Table 1
Component constructs from the Theoretical Framework on Acceptability.
| COMPONENT CONSTRUCTS | DEFINITIONa | APPLICATION TO THE ZAMBIAN FOLKTALES CHILDREN’S BOOK INTERVENTION |
|---|---|---|
| Affective attitude | How an individual feels about the intervention | What community members feel about the book |
| Ethicality | The extent to which the intervention has good fit with an individual’s value system | How the book relates to the culture beliefs and value systems within these communities |
| Self-efficacy | The participant’s confidence that they can perform the behavior(s) required to participate in the intervention | How easy community members feel the book is to use What facilitates use of the book |
| Intervention coherence | The extent to which the participant understands the intervention and how it works | How the book is used within these communities |
| Perceived effectiveness | The extent to which the intervention is perceived as likely to achieve its purpose | What community members think about the effectiveness of the book |
| Burden | Perceived amount of effort that is required to participate in the intervention | What amount of effort community members think is needed to use the book What barriers or challenges exist to using the book |
| Opportunity costs | The extent to which benefits, profits, or values must be given up to engage in the intervention | What community members think must be given up to use the book |
[i] a Definitions quoted from Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: An overview of reviews and development of a theoretical framework. BMC Health Services Research 2017; 17. DOI: 10.1186/s12913-017-2031-8.
Table 2
Community perceptions of Zambian Folktales Children’s Book content and use by theoretical framework construct, including illustrative quotes.
| COMPONENT CONSTRUCT | THEMES | ILLUSTRATIVE QUOTES |
|---|---|---|
| Affective Attitude | 1. Positive views from caregivers 2. Engages & entertains children: children enjoy the book and are happy to read; ask parents to read to them 3. Appreciate folktales stories: help connect with ancestry; their grandparents were taught some stories as children | “I heard that the majority of people are praising this book because the majority of children are kept busy with this book. Even those who do not know how to read can point at pictures, here is a cow, this is a goat.” – Community member, female, Pemba district “It made me happy that this book teaches everything that is in the country Zambia. It teaches you good and bad that you can follow and do to succeed in this country Zambia.” – Community member, female, Choma district “People have praised the books especially on the folktales. Children who are born these days do not know the folktales so they thank the government that they made such an initiative to also teach children old things.” – Community member, female, Choma district |
| Ethicality | 1. Stories teach life lessons and values: teaches children (and adults) lessons about how to live well, about love, forgiveness, humility, work ethic, respect, etc.; lessons are important to children’s growth; lessons guide children and families in the way of living well; adults also find value in the lessons; morals in line with religious beliefs | “This book teaches about how we are supposed to help each other or how to teach children on how they are supposed to help each other.” – Community member, female, Kalomo district “The stories teach that you are not supposed to [seek] revenge, like one story of the crocodile, which … shows that you are not supposed to do bad things to your friend. When someone wrongs you, you should learn to forgive.” – Community member, female, Pemba district “I am telling the story of how the lion learned to be thankful. He was helped by an antelope from a ditch but at the end he wanted to eat it. We take the lesson of being thankful to the person who has helped you not that you go against someone who is helping you.” - Community member, female, Choma district |
| Self-Efficacy | 1. Pictures support narrative: make book easy to use: help children understand stories; support and reinforce lessons being taught 2. Book written in local language: easier for caregivers and children to use 3. Language easy to understand: language is simple; appropriate to read to young children | “Because in the book there are pictures that we can see, so when we are looking at those pictures, we are able to tell what the story means, even if you don’t know how to read that story, [the pictures] can guide you.” – Community member, female, Kalomo district “What makes it easy, it is not only in one language it is in all languages. If I cannot read English, then Chitonga will be easier for me to read for the child.” – Community member, female, Pemba district “[Community members] feel good about the stories, and how they are written and how they are drawn. They help to relate when you are reading, cause if you read here is a rabbit, and you will actually see the rabbit in the pictures.” – Community member, female, Choma district |
| Intervention Coherence | 1. Read at home: caregivers and other family members read to children; set aside or prioritize time to sit together and read; parents and older siblings primarily read to young children 2. Read in groups outside the home: groups of friends and neighbors sit together and read; older children read to younger children 3. Book facilitates dialogue: caregivers ask children questions about the story and/or pictures; comment and explain stories and lessons to children 4. Children identify objects in pictures 5. Pictures facilitate independent use: children look at book independently particularly the pictures; young children sit together and look at books; children tell each other stories | “The way we use it in my family, the time we are chatting in the evenings after eating that is when we sit and start reading stories and teaching the children.” – Community member, female, Kalomo district “We do not only read for the children alone. When we read for our children, they also tell their friends to come at this time so the mother or grandmother can read for them too.” – Community member, female, Kalomo district “I sit my children down after eating and tell them to bring the book and so I ask them which story do you like the most, and so they show me and I read for them.” – Community member, female, Pemba district “When I have finished reading them a story…I will not just leave it there. I will explain… how we are supposed to live as Christians. If you have something, you have to share with your friends. That is want God requires he does not like stingy people. I tell them everything about heaven and earth.” – Community member, female, Kalomo district “As I read, I show the child things [in the pictures].” – Community member, female, Nyimba district “Children find time alone that they sit and read. Or the time they are herding goats, you find those that are able to read, they take it with them. …Those who are not yet able to read also envy it, like ‘this one knows how to read, I also want to know how to read.’” – Community member, female, Kalomo district |
| Perceived Effectiveness | 1. Children are learning and being prepared for school: children learn vocabulary and reading comprehension; reading develops children’s brains and speech; pictures teach children to identify objects as they will in school; prepares children for school environment 2. Increases interactions with friends/family 3. Teaches children how to interact with others: book stories teach manners, respect, following instructions, etc; improves relationships | “The book helps to children who are supposed to start grade one because it has words a child who is starting grade one should know what they mean.” – Community member, female, Pemba district “I have seen when the children listen to these stories and when they sit with their fellow children, they share the stories saying, ‘my mother told me this and that from the book’. So that is how that friendship is going to be strong because they share new things that they didn’t know.” – Community member, female, Nyimba district “At home, if [children] are found with something and the friends do not have [the same] and the child is stingy then I just tell him that ‘You have forgotten what we were saying, what did we read in the book?’ Then you just see the child sharing with the friend.” – Community member, female, Nyimba district |
| Burden | 1. Nothing difficult: caregivers find book easy to understand and use 2. Adult Illiteracy: families without a family member who can read have a difficult time using the book; some vocabulary was challenging | “The only difficulty that can be there is if you are not able to read. What they read they do, they just do not know how to read then they cannot be able to know the goodness in that book.” – Community member, female, Choma district “[Some households] do not have anyone who can read, so sometimes for those who really want to know the stories, [the caregivers] will go to one who knows how to read in a group or ask that they teach them how to read. [They will say,] ‘This thing has really interested me, please teach me so that even my children should know it.’” – Community member, female, Kalomo district |
| Opportunity Costs | No themes arose | No themes arose |