The effect of job aids on knowledge retention among Patent and Proprietary Medicine Vendors trained to administer injectable contraceptives: longitudinal results from implementation science in Nigeria

Abstract Background: To increase access to voluntary family planning (FP) services, policymakers in Nigeria are debating how to task share the provision of injectable contraceptives to drug shop owners known as Patent and Proprietary Medicine Vendors (PPMVs). Globally, task sharing FP services to drug shops is a promising practice, but more information is needed on how to support PPMVs in providing high quality FP, including injectable services. Methods: 194 PPMVs were trained to provide FP counseling and administration of injectable contraceptive services in Bauchi, Cross River, Ebonyi and Kaduna states. PPMVs were interviewed immediately before, immediately after, and 9 months after the training. Three variables were used to assess injectable contraceptive knowledge: 1) intramuscular depot-medroxyprogesterone acetate (DMPA-IM) knowledge: a combination of three questions related to device type, injection location, and reinjection frequency; 2) subcutaneous DMPA (DMPA-SC) knowledge: a combination of the same three questions but for DMPA-SC; and 3) knowledge of at least 4 of the 7 common side effects of progestin-only injectables. Three separate adjusted logistic regression models were conducted to determine the factors that influence PPMV knowledge of injectable contraceptives 9 months after the training. Results: A little over half of PPMVs (56%) reported using at least two job aids at 9 months. PPMVs’ knowledge of DMPA-IM, DMPA-SC and side effects were low before the training but increased immediately after. Nine months later, knowledge levels remained higher than pre-test levels but generally reduced compared to post-test levels. PPMVs who reported using at least 2 FP job aids were 2.6 (95% CI: 1.4-5.1) times more likely to have complete DMPA-IM knowledge 9 months after the training compared to those who did not use job aids or only used one, while adjusting for PPMV characteristics. Similar results were observed for knowledge of DMPA-SC (AOR: 2.5; 95% CI: 1.2-4.6) and side effects (AOR: 2.5; 95% CI: 1.3-4.8). Conclusion: Training PPMVs to use proven FP job aids should be incorporated into routine trainings, as they reinforce knowledge months after a training and can help PPMVs to retain information. When designing scale-up programs, jobs aids are a good investment for larger capacity-building strategies.

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The effect of job aids on knowledge retention among Patent and Proprietary Medicine Vendors trained to administer injectable contraceptives: Longitudinal results from implementation science in Nigeria.

10.21203/rs.2.11179/v3 ◽

2019 ◽

Author(s):

Sara Chace Dwyer ◽

Aparna Jain ◽

Salisu Ishaku ◽

Faizah Okunade ◽

Chiamaka Uzomba ◽

...

Keyword(s):

Side Effects ◽

Scale Up ◽

Knowledge Retention ◽

Drug Shop ◽

Logistic Regression Models ◽

Job Aids ◽

Injectable Contraceptive ◽

Good Investment ◽

Post Test ◽

Injectable Contraceptives

Abstract Background: To increase access to voluntary family planning (FP) services, policymakers in Nigeria are debating how to task share the provision of injectable contraceptives to drug shop owners known as Patent and Proprietary Medicine Vendors (PPMVs). Globally, task sharing FP services to drug shops is a promising practice, but more information is needed on how to support PPMVs in providing high quality FP, including injectable services. Methods: 194 PPMVs were trained to provide FP counseling and administration of injectable contraceptive services in Bauchi, Cross River, Ebonyi and Kaduna states. PPMVs were interviewed immediately before, immediately after, and 9 months after the training. Three variables were used to assess injectable contraceptive knowledge: 1) intramuscular depot-medroxyprogesterone acetate (DMPA-IM) knowledge: a combination of three questions related to device type, injection location, and reinjection frequency; 2) subcutaneous DMPA (DMPA-SC) knowledge: a combination of the same three questions but for DMPA-SC; and 3) knowledge of at least 4 of the 7 common side effects of progestin-only injectables. Three separate adjusted logistic regression models were conducted to determine the factors that influence PPMV knowledge of injectable contraceptives 9 months after the training. Results: A little over half of PPMVs (56%) reported using at least two job aids at 9 months. PPMVs’ knowledge of DMPA-IM, DMPA-SC and side effects were low before the training but increased immediately after. Nine months later, knowledge levels remained higher than pre-test levels but generally reduced compared to post-test levels. PPMVs who reported using at least 2 FP job aids were 2.6 (95% CI: 1.4-5.1) times more likely to have complete DMPA-IM knowledge 9 months after the training compared to those who did not use job aids or only used one, while adjusting for PPMV characteristics. Similar results were observed for knowledge of DMPA-SC (AOR: 2.5; 95% CI: 1.2-4.6) and side effects (AOR: 2.5; 95% CI: 1.3-4.8). Conclusion: Training PPMVs to use proven FP job aids should be incorporated into routine trainings, as they reinforce knowledge months after a training and can help PPMVs to retain information. When designing scale-up programs, jobs aids are a good investment for larger capacity-building strategies.

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The effect of job aids on knowledge retention among Patent and Proprietary Medicine Vendors trained to administer injectable contraceptives: Longitudinal results from implementation science in Nigeria.

10.21203/rs.2.11179/v4 ◽

2019 ◽

Author(s):

Sara Chace Dwyer ◽

Aparna Jain ◽

Salisu Ishaku ◽

Faizah Okunade ◽

Chiamaka Uzomba ◽

...

Keyword(s):

Side Effects ◽

Scale Up ◽

Knowledge Retention ◽

Drug Shop ◽

Logistic Regression Models ◽

Job Aids ◽

Injectable Contraceptive ◽

Good Investment ◽

Post Test ◽

Injectable Contraceptives

Abstract Background: To increase access to voluntary family planning (FP) services, policymakers in Nigeria are debating how to task share the provision of injectable contraceptives to drug shop owners known as Patent and Proprietary Medicine Vendors (PPMVs). Globally, task sharing FP services to drug shops is a promising practice, but more information is needed on how to support PPMVs in providing high quality FP, including injectable services. Methods: 194 PPMVs were trained to provide FP counseling and administration of injectable contraceptive services in Bauchi, Cross River, Ebonyi and Kaduna states. PPMVs were interviewed immediately before, immediately after, and 9 months after the training. Three variables were used to assess injectable contraceptive knowledge: 1) intramuscular depot-medroxyprogesterone acetate (DMPA-IM) knowledge: a combination of three questions related to device type, injection location, and reinjection frequency; 2) subcutaneous DMPA (DMPA-SC) knowledge: a combination of the same three questions but for DMPA-SC; and 3) knowledge of at least 4 of the 7 common side effects of progestin-only injectables. Three separate adjusted logistic regression models were conducted to determine the factors that influence PPMV knowledge of injectable contraceptives 9 months after the training. Results: A little over half of PPMVs (56%) reported using at least two job aids at 9 months. PPMVs’ knowledge of DMPA-IM, DMPA-SC and side effects were low before the training but increased immediately after. Nine months later, knowledge levels remained higher than pre-test levels but generally reduced compared to post-test levels. PPMVs who reported using at least 2 FP job aids were 2.6 (95% CI: 1.4-5.1) times more likely to have complete DMPA-IM knowledge 9 months after the training compared to those who did not use job aids or only used one, while adjusting for PPMV characteristics. Similar results were observed for knowledge of DMPA-SC (AOR: 2.5; 95% CI: 1.2-4.6) and side effects (AOR: 2.5; 95% CI: 1.3-4.8). Conclusion: Training PPMVs to use proven FP job aids should be incorporated into routine trainings, as they reinforce knowledge months after a training and can help PPMVs to retain information. When designing scale-up programs, jobs aids are a good investment for larger capacity-building strategies.

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The positive effect of job aids on Patent and Proprietary Medicine Vendor injectable contraceptive knowledge 9 months after training: Longitudinal results from implementation science research in Nigeria

10.21203/rs.2.11179/v1 ◽

2019 ◽

Author(s):

Sara Chace Dwyer ◽

Aparna Jain ◽

Salisu Ishaku ◽

Faizah Okunade ◽

Chiamaka Uzomba ◽

...

Keyword(s):

Logistic Regression ◽

Family Planning ◽

Regression Models ◽

Task Sharing ◽

Family Planning Services ◽

Logistic Regression Models ◽

Job Aids ◽

Injectable Contraceptive ◽

Drug Shops ◽

Injectable Contraceptives

Abstract Background To increase access to voluntary family planning services, policymakers in Nigeria are debating how to task share the provision of injectable contraceptives to drug shop owners known as Patent and Proprietary Medicine Vendors (PPMVs). Globally, task sharing family planning services to drug shops has been identified as a promising practice, but more evidence is needed on how to support PPMVs in providing family planning, such as injectable services, if policy were changed. Methods Data were collected from 194 PPMVs in Bauchi, Cross River, Ebonyi and Kaduna states at three time points. PPMVs were trained to provide family planning counseling and injectable contraceptive services, including administration. PPMVs were interviewed immediately before, immediately after, and 9 months after the training. Three outcome variables were used to represent knowledge of injectable contraceptives: intramuscular deo-medroxyprogesterone acetate (DMPA) knowledge, subcutaneous DMPA knowledge, and knowledge of 4 or more of 7 common side effects of progestin-only injectables. Unadjusted and adjusted logistic regression models were conducted for each outcome variable to determine which factors affect PPMV knowledge of injectable contraceptives 9 months after the training. Results PPMVs’ intramuscular and subcutaneous DMPA knowledge and side effect knowledge was low before the training and then increased immediately afterwards. Nine months following the training, intramuscular and subcutaneous DMPA knowledge decreased and side effect knowledge remained relatively the same compared to the post-training results. Results from three logistic regression models found that PPMVs who reported using at least 2 of the 3 family planning job aids provided during the training had significantly higher knowledge compared to those who reported using one or no job aids. Conclusion Providing PPMVs with family planning job aids as part of a larger capacity-building strategy should be considered as they may help PPMVs retain knowledge after training. These results contribute to the literature on task sharing family planning services to private sector drug shops and implications for scale-up.

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DESCRIPTION OF MENSTRUAL CYCLE DISORDERS IN 3 MONTHS INJECTABLE CONTRACEPTIVE USERS

Journal of Vocational Nursing ◽

10.20473/jovin.v2i2.30327 ◽

2021 ◽

Vol 2 (2) ◽

pp. 97

Author(s):

Amellia Mardhika ◽

Yolanda Dwi Safitri ◽

Lailatul Fadliyah ◽

Riris Medawati

Keyword(s):

Side Effects ◽

Menstrual Cycle ◽

Total Population ◽

Sampling Technique ◽

Hormonal Contraceptive ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Injectable Contraceptive ◽

Cycle Disorders ◽

Injectable Contraceptives

3-month injectable contraception is a hormonal contraceptive that is widely used by women of childbearing age (WUS) because it is very effective in preventing pregnancy, and includes the Intermediate-term Method. The use of 3-month injectable contraceptives also has drawbacks or side effects, one of which is menstrual cycle disorders. The purpose of this study was to determine the description of menstrual cycle disorders in users of 3-month injectable contraceptives.This study used a descriptive design. The population in this study was women of childbearing age who used injection contraception for 3 months at the sub-health center of Tanjung Village. The total population in this study was 48 samples. The sampling technique was carried out by the total sampling technique. The analytical method used in this study was descriptive statistics.The results of the study showed that using 3-month injectable contraceptives were found that 29 respondents (60.4%) experienced amenorrhea, 15 respondents (31.3%) spotting, and 4 respondents (8.3%) did not experience menstrual cycle disorders.Most users of 3-month injectable contraceptives experience amenorrhea

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Therapeutic Aspects of Squill; An Evidence-Based Review

Current Drug Discovery Technologies ◽

10.2174/1570163816666190125154745 ◽

2020 ◽

Vol 17 (3) ◽

pp. 318-324 ◽

Cited By ~ 1

Author(s):

Khadije Saket ◽

Jalil T. Afshari ◽

Ehsan Saburi ◽

Mahdi Yousefi ◽

Roshanak Salari

Keyword(s):

Side Effects ◽

Traditional Medicine ◽

Respiratory Diseases ◽

Low Cost ◽

Current Evidence ◽

Evidence Based ◽

Helminthic Infections ◽

Traditional Persian Medicine ◽

Healing Of Wounds ◽

Bioactive Agents

From ancient times, medicinal plants have been usually utilized to treat many disorders, but today, interest in these herbs is again aroused, because of their fewer side effects and low-cost. In traditional medicine, for many diseases, various medicinal herbs have been suggested so far. Drimia maritime, also named squill, is an important medicinal plant for the treatment of many diseases, especially respiratory diseases. In the current evidence-based study, we conducted a review of the general characteristics, ingredients, administration form, and side effects of squill in traditional medicine. For this purpose, traditional Persian medicine literatures and electronic databases were examined including PubMed, Scopus, and Google Scholar. Many compounds are isolated from D.maritima, including scillaren, scillirubroside, scillarenin, and bufadienolide glycosides. Oxymel is the most commonly used form of squill for various diseases, especially respiratory diseases. Besides, squill has been used in the treatment of cardiovascular, digestive, and dermatological disorders, it is also used against various cancer cells for its antioxidant and cytotoxic properties. Moreover, there is relatively reliable evidence of its benefits for bacterial and helminthic infections, rheumatism, edema, gout, abortion induction, healing of wounds and urine induction. It seems that supplementary studies are required to explore the bioactive agents and their effective mechanisms.

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Natural Phytochemicals and Their Therapeutic Role in Management of Several Diseases: A Review

Current Traditional Medicine ◽

10.2174/2215083805666190807111817 ◽

2020 ◽

Vol 6 (1) ◽

pp. 43-53 ◽

Cited By ~ 2

Author(s):

Nitin R. Shirsath ◽

Ajaygiri K. Goswami

Keyword(s):

Side Effects ◽

Low Cost ◽

Herbal Medicines ◽

Biological Source ◽

Natural Medicine ◽

Synthetic Chemicals ◽

Alternative Approach ◽

Health Related ◽

Activity Mechanism ◽

Natural Medicines

Introduction: These days, a lot of people face some health-related problems in day to day life. The conventional synthetic medicine is not effective enough to cure them alone. The conventional therapy for the management of these health-related issues involves the use of hazardous synthetic chemicals and surgical diagnosis, which have lots of serious side effects. It is necessary to conduct research on herbal medicines, this is an alternative approach to avoid the side effects of synthetic medicines to achieve high effectiveness, low cost and improve patient compliance. Methods: The present survey is an analysis of some of the available data on the use of plants with their biological source, active phytochemicals constituents and a probable activity/ mechanism of action of several classes of drugs. This work also focused on highlighting the advantages of natural medicines for maximum utilization. Results: This article aims to increase awareness about natural medicine and help people find a suitable herbal medicine for the treatment of specific diseases. Conclusion: This article also exhibits the scope for further process in the development of new natural substance for the management of several diseases.

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Exposure to PM2.5 and Obesity Prevalence in the Greater Mexico City Area

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052301 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2301

Author(s):

Marcela Tamayo-Ortiz ◽

Martha María Téllez-Rojo ◽

Stephen J. Rothenberg ◽

Ivan Gutiérrez-Avila ◽

Allan Carpenter Just ◽

...

Keyword(s):

Mexico City ◽

Latin American ◽

Meta Analysis ◽

Obesity Prevalence ◽

Logistic Regression Models ◽

City Area ◽

Adolescents And Adults ◽

Pm2.5 Exposure ◽

Greater Mexico ◽

Adjusted Logistic Regression

Exposure to PM2.5 has been associated with the prevalence of obesity. In the Greater Mexico City Area (GMCA), both are ranked among the highest in the world. Our aim was to analyze this association in children, adolescents, and adults in the GMCA. We used data from the 2006 and 2012 Mexican National Surveys of Health and Nutrition (ENSANUT). Participants’ past-year exposure to ambient PM2.5 was assessed using land use terms and satellite-derived aerosol optical depth estimates; weight and height were measured. We used survey-adjusted logistic regression models to estimate the odds ratios (ORs) of obesity (vs. normal-overweight) for every 10 µg/m3 increase in annual PM2.5 exposure for children, adolescents, and adults. Using a meta-analysis approach, we estimated the overall odds of obesity. We analyzed data representing 19.3 million and 20.9 million GMCA individuals from ENSANUT 2006 and 2012, respectively. The overall pooled estimate between PM2.5 exposure and obesity was OR = 1.96 (95% CI: 1.21, 3.18). For adolescents, a 10 µg/m3 increase in PM2.5 was associated with an OR of 3.53 (95% CI: 1.45, 8.58) and 3.79 (95% CI: 1.40, 10.24) in 2006 and 2012, respectively. More studies such as this are recommended in Latin American cities with similar air pollution and obesity conditions.

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Sleep duration and napping in relation to colorectal and gastric cancer in the MCC-Spain study

Scientific Reports ◽

10.1038/s41598-021-91275-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kyriaki Papantoniou ◽

Gemma Castaño-Vinyals ◽

Ana Espinosa ◽

Michelle C. Turner ◽

Vicente Martín-Sánchez ◽

...

Keyword(s):

Gastric Cancer ◽

Sleep Duration ◽

Night Shift ◽

Work History ◽

Logistic Regression Models ◽

Short Sleep ◽

Long Sleep ◽

Adjusted Logistic Regression ◽

Population Controls ◽

Control Study

AbstractSleep duration is a novel and potentially modifiable risk factor for cancer. We evaluated the association of self-reported sleep duration and daytime napping with odds of colorectal and gastric cancer. We included 2008 incident colorectal cancer cases, 542 gastric cancer cases and 3622 frequency-matched population controls, recruited in the MCC-Spain case–control study (2008–2013). Sleep information, socio-demographic and lifestyle characteristics were obtained through personal interviews. Multivariable adjusted logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI) for cancer, across categories of sleep duration (≤ 5, 6, 7, 8, ≥ 9 hours/day), daytime napping frequency (naps/week) and duration (minutes/nap). Compared to 7 hours of sleep, long sleep was associated with increased odds of colorectal (OR≥9 hours: 1.59; 95%CI 1.30–1.94) and gastric cancer (OR≥9 hours: 1.95; 1.37–2.76); short sleep was associated with increased odds of gastric cancer (OR≤5 hours: 1.32; 0.93–1.88). Frequent and long daytime naps increased the odds of colorectal (OR6–7 naps/week, ≥30 min: 1.32; 1.14–1.54) and gastric cancer (OR6–7 naps/week, ≥30 min: 1.56; 1.21–2.02). Effects of short sleep and frequent long naps were stronger among participants with night shift-work history. Sleep and circadian disruption may jointly play a role in the etiology of colorectal and gastric cancer.

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