Postdoctoral Research Fellow Brigham and Women's Hospital, Harvard Medical School Boston, Massachusetts, United States
Background: Neuroimaging techniques such as magnetic resonance imaging (MRI) and electroencephalography (EEG) offer early and sensitive identification of neural markers likely to predict atypical neurodevelopment. However, implementation of such techniques is limited in low-and-middle-income countries where burden of neurodevelopmental morbidities is high. Objective: To explore the acceptability of MRI and EEG amongst community stakeholders in rural Amhara, Ethiopia. Design/Methods: We conducted interviews with parents of children < 24 months and community members including religious leaders in rural Amhara, Ethiopia in September 2022. A structured interview guide was used to explore perceptions, prior experience, acceptability, and feasibility of introduction of MRI and EEG. Interviews were transcribed verbatim, translated to English, and independently double-coded. Abductive thematic analysis was used to identify themes. Results: Twenty-five participants were interviewed (Mothers=13, Fathers=7, Other=5). Participants reported familiarity with routine imaging such as ultrasound and X-ray. Knowledge of MRI and EEG was limited and no participants had previous experience. Broadly, participants responded positively with openness toward informative videos showing MRI and EEG acquisition. Participants found procedures acceptable, and that ensuring sleep and noise protection during MRI would be helpful. Some parents were enthusiastic about having their children undergo neuroimaging to learn more about their child's development, and noted that MRI/EEG were advanced technology that are unlikely to present adverse effects to their children. Some parents expressed concerns about separation from the child and negative effects on the child’s brain due to radiation, electrical exposure, and use of EEG electrodes. Potential logistical barriers identified included transportation challenges, especially for rural-dwelling families. Those with lesser education were also identified to be less accepting of MRI/EEG. Among several mothers, consent from their husbands was necessary for participation. Recommendations to improve acceptability included engaging healthcare providers and community leaders such as religious leaders and community activists to improve awareness.
Conclusion(s): This formative research revealed approaches to increase acceptability of MRI/EEG introduction into the rural Amhara community. Key learning points include the importance of communicating the safety of procedures, creating community buy-in by involving fathers and leveraging community leaders to increase acceptability, and reducing logistical barriers.
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