scholarly journals mHealth tool to improve community health agent performance for child development: study protocol for a cluster-randomised controlled trial in Peru

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028361 ◽  
Author(s):  
Christopher Michael Westgard ◽  
Natalia Rivadeneyra ◽  
Patricia Mechael
Keyword(s):  
Child Development ◽  
Child Health ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Child Rearing ◽  
Development Indicators ◽  
Cluster Randomised ◽  
Health And Development ◽  
Randomised Controlled ◽  
The Impact

IntroductionCultivating child health and development creates long-term impact on the well-being of the individual and society. The Amazon of Peru has high levels of many risk factors that are associated with poor child development. The use of ‘community health agents’ (CHAs) has been shown to be a potential solution to improve child development outcomes. Additionally, mobile information and communication technology (ICT) can potentially increase the performance and impact of CHAs. However, there is a knowledge gap in how mobile ICT can be deployed to improve child development in low resource settings.Methods and analysisThe current study will evaluate the implementation and impact of a tablet-based application that intends to improve the performance of CHAs, thus improving the child-rearing practices of caregivers and ultimately child health and development indicators. The CHAs will use the app during their home visits to record child health indicators and present information, images and videos to teach key health messages. The impact will be evaluated through an experimental cluster randomised controlled trial. The clusters will be assigned to the intervention or control group based on a covariate-constrained randomisation method. The impact on child development scores, anaemia and chronic malnutrition will be assessed with an analysis of covariance. The secondary outcomes include knowledge of healthy child-rearing practices by caregivers, performance of CHAs and use of health services. The process evaluation will report on implementation outcomes. The study will be implemented in the Amazon region of Peru with children under 4. The results of the study will provide evidence on the potential of a mHealth tool to improve child health and development indicators in the region.Ethics and disseminationThe study received approval from National Hospital ‘San Bartolome’ Institutional Ethics Committee on 8 November 2018 (IRB Approval #15463–18) and will be disseminated via peer-reviewed publications.Trial registration numberISRCTN43591826.

scholarly journals Social capital is associated with lower mosquito vector indices: secondary analysis from a cluster randomised controlled trial of community mobilisation for dengue prevention in Mexico

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Víctor Alvarado-Castro ◽  
Sergio Paredes-Solís ◽  
Elizabeth Nava-Aguilera ◽  
Arcadio Morales-Pérez ◽  
Miguel Flores-Moreno ◽  
...  
Keyword(s):  
Social Capital ◽  
Multivariate Analysis ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Cluster Randomised Controlled Trial ◽  
Community Mobilisation ◽  
Cluster Randomised ◽  
Camino Verde ◽  
Randomised Controlled ◽  
The Impact

Abstract Background Control of the Aedes aegypti mosquito is central to reducing the risk of dengue, zika, chikungunya, and yellow fever. Randomised controlled trials, including the Camino Verde trial in Mexico and Nicaragua, demonstrate the convincing impact of community mobilisation interventions on vector indices. These interventions might work through building social capital but little is known about the relationship between social capital and vector indices. Methods A secondary analysis used data collected from 45 intervention clusters and 45 control clusters in the impact survey of the Mexican arm of the Camino Verde cluster randomised controlled trial. Factor analysis combined responses to questions about aspects of social capital to create a social capital index with four constructs, their weighted averages then combined into a single scale. We categorised households as having high or low social capital based on their score on this scale. We examined associations between social capital and larval and pupal vector indices, taking account of the effects of other variables in a multivariate analysis. We report associations as odds ratios and 95% confidence intervals. Results The four social capital constructs were involvement, participation, investment, and communication. Among the 10,112 households, those in rural communities were much more likely to have a high social capital score (OR 4.51, 95% CIca 3.26–6.26). Households in intervention sites had higher social capital, although the association was not significant at the 5% level. Households with high social capital were more likely to be negative for larvae or pupae (OR 1.38, 95% CIca 1.12–1.69) and for pupae specifically (OR 1.37, 95% CIca 1.08–1.74). There was interaction between intervention status and social capital; in multivariate analysis, a combined variable of intervention/high social capital remained associated with larvae or pupae (ORa l.56, 95% CIca 1.19–2.04) and with pupae specifically (ORa 1.65, 95% CIca 1.20–2.28). Conclusion This is the first report of an association of high social capital with low vector indices. Our findings support the idea that the Camino Verde community mobilisation intervention worked partly through an interaction with social capital. Understanding such interactions may help to maximise the impact of future community mobilisation interventions.

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