scholarly journals Do home pregnancy tests bring women to community health workers for antenatal care counselling? A randomized controlled trial in Madagascar

2019 ◽  
Vol 34 (8) ◽  
pp. 566-573
Author(s):  
Alison B Comfort ◽  
Randall C Juras ◽  
Sarah E K Bradley ◽  
Justin Ranjalahy Rasolofomanana ◽  
Anja Noeliarivelo Ranjalahy ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Reproductive Health ◽  
Health Services ◽  
Antenatal Care ◽  
Health Workers ◽  
Controlled Trial ◽  
Control Group ◽  
Reproductive Health Services ◽  
Randomized Controlled

Abstract Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tests brought more clients for antenatal care (ANC) counselling. We implemented a randomized controlled trial among CHWs providing reproductive health services to women in Eastern Madagascar. We used ordinary least squares regressions to estimate the effect of the intervention, with district- and month-fixed effects and CHW baseline characteristics as control variables. Our outcomes of interest included whether the intervention increased: (1) the number of women at risk of pregnancy who sought services from CHWs; (2) the number of these women who knew they were pregnant by the end of visit; and (3) the number of these women who received ANC counselling during visit. We found that providing pregnancy tests to CHWs to distribute to their clients for free significantly increased the number of women at risk of pregnancy who sought services from CHWs. At follow-up, treatment-group CHWs provided services to 6.3 clients compared with 4.2 clients among control-group CHWs, which represents a 50% relative increase from the control-group mean. A significantly higher number of these clients knew they were pregnant by the end of the visit, with a mean of 0.95 in treatment compared with 0.10 in control (Coeff. 0.86; 95% CI 0.59–1.13). A significantly higher number of these clients received antenatal counselling at the visit (Coeff. 0.4; 95% CI 0.14–0.64). Introducing free home pregnancy tests as part of community-based health services can improve pregnancy care by attracting more clients at risk of pregnancy to services at the community level, enabling more women to confirm they are pregnant and receive antenatal counselling.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering Due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3097
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic, many primary care professionals were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psychosocial support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received ‘care as usual’. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW interventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Early intervention for children at risk of visual processing dysfunctions from 1 year of age: a randomized controlled trial protocol

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marlou J. G. Kooiker ◽  
Yoni van der Linden ◽  
Jenneke van Dijk ◽  
Ymie J. van der Zee ◽  
Renate M. C. Swarte ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Visual Processing ◽  
Intervention Program ◽  
Controlled Trial ◽  
Clinical Care ◽  
Control Group ◽  
Randomized Controlled ◽  
Extremely Preterm ◽  
Intervention Protocol

Abstract Background An increasing number of children are suffering from brain damage-related visual processing dysfunctions (VPD). There is currently a lack of evidence-based intervention methods that can be used early in development. We developed a visual intervention protocol suitable from 1 year of age. The protocol is structured, comprehensive and individually adaptive, and is paired with quantitative outcome assessments. Our aim is to investigate the effectiveness of this first visual intervention program for young children with (a risk of) VPD. Methods This is a single-blind, placebo-controlled trial that is embedded within standard clinical care. The study population consists of 100 children born very or extremely preterm (< 30 weeks) at 1 year of corrected age (CA), of whom 50% are expected to have VPD. First, children undergo a visual screening at 1 year CA. If they are classified as being at risk of VPD, they are referred to standard care, which involves an ophthalmic and visual function assessment and a (newly developed) visual intervention program. This program consists of a general protocol (standardized and similar for all children) and a supplement protocol (adapted to the specific needs of the child). Children are randomly allocated to an intervention group (starting upon inclusion at 1 year CA) or a control group (postponed: starting at 2 years CA). The control group will receive a placebo treatment. The effectiveness of early visual intervention will be examined with follow-up visual and neurocognitive assessments after 1 year (upon completion of the direct intervention) and after 2 years (upon completion of the postponed intervention). Discussion Through this randomized controlled trial we will establish the effectiveness of a new and early visual intervention program. Combining a general and supplement protocol enables both structured comparisons between participants and groups, and custom habilitation that is tailored to a child’s specific needs. The design ensures that all included children will benefit from participation by advancing the age at which they start receiving an intervention. We expect results to be applicable to the overall population of children with (a risk of) VPD early in life. Trial registration Netherlands Trial Register: NTR6952. Registered 19 January 2018.

scholarly journals Community Health Workers as a Strategy to Tackle Psychosocial Suffering due to Physical Distancing: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Dorien Vanden Bossche ◽  
Susan Lagaert ◽  
Sara Willems ◽  
Peter Decat
Keyword(s):  
Randomized Controlled Trial ◽  
Community Health ◽  
Health Workers ◽  
Psychosocial Support ◽  
Controlled Trial ◽  
Intervention Group ◽  
Psychosocial Health ◽  
Control Group ◽  
Randomized Controlled ◽  
The Impact

Background: During the COVID-19 pandemic some family physicians were overburdened and experienced difficulties reaching vulnerable patients and meeting the increased need for psycho-social support. This randomized controlled trial (RCT) tested whether a primary healthcare (PHC) based community health worker (CHW) intervention could tackle psychosocial suffering due to physical distancing measures in patients with limited social networks. Methods: CHWs provided 8 weeks of tailored psychosocial support to the intervention group. Control group patients received &lsquo;care as usual&rsquo;. The impact on feelings of emotional support, social isolation, social participation, anxiety and fear of COVID-19 were measured longitudinally using a face-to-face survey to determine their mean change from baseline. Self-rated change in psychosocial health at 8 weeks was determined. Results: We failed to find a significant effect of the intervention on the prespecified psychosocial health measures. However, the intervention did lead to significant improvement in self-rated change in psychosocial health. Conclusions: This study confirms partially the existing evidence on the effectiveness of CHW in-terventions as a strategy to address mental health in PHC in a COVID context. Further research is needed to elaborate the implementation of CHWs in PHC to reach vulnerable populations during and after health crises.

scholarly journals Pregnant Women’s Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study

10.2196/28680 ◽  
2021 ◽  
Vol 5 (7) ◽  
pp. e28680
Author(s):  
Bente Walter ◽  
Hege Indreboe ◽  
Mirjam Lukasse ◽  
Lena Henriksen ◽  
Lisa Garnweidner-Holme
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Antenatal Care ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Control Group ◽  
Safety Behaviors ◽  
Face To Face ◽  
Randomized Controlled ◽  
At Home

Background Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV. Objective The aim of this study was to explore pregnant women’s attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care. Methods Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis. Results Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women’s attitudes toward and experiences with the tablet intervention. Conclusions Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet. Trial Registration ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277

scholarly journals Pregnant Women’s Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study (Preprint)

2021 ◽  
Author(s):  
Bente Walter ◽  
Hege Indreboe ◽  
Mirjam Lukasse ◽  
Lena Henriksen ◽  
Lisa Garnweidner-Holme
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Antenatal Care ◽  
Health Care Professionals ◽  
Controlled Trial ◽  
Control Group ◽  
Safety Behaviors ◽  
Face To Face ◽  
Randomized Controlled ◽  
At Home

BACKGROUND Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV. OBJECTIVE The aim of this study was to explore pregnant women’s attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care. METHODS Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis. RESULTS Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women’s attitudes toward and experiences with the tablet intervention. CONCLUSIONS Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet. CLINICALTRIAL ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277

scholarly journals The Impact of Islamic-Based Disaster Response Competencies Program on Nurses: A Computer-based Training Randomized Controlled Trial

2021 ◽  
Vol 15 (1) ◽  
pp. 433-443
Author(s):  
Cut Husna ◽  
Mustanir Yahya ◽  
Hajjul Kamil ◽  
Teuku Tahlil
Keyword(s):  
Randomized Controlled Trial ◽  
Health Services ◽  
Disaster Response ◽  
Islamic Law ◽  
Controlled Trial ◽  
Control Group ◽  
Muslim Country ◽  
Randomized Controlled ◽  
Group Knowledge ◽  
Aceh Province

Introduction: Disasters have a significant impact on physical, psychological, psychosocial, and spiritual conditions. Indonesia, a predominately Muslim country, is a country of high vulnerability and risk for disasters. The nurses are frontliners and care providers need sufficient competencies in handling the survivors in health service centers. Local government regulations in the Aceh Province required Islamic-based health services. Objective: The study aims to identify the effectiveness of the Islamic-based disaster response competencies on nurses at the Banda Aceh Hospitals. Methods: A randomized controlled trial with a pre- and post-tests with a control group design was used in this study. The population was all nurses at three hospitals in four wards: emergency department, intensive care, medical, and surgical wards. The samples were selected using cluster random sampling and assigned into three groups: evidence = 50, Islamic = 49, and control = 48. Data were analyzed using parametric and non-parametric tests. Results: The results showed a significant increase in nurses’ knowledge, skills, and attitudes of disaster response in the evidence and Islamic groups with the mean and SD of the Islamic group in post-test 1 and 2 (knowledge = 15.9±2.9 and 15.8±2.9, skills = 19.0±1.4 and 18.9±1.4, attitude = 108.1±6.9 and 108.2±6.9) were higher than the evidence group (knowledge = 15.6±2.7 and 15.5±2.7, skills = 18.7±1.5 and 18.8±1.5, attitudes = 107.5±7.4 and 107.4±7.3) and the control group (knowledge=13.8±4.0 and 13.9±4.0, skills = 17.9±1.9 and 17.9±1.9, attitude = 104.5±8.8 and 104.6±8.8), respectively. Conclusion: The results indicate the Islamic group is more effective in increasing the disaster response competencies of nurses. This finding suggests the importance of developing regulations including policies, guidelines, emergency and disaster training, and public health services to support the implementation of an appropriate Islamic-based disaster nursing responses for hospitals in the Aceh Province and other regions with the implementation of Islamic law. Request number ANZCTR 378930

scholarly journals Effect of Lipid-based Nutrient Supplement - Medium Quantity on Reduction of Stunting in Children 6–23 Months of Age in Sindh, Pakistan: A Cluster Randomized Controlled Trial (OR25-06-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sajid Soofi ◽  
Gul Nawaz ◽  
Cecilia Garzon
Keyword(s):  
Randomized Controlled Trial ◽  
Health Services ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Government Health ◽  
Randomized Controlled ◽  
Nutrient Supplement ◽  
Cluster Randomized

Abstract Objectives We evaluated the effectiveness of a locally produced lipid-based nutrient supplement - medium-quantity (LNS-MQ) known as Wawamum to prevent stunting in children 6–23 months of age in Thatta and Sujawal districts of Sindh province, Pakistan. Methods A cluster randomized controlled trial was conducted and a total of 870 children between 6–18 months old were enrolled. Children in the intervention group received 50 grams/day of Wawamum for 6 months, while children in the control group received standard government health services, not including Wawamum. The primary outcome was stunting risk reduction among children 6–23 months of age. Results Children who received Wawamum were found to have a significantly reduced risk of stunting (RR = 0.91, 95% CI; 0.88–0.94, P < 0.001) and wasting (RR = 0.78, 95% CI; 0.67–0.92, p-0.004) as compared to children who received the standard government health services. A non-significant impact was observed on underweight (RR = 0.94, 95% CI; 0.85–1.04, p-0.241) in the intervention group compared to the control group. Statistically significant reduction in anaemia in the intervention group was also found as compared to the control group (RR = 0.97, 95% CI; 0.94–0.99, p-0.008). The reduction in risk of severe anaemia was even more evident (RR = 0.45, 95% CI; 0.28–0.99, p-0.002) in the intervention group than in the control group. The mean compliance of Wawamum was 60.3% among children. Conclusions The study confirmed the plausibility of achieving nutrition gains in the short-term with a locally produced LNS-MQ, known as Wawamum, through the primary health care system. The risk of stunting and wasting was reduced by 9% and 22%, respectively. The statistically significant reduction in risk of stunting, wasting and anaemia among children 6–23 months of age showed that an immediate improvement in these nutrition indicators is indeed possible. This approach can be scaled up in similar settings to achieve positive outcomes for nutrition and health. Funding Sources World Health Organization.

scholarly journals Effects of Traditional vs. iPad-Enhanced Aerobic Exercise on Wayfinding Efficacy and Cognition: A Pilot Randomized Controlled Trial

2019 ◽  
Vol 16 (18) ◽  
pp. 3495 ◽  
Author(s):  
Daniel Palac ◽  
Tiffany Bullard ◽  
Jason D. Cohen ◽  
Lydia T. Nguyen ◽  
Raksha A. Mudar ◽  
...  
Keyword(s):  
At Risk ◽  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Aerobic Exercise ◽  
Cognitive Functioning ◽  
Self Efficacy ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Experimental Group

The purpose of this pilot study was to test the feasibility and efficacy of an iPad-enhanced aerobic exercise intervention designed to enhance wayfinding efficacy and performance and relevant cognitive functioning among middle-aged adults at risk for cognitive impairment. Twenty-seven low active adults (21 females) aged 45 to 62 years (51.22 ± 5.20) participated in a ten-week randomized controlled trial. Participants were randomized to an iPad-enhanced aerobic exercise group (experimental group) or an aerobic exercise-only group (control group) following baseline assessment. Both groups exercised at 50% to 75% of age-predicted heart rate maximum for 30 to 50 min/d, 2 d/wk for 10 weeks. During aerobic exercise, the experimental group engaged in virtual tours delivered via iPad. Baseline and post-intervention assessments of wayfinding self-efficacy, wayfinding task performance, cognitive functioning, electroencephalogram (EEG), and psychosocial questionnaires were administered. The results suggest that ten weeks of iPad-enhanced, moderately intense aerobic exercise had specific effects on wayfinding self-efficacy; however, no statistical differences were found between groups on the behavioral wayfinding task or spatial memory performance at follow-up. Performance scores on an inhibitory attentional-control cognitive assessment revealed significant differences between groups, favoring the experimental group (p < 0.05). Virtual reality-enhanced aerobic exercise may prove to be an effective method for improving cognitive function and increasing confidence to navigate real-world scenarios among individuals at risk of cognitive impairment.

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