scholarly journals A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom

2016 ◽  
Vol 37 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Jacqui S. Reilly ◽  
Lesley Price ◽  
Sue Lang ◽  
Chris Robertson ◽  
Francine Cheater ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hand Hygiene ◽  
Disease Control ◽  
Controlled Trial ◽  
Bacterial Count ◽  
World Health ◽  
Direct Patient Care ◽  
Randomized Controlled ◽  
The World ◽  
Centers For Disease Control

OBJECTIVETo evaluate the microbiologic effectiveness of the World Health Organization’s 6-step and the Centers for Disease Control and Prevention’s 3-step hand hygiene techniques using alcohol-based handrub.DESIGNA parallel group randomized controlled trial.SETTINGAn acute care inner-city teaching hospital (Glasgow).PARTICIPANTSDoctors (n=42) and nurses (n=78) undertaking direct patient care.INTERVENTIONRandom 1:1 allocation of the 6-step (n=60) or the 3-step (n=60) technique.RESULTSThe 6-step technique was microbiologically more effective at reducing the median log10 bacterial count. The 6-step technique reduced the count from 3.28 CFU/mL (95% CI, 3.11–3.38 CFU/mL) to 2.58 CFU/mL (2.08–2.93 CFU/mL), whereas the 3-step reduced it from 3.08 CFU/mL (2.977–3.27 CFU/mL) to 2.88 CFU/mL (−2.58 to 3.15 CFU/mL) (P=.02). However, the 6-step technique did not increase the total hand coverage area (98.8% vs 99.0%, P=.15) and required 15% (95% CI, 6%-24%) more time (42.50 seconds vs 35.0 seconds, P=.002). Total hand coverage was not related to the reduction in bacterial count.CONCLUSIONSTwo techniques for hand hygiene using alcohol-based handrub are promoted in international guidance, the 6-step by the World Health Organization and 3-step by the Centers for Disease Control and Prevention. The study provides the first evidence in a randomized controlled trial that the 6-step technique is superior, thus these international guidance documents should consider this evidence, as should healthcare organizations using the 3-step technique in practice.Infect Control Hosp Epidemiol 2016;37:661–666

The Effect of Mobile Instant Messaging versus Face-to-Face Counseling on the Primiparous Mothers’ Breastfeeding Self-efficacy: A Pilot Randomized Controlled Trial

2020 ◽  
Author(s):  
Manoosh Mehrabi ◽  
Shoale Zarei ◽  
Leila Bazrafkan ◽  
Ali Reza Safarpour
Keyword(s):  
Randomized Controlled Trial ◽  
Self Efficacy ◽  
Instant Messaging ◽  
Controlled Trial ◽  
World Health ◽  
Face To Face ◽  
Randomized Controlled ◽  
The World ◽  
The Impact ◽  
Pilot Randomized Controlled Trial

Abstract Background Increasing breastfeeding rates around the world is one of the most important goals of the World Health Organization. Self-efficacy is a modifying and predictive factor for initiation and continuation of breastfeeding. This study was conducted to investigate the impact of mobile-based education and regular delivery of designed messages on breastfeeding self-efficacy in primiparous mothers. Methods This study was a double blind pilot randomized controlled trial, in which a hundred and twenty primiparous breastfeeding mothers were randomly allocated into two groups using permuted block randomization. The standard method conseling arm received routine counseling interventions and the intervention arm received a mobile instant messaging program in addition to the usual counseling. The main objective of this study was to compare self-efficacy in face-to-face counseling group and mobile instant messaging group. Self-efficacy levels were compared in the two groups before and after the study procedures. Results In this study, 60 mothers were studied in each group, and then the collected data were analyzed. The mean post-test scores in the intervention group (60.40 ± 4.92) and the control group (50.10 ± 7.60) were compared in the main analysis. The results indicated a statistically significant difference (p <0.001). Given the amount of effect size ( d= 0.99; 95% CI=1.19-2.02 ) it appears that there is a high level correlation between the applied intervention and level of self-efficacy among the study participants, especially those with higher levels of education. Secondary findings of the study involved evaluating the effects of education, occupation, family income, lactation duration and spouse support for breastfeeding self-efficacy. Except for the maternal education level, which had a significant relationship with the level of breastfeeding self-efficacy (p= 0.02), the other factors did not show any correlation with self-efficacy in breastfeeding. Conclusion The pilot study provided valuable information for feasibility assessment of randomized controlled trials in future studies with larger sample sizes and more participant diversity.

scholarly journals Handwashing effect on diarrheal incidence in children under 5 years old in rural eastern Ethiopia: a cluster randomized controlled trial

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Ephrem Tefera Solomon ◽  
Sirak Robele Gari ◽  
Helmut Kloos ◽  
Bezatu Mengistie Alemu
Keyword(s):  
Randomized Controlled Trial ◽  
Hand Hygiene ◽  
Controlled Trial ◽  
Eastern Ethiopia ◽  
Randomized Controlled ◽  
Dire Dawa ◽  
Cluster Randomized ◽  
Diarrheal Incidence ◽  
Handwashing With Soap ◽  
Children Under 5

Abstract Background Handwashing with soap reduces diarrheal diseases burden considerably. However, the importance of handwashing in homes has received little attention in rural eastern Ethiopia. The effectiveness of handwashing may be reduced by lack of information on when and in what event hands must be washed, the frequency of handwashing, the individual who should wash his/her hands, and the procedure of handwashing. In these areas, indicators of adherence to handwashing are yet to be established. This study aimed at assessing the efficiency of handwashing on reducing diarrheal disease in children under 5 years old in rural kebeles of Dire Dawa, east Ethiopia. Methods Community-based cluster randomized controlled trial was conducted in rural kebeles of Dire Dawa for 4 months starting from October 2018 to January 2019. Selected clusters were randomized in intervention and control arms using draw method and data collectors conducted the baseline survey. Households assigned to the intervention group were given two bars of plain soap on a bi-monthly basis together with information promoting hand hygiene. Control households were allowed to continue their habitual handwashing practices. We compared the diarrheal incidences of the intervention and non-intervention households. Generalized estimation equations using Poisson family and log choice of the link was employed to calculate adjusted incidence rate ratio with its 95% confidence interval. Results We recorded a significant lesser diarrheal incidence in the handwashing arm than in the non-intervention arm (6.9 versus 13.8 episodes per 100 person weeks of observation). In all, there was a 41% reduction in diarrheal incidence in the intervention arm in relation to the non-intervention arm. Conclusion Handwashing with soap complemented with hand hygiene promotion significantly decreased diarrheal episodes in children under 5 years old in rural kebeles of Dire Dawa. We recommend the promotion and adaptation of washing hands using soap at recommended times to be an effective means of reducing childhood diarrhea morbidity in rural populations of Ethiopia towards achieving the Sustainable Development Goal 6. Trial registration PACTR, PACTR201807815961394. Registered 16 July 2018,

scholarly journals Research and Implementation Lessons Learned From a Youth-Targeted Digital Health Randomized Controlled Trial (the ARMADILLO Study)

10.2196/13005 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13005
Author(s):  
Lianne Gonsalves ◽  
Winnie Wangari Njeri ◽  
Megan Schroeder ◽  
Jefferson Mwaisaka ◽  
Peter Gichangi
Keyword(s):  
Randomized Controlled Trial ◽  
Digital Health ◽  
Controlled Trial ◽  
Text Message ◽  
Health Interventions ◽  
World Health ◽  
Intervention Period ◽  
Implementation Challenges ◽  
Randomized Controlled ◽  
Client Side

Background Evidence is lacking on the efficacy of sexual and reproductive health (SRH) communication interventions for youth (aged 15-24 years), especially from low- and middle-income countries. Therefore, the World Health Organization initiated the Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) program, a free, menu-based, on-demand text message (SMS, short message service) platform providing validated SRH content developed in collaboration with young people. A randomized controlled trial (RCT) assessing the effect of the ARMADILLO intervention on SRH-related outcomes was implemented in Kwale County, Kenya. Objective This paper describes the implementation challenges related to the RCT, observed during enrollment and the intervention period, and their implications for digital health researchers and program implementers. Methods This was an open, three-armed RCT. Following completion of a baseline survey, participants were randomized into the ARMADILLO intervention (arm 1), a once-a-week contact SMS text message (arm 2), or usual care (arm 3, no intervention). The intervention period lasted seven weeks, after which participants completed an endline survey. Results Two study team decisions had significant implications for the success of the trial’s enrollment and intervention implementation: a hands-off participant recruitment process and a design flaw in an initial language selection menu. As a result, three weeks after recruitment began, 660 participants had been randomized; however, 107 (53%) participants in arm 1 and 136 (62%) in arm 2 were “stuck” at the language menu. The research team called 231 of these nonengaging participants and successfully reached 136 to learn reasons for nonengagement. Thirty-two phone numbers were found to be either not linked to our participants (a wrong number) or not in their primary possession (a shared phone). Among eligible participants, 30 participants indicated that they had assumed the introductory message was a scam or spam. Twenty-seven participants were confused by some aspect of the system. Eleven were apathetic about engaging. Twenty-four nonengagers experienced some sort of technical issue. All participants eventually started their seven-week study period. Conclusions The ARMADILLO study’s implementation challenges provide several lessons related to both researching and implementing client-side digital health interventions, including (1) have meticulous phone data collection protocols to reduce wrong numbers, (2) train participants on the digital intervention in efficacy assessments, and (3) recognize that client-side digital health interventions have analog discontinuation challenges. Implementation lessons were (1) determine whether an intervention requires phone ownership or phone access, (2) digital health campaigns need to establish a credible presence in a busy digital space, and (3) interest in a service can be sporadic or fleeting. Clinical Trial International Standard Randomized Controlled Trial Number (ISRCTN): 85156148; http://www.isrctn. com/ISRCTN85156148

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