholders, self-attributed behaviour changes among listeners, comfort communicating with providers, community engagement, barriers to acting on messages, and other health information sources. Analyses accounted for the complex survey design and were conducted in R version 4.3.1.

Results

Programme exposure was substantial overall and higher in Kailahun than in Moyamba (68% vs. 47%, \(\:p<0.001\) ). Among listeners, perceptions were highly favourable in both districts, with mean scores of 4.6–4.8 out of 5 for ease of understanding, relevance, usefulness, and trust, although perceived relevance and trust were modestly lower in Moyamba. Self-attributed behaviour change was widely reported among listeners in both settings (98% in Kailahun and 94% in Moyamba; \(\:p=0.11\) ), with commonly cited changes including greater bed-net use, more routine health-facility visits, and improved hygiene practices. Trust in health workers was high in both districts, while trust in religious leaders, chiefs, and youth representatives was higher in Kailahun. Among non-listeners, alternative health information channels also differed by context, with greater reliance on health-facility staff in Moyamba and on community meetings and local leaders in Kailahun.

Conclusion

The ReBUILD for Resilience health-talk programme achieved meaningful reach and was perceived as useful and trustworthy in two distinct settings in Sierra Leone. Respondents frequently attributed positive health-related actions to the programme, although causal inference is limited by the cross-sectional design and self-reported outcomes. Differences in engagement and trust patterns suggest that radio health communication may be strengthened by context-specific delivery strategies, multilingual programming, improved device access, and integration with health-facility counselling and community-based communication channels.