Overall Assessment: Good, Feasible Topic for a CRRI Project

• Cross-sectional, observational, no intervention → ethically simple, feasible in 3 months, no follow-up needed
• Topic is current and internationally relevant — recent 2025 systematic reviews confirm active research interest (digital health in pregnancy is a "hot" area), but a specific tertiary-care hospital, exposure-vs-knowledge association study in India is still a genuine local gap — most existing literature is qualitative or from high-income countries.
• Data is easily collectible via a single-sitting questionnaire in the ANC OPD — realistic for a 3-month CRRI window.
• Naturally links to your interest categories (ANC/PNC/MCH) that you scribbled in your notes.

• "Digital health information exposure" is vague — you must operationally define it (see below) or reviewers/guide will ask.
• "Pregnancy-related knowledge" also needs a defined, scorable domain (e.g., danger signs, nutrition, birth preparedness, breastfeeding) — don't try to cover all of obstetric knowledge.
• Association ≠ causation — a cross-sectional design can only show association; say so explicitly, don't overclaim causality.

Refining the Title (optional but recommended)

Walking Through Your Protocol Structure

1. Background/Introduction (Broad → Narrow → Gap)

• Para 1: Global burden — maternal mortality/morbidity, importance of ANC knowledge in reducing complications (WHO/Govt of India data).
• Para 2: Shift in health information seeking — smartphone penetration, internet use in India, rise of WhatsApp/YouTube/pregnancy apps/government tools (e.g. mMitra, Kilkari) as parallel/alternative sources to doctor/ANC counselling.
• Para 3: What's known — cite the literature you'll find (see below), including recent reviews (2025) showing mixed effects of digital health tools on maternal knowledge/behavior.
• Para 4 (the Gap, circle it like your notes): Most studies look at digital health interventions (apps designed by researchers) or are qualitative; few quantify the association between real-world spontaneous digital information exposure and actual knowledge scores in Indian tertiary hospital ANC attendees. This justifies your study.

• Systematic review on digital health interventions in high-risk pregnancies (2025) - useful as background on effectiveness of digital tools generally.
• Qualitative work on digital health literacy in pregnancy showing internet as a major information source but with validity concerns - good for your rationale.
• Development of an e-health literacy scale specific to pregnant women (multi-dimensional, Cronbach's alpha 0.937) - useful methodological reference for your tool.

2. Aim & Objectives

• Aim: To study the association between digital health information exposure and pregnancy-related knowledge among antenatal mothers attending the ANC OPD of [hospital name].
• Primary objective: To assess the level of pregnancy-related knowledge among antenatal mothers and its association with digital health information exposure.
• Secondary objectives (your "1°/2°" notation):
  1. To determine the proportion of antenatal mothers exposed to digital sources of health information (type, frequency, platforms used).
  2. To assess the level of knowledge regarding antenatal care/danger signs/nutrition among study participants.
  3. To find the association between socio-demographic factors (age, education, parity, socioeconomic status) and knowledge level.

3. Review of Literature

• Studies on internet/social media use in pregnancy (India + globally)
• Studies on ANC knowledge levels (KAP studies) in Indian tertiary hospitals
• Studies validating digital/eHealth literacy tools in pregnant populations

• Development and validation of an e-health literacy scale for pregnant women (mHealth, 2025) — gives you a validated multi-dimensional tool (22 items, 4 domains: acquisition, evaluation, interaction, application) you can adapt.
• Norman & Skinner, eHEALS: The eHealth Literacy Scale — the original 8-item generic tool, widely used, easy to adapt/translate.
• Qualitative study on digital health literacy and learning needs in pregnancy (European Journal of Midwifery) — shows internet is a top information source but women worry about validity — strengthens your gap statement.
• Systematic reviews on digital health interventions in pregnancy (2025) — background on effectiveness, mixed evidence.

4. Materials & Methodology

• Month 1: Finalize protocol, IEC submission/approval, pretest questionnaire, pilot study (10% of sample)
• Month 2: Data collection
• Month 3: Data entry, analysis, write-up

• Pregnant women attending ANC OPD during study period
• Willing to give informed consent
• Owns/has access to a smartphone or has used internet/digital media at least once during current pregnancy (relevant for the "exposed" arm; if you want the full spectrum, don't restrict — just record exposure status for everyone)
• Age ≥18 years (avoid consent complications with minors)

• Not willing to participate
• Unable to communicate/comprehend the questionnaire (e.g., severe illness, cognitive impairment)
• High-risk pregnancy requiring immediate attention (to avoid interfering with care)

• Z = 1.96 (95% CI), p = 0.5, q = 0.5, d = 0.05 (absolute precision)
• n = (1.96² × 0.5 × 0.5) / 0.05² = 384
• Add ~10% for non-response/incomplete forms → ~420-425

1. Socio-demographic profile (age, education, parity, gravida, SES via a validated scale e.g. B.G. Prasad or Kuppuswamy)
2. Digital health information exposure — adapt a short version of eHEALS or the pregnancy-specific e-health literacy scale (acquisition/evaluation/application items), plus simple items on: which platforms (WhatsApp, YouTube, Google, Instagram/Facebook groups, government apps like mMitra), frequency of use, and trust in the information
3. Pregnancy-related knowledge score — a validated ANC knowledge questionnaire (danger signs of pregnancy, nutrition, birth preparedness, breastfeeding, immunization) — you can build this from WHO/Govt of India ANC guidelines and validate via expert content validity + pilot Cronbach's alpha

• Descriptive stats: proportions, mean ± SD for knowledge score
• Categorize "exposed" vs "not exposed" to digital health info (or level of exposure — low/moderate/high)
• Categorize knowledge as adequate/inadequate using a cutoff (e.g., median split or ≥60% correct)
• Association: Chi-square test (categorical exposure vs knowledge category); if continuous, unpaired t-test/ANOVA; multivariable binary logistic regression to adjust for confounders (education, parity, SES, age) and report adjusted odds ratio (AOR) with 95% CI
• p < 0.05 significance

5. Data Collection → Results → Discussion

• Present results as tables: socio-demographic profile, exposure prevalence, knowledge score distribution, cross-tabulation of exposure vs knowledge, regression table.
• Discussion: compare your findings with the literature reviewed (proportions of exposure, knowledge adequacy, strength of association) — explicitly state agreement/disagreement with the studies cited above.

6. Strengths & Limitations

• Strengths: adequately powered sample, validated tools, tertiary-care setting generalizable to referral population.
• Limitations: cross-sectional design (no causality), single-center (limited generalizability), self-reported exposure (recall/social desirability bias), interviewer-administered (possible interviewer bias).

7. Conclusion, Recommendations, References

• Recommendations should be actionable for a CRRI-level paper: e.g., healthcare providers actively curate/recommend trusted digital resources (government apps, verified YouTube channels) during ANC visits, health education modules incorporating digital literacy.
• References: Vancouver style, include the WHO ANC guidelines, Park's PSM chapter on antenatal care and health education, and the studies identified above.

Practical Tips for You as a CRRI

1. Coordinate early with your community medicine guide on the exact knowledge domains and the exposure tool — get their sign-off before finalizing the questionnaire, since IEC approval and pretesting take time within your 3-month window.
2. Submit IEC application in week 1 — approval can take 2-4 weeks; don't lose time.
3. Use Google Forms or KoboToolbox for data entry directly on a tablet/phone during interviews to save transcription time — syncs well with your "Zoho software" plan too.
4. Keep the knowledge questionnaire short and validated (10-15 items) — pilot it for internal consistency (Cronbach's alpha ≥0.7) before rollout.
5. Since you have only 3 months, consecutive sampling in the OPD (rather than random sampling from a list) is the most time-efficient and standard for CRRI-level cross-sectional studies.

Recommendation: ANC (Antenatal Care) is the best choice for you as a CRRI, followed by PNC as a close second. MED (communicable/NCD) is the least practical given your 3-month CRRI window.

Why ANC wins

1. You already have a fully worked-out, ethically simple, feasible protocol for it (digital health exposure and pregnancy knowledge) — restarting for PNC or MED means redoing the background, gap analysis, tool selection, and sample size work.
2. ANC OPD patient turnover in a tertiary hospital is typically the highest of the three, which matters enormously when you only have ~2 months for actual data collection inside a 3-month project.
3. The digital-health angle is genuinely under-studied in the Indian antenatal population specifically (most existing work is qualitative or from high-income countries, as I found earlier) — good publication potential for a CRRI-level paper.

When PNC would be the better pick instead

Why MED (communicable/NCD) is the weakest choice for you right now

ANC (Antenatal Care)

1. Association between digital health information exposure and pregnancy-related knowledge among ANC attendees (your original topic - still the strongest option).
2. Awareness and practice of Birth Preparedness and Complication Readiness (BPCR) among antenatal mothers at a tertiary hospital.
3. Knowledge and compliance with iron-folic acid/calcium supplementation and factors affecting adherence among ANC attendees.
4. Awareness of gestational diabetes mellitus (GDM) screening and its determinants among pregnant women.
5. Prevalence of food taboos/misconceptions during pregnancy and their association with nutritional knowledge.
6. Awareness of danger signs of pregnancy and health-seeking behavior among rural vs urban ANC attendees (good comparative angle, still just a questionnaire).

PNC (Postnatal Care)

1. Knowledge, attitude and practice of exclusive breastfeeding among postnatal mothers at discharge - well-established, easy tool available (I found existing Indian studies from Garhwal you can cite as comparison).
2. Awareness and uptake intention of postpartum contraception among postnatal mothers before discharge.
3. Knowledge of essential newborn care practices (thermal care, cord care, danger signs) among mothers in the postnatal ward.
4. Association between digital/social media exposure and breastfeeding practices among postnatal mothers (mirrors your ANC digital-health angle - unique combo, not much Indian literature on this specific pairing).
5. Awareness regarding infant immunization schedule among postnatal mothers and its correlation with education/parity.
6. Screening for postpartum blues/depression awareness among postnatal mothers (needs psychiatry department support for referral pathway - flag ethically but doable as an awareness-only questionnaire, not a diagnostic study).

MED - Communicable & Non-Communicable Diseases

1. Awareness of hypertension and its risk factors among adult medicine OPD attendees, with opportunistic BP screening.
2. Knowledge and awareness of diabetes mellitus and its complications among adult OPD patients.
3. Awareness of stroke/heart attack warning signs (FAST rule) among general OPD attendees - very quick to administer.
4. Tobacco use pattern and quit-attempt awareness among adult male patients attending OPD.
5. Awareness of social media/WhatsApp-driven health misinformation about NCDs (diabetes/hypertension home remedies) among OPD attendees - a genuinely novel, easy, questionnaire-only angle tied to current research interest in digital misinformation.

1. Awareness of TB symptoms and DOTS treatment adherence among patients attending the chest/TB OPD.
2. Knowledge and practices regarding dengue/vector-borne disease prevention among patients attending general OPD (seasonal, relevant, easy).
3. Awareness of rabies post-exposure prophylaxis among patients attending the anti-rabies clinic.
4. Knowledge and attitude toward HIV transmission and prevention among antenatal mothers (a good CD+ANC crossover if you want a combined angle).
5. Hand hygiene awareness and practice among hospital attendants/caregivers - fast, observational + questionnaire, almost zero logistics.

My top pick per category (feasibility + novelty balance)

• ANC: your existing digital-health-exposure-and-knowledge topic — no reason to change, it's already fully worked out.
• PNC: digital/social media exposure and breastfeeding practices — keeps your "digital health" theme consistent across submissions if you ever need a second project, and is under-studied in India.
• MED: awareness of hypertension/diabetes risk factors with opportunistic screening in OPD, or the social-media-misinformation-about-NCDs angle if you want something more novel and paper-worthy.