scholarly journals Use of community-based interventions to promote family planning use among pastoralist women in Ethiopia: cluster randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta Bezabih
Keyword(s):  
Family Planning ◽  
Women's Education ◽  
Controlled Trial ◽  
Male Involvement ◽  
Married Women ◽  
Intention To Use ◽  
Community Based Interventions ◽  
Community Based ◽  
Pastoralist Communities ◽  
Randomized Controlled

Abstract Background Afar region is one of the pastoralist dominated regions in Ethiopia. The region is characterized by a low contraceptive prevalence rate (CPR) of 5.4%. Lack of awareness of contraceptive use, husband objection and religious barriers are attributed to low CPR in the region. This study assessed the effect of community-based interventions for promoting family planning (FP) use among pastoralist communities in Ethiopia. Methods The study design was a three-arm, parallel, clustered randomized controlled trial (CRT). The three study arms were: (1) male involvement in family planning (FP) education; (2) women’s education on FP; and (3) control. A total of 33 clusters were randomized and allocated with a one-to-one ratio. Intervention components included (1) health education on FP to married women and men by faema leaders (a traditional community-based structure that serves as a social support group); (2) video-assisted message on FP; and (3) assisting the faema leader using health workers and health extension workers (HEWs). The intervention was given for a total of nine months. FP use and intentions were measured as outcome variables. In addition, a cluster-level summary considering a cluster effect analysis was performed. The result was presented with t.test, adjusted risks and its 95% confidence interval (CI). Results The proportion of FP use among the arms was 34% in the male involvement in FP education, 17.5% in women’s education on FP and 4.3% in the control. There was a positive change in the proportion of FP use in the male involvement in FP education and women’s education on FP arms with absolute risk (AR) of 0.29 (95% CI, 0.23,0.34) and 0.13 (95% CI,0.08,0.17), respectively, as compared to the control arm. Similarly, married women in the male involvement in FP education and women’s education on FP arms had 3.4 (2.48, 4.91) and 2.1 (1.50, 2.95) higher intention to use FP, respectively, as compared with the control arm. Conclusion The present study suggests that in such male-dominated pastoralist communities with more considerable religious barriers, the community-based health education mainly targeting males appears to be a promising strategy for improving FP use and intention to use FP. Trial registration ClinicalTrials.gov, NCT03450564, March, 2018.

scholarly journals Use of Community-based Interventions to Promote Family Planning Use Among Pastoralist Women in Ethiopia: Cluster Randomized Controlled Trial

2020 ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta Bezabih
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Male Involvement ◽  
Married Women ◽  
Intention To Use ◽  
Community Based Interventions ◽  
Community Based ◽  
Randomized Controlled ◽  
Afar Region ◽  
Cluster Randomized

Abstract Background- Afar region is one of the pastoralists dominated regions in Ethiopia. The region is characterized by a low contraceptive prevalence rate (CPR) with 5.4%. Lack of awareness, husband objection, and religious influence was the reasons attributed to low CPR in the region. As objective we assessed the effect of a community-based interventions for promoting FP use among pastoralist communities of Afar region state, Ethiopia.MethodsThe design was parallel, cluster randomized controlled trial (CRT) recruiting married women. It had three arms: 1) women’s education on FP, 2) male involvement in FP education and 3) control with one to one ratio. A total of 33 kebeles (lowest administrative structure) were randomized and allocated. Women’s FP education and male involvement in FP education were the interventions. It was implemented using 1) health education on FP to married women and men by faema leaders (a traditional community-based structure that serves as a social support group) 2) Video-assisted message on FP, and 3) Assisting the faema leader using health workers. The intervention was given for a total of 9 months. FP use and intentions were measured as outcome variables based on woman’s perspectives. Cluster level summaries considering a cluster effect analysis was performed. The result was presented with adjusted risks and 95% CI. A p-value < 0.05 was used to declare statistically significant.ResultsThere was a positive change in the proportion of married women who use FP in the women’s FP education arm, absolute risk (AR) of 0.13(95% CI,0.08,0.17) and male involvement arm with AR of 0.29 (95% CI, 0.23,0.34) as compared to the control arm. In the control arm, the proportion of FP use was 4.3%, whereas it was 17.5% with women who receive FP education and 34% in the male involvement arm. Furthermore, the proportion of married women who had high intention to use FP was high in arms of women’s FP education and male involvement with AR = 3.4(95% CI: 2.48,4.91) and AR = 2.1 (95% CI: 1.5,2.95), respectively as compared with the control arm.ConclusionThe community-based interventions brings a significant change in increasing FP users and intention to use FP.Trial registration : NCT03450564

scholarly journals Use of community-based interventions to promote Family Planning use among Pastoralist women in Ethiopia: Cluster randomized controlled trial

2021 ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta Bezabih
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Male Involvement ◽  
Married Women ◽  
Intention To Use ◽  
Community Based Interventions ◽  
Community Based ◽  
Randomized Controlled ◽  
Afar Region ◽  
Cluster Randomized

Abstract Background: - Afar region is one of the pastoralists dominated regions in Ethiopia. The region is characterized by a low contraceptive prevalence rate (CPR) with 5.4%. Lack of awareness, husband objection, and religious influence was the reasons attributed to low CPR in the region. As objective we assessed the effect of a community-based interventions for promoting FP use among pastoralist communities of Afar region state, Ethiopia.Methods: The design was parallel, cluster randomized controlled trial (CRT) recruiting married women. It had three arms: 1) women’s education on FP, 2) male involvement in FP education and 3) control with one to one ratio. A total of 33 kebeles (lowest administrative structure) were randomized and allocated. Women’s FP education and male involvement in FP education were the interventions. It was implemented using 1) health education on FP to married women and men by faema leaders (a traditional community-based structure that serves as a social support group) 2) Video-assisted message on FP, and 3) Assisting the faema leader using health workers. The intervention was given for a total of 9 months. FP use and intentions were measured as outcome variables based on woman’s perspectives. Cluster level summaries considering a cluster effect analysis was performed. The result was presented with adjusted risks and 95% CI. A p-value <0.05 was used to declare statistically significant.Results: There was a positive change in the proportion of married women who use FP in the women’s FP education arm, absolute risk (AR) of 0.13(95% CI,0.08,0.17) and male involvement arm with AR of 0.29 (95% CI, 0.23,0.34) as compared to the control arm. In the control arm, the proportion of FP use was 4.3%, whereas it was 17.5% with women who receive FP education and 34% in the male involvement arm. Furthermore, the proportion of married women who had high intention to use FP was high in arms of women’s FP education and male involvement with AR=3.4(95% CI: 2.48,4.91) and AR=2.1 (95% CI: 1.5,2.95), respectively as compared with the control arm. Conclusion: The present study highlighted the effctienesswomen’s education on FP and male involvement in FP education brings a significant change in increasing the number of women who use FP and intention. Using the community-led support groups in the pastoralist community appears to be effective in increasing the number of women FP users and intention to use.Trial registration: NCT03450564

scholarly journals Use of community-based intervention to promote Family Planning use among Pastoralist women in Ethiopia: Cluster randomized controlled trial

2020 ◽  
Author(s):  
Mussie Alemayehu ◽  
Araya Abrha Medhanyie ◽  
Elizabeth Reed ◽  
Afework Mulugeta Bezabih
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Male Involvement ◽  
Married Women ◽  
Cluster Randomized Controlled Trial ◽  
P Value ◽  
Intention To Use ◽  
Community Based ◽  
Randomized Controlled ◽  
Cluster Randomized

AbstractObjectiveWe assessed the effect of a community-based intervention for promoting FP use and intention among pastoralist communities of Afar region state, Ethiopia.MethodsThe design was parallel, cluster randomized controlled trial (CRT) recruiting married women. It had three arms: 1) women’s FP education, 2) male involvement and 3) control with one to one ratio. A total of 33 kebeles were randomized and allocated. Data were collected through an open data kit. Women’s FP education and male involvement in FP service were the interventions. It was implemented with the assistance of a faema leader using a separate group meeting for males and women and disseminates video recorded messages on FP. The intervention was given for a total of 9 months. FP use and intentions were measured. Cluster level summaries considering a cluster effect analysis was performed. The result was presented with adjusted risks and 95% CI. A p-value < 0.05 was used to declare statistically significant.ResultsThere was a positive change in the proportion of married women who use FP in the women’s FP education arm, absolute risk (AR) of 0.13(95% CI,0.08,0.17) and male involvement arm with AR of 0.29 (95% CI, 0.23,0.34) as compared to the control arm. In the control arm, the proportion of FP use was 4.3%, whereas it was 17.5% with women who receive FP education and 34% in the male involvement arm. Furthermore, the proportion of married women who had high intention to use FP was high in arms of women’s FP education and male involvement with AR = 3.4(95% CI: 2.48,4.91) and AR = 2.1 (95% CI: 1.5,2.95), respectively as compared with the control arm.ConclusionThe community-based intervention (male involvement and women’s education about FP use) brings a significant change in increasing FP users and promotes the intention to use FP.

scholarly journals Efficacy of Nutrition and WASH/Malaria Educational Community-Based Interventions in Reducing Anemia in Preschool Children from Bengo, Angola: Study Protocol of a Randomized Controlled Trial

2019 ◽  
Vol 16 (3) ◽  
pp. 466
Author(s):  
Cláudia Fançony ◽  
Ânia Soares ◽  
João Lavinha ◽  
Henrique Barros ◽  
Miguel Brito
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Mortality Rates ◽  
Therapeutic Interventions ◽  
Educational Community ◽  
Community Based Interventions ◽  
Community Based ◽  
Urogenital Schistosomiasis ◽  
Randomized Controlled ◽  
Cluster Randomized

Angola reports one of the highest infant mortality rates in the world, and anemia represents one of its important causes. Recent studies, in under-five children from the Bengo province of Angola, described high prevalence’s, suggesting malaria, undernutrition and urogenital schistosomiasis as important contributors for the occurrence and spatial variations of anemia. Educational community-based interventions, either in Nutrition and Water, Sanitation, Hygiene and Malaria are recommended to correct anemia. Herein, we designed a cluster-randomized controlled trial to study the efficacy of two educational-plus-therapeutic interventions in the reduction of anemia: one in nutrition and the other in WASH/Malaria. Socioeconomic, nutritional, anthropometric, parasitological and biochemical data will be collected from all willing-to-participate children, aging under four and resident in the Health Research Center of Angola study area. Considering the multifactorial causes of this condition, determining the efficacy of both interventions might help documenting weaknesses and opportunities for planning integrated strategies to reduce anemia.

scholarly journals Exploring User-Centered Counseling and Male Involvement in Contraceptive Decision-Making: Protocol for a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Mahesh Karra ◽  
Kexin Zhang
Keyword(s):  
Decision Making ◽  
Randomized Controlled Trial ◽  
Family Planning ◽  
Controlled Trial ◽  
Male Involvement ◽  
Contraceptive Methods ◽  
Randomized Controlled ◽  
Family Planning Counseling ◽  
User Centered

BACKGROUND As a means to achieve full, free, and informed choice within the frameworks of reproductive autonomy and women’s rights, family planning programs have increasingly begun to adopt user-centered approaches to counseling and service provision. These approaches have stressed the role of the individual client as the focal point of interaction and the key decision-maker. However, little is known about how user-centered approaches to family planning, particularly through the family planning counseling process, shape women’s and couple’s preferences and characterize their choices. OBJECTIVE We conduct a multi-armed randomized controlled trial that identifies the causal impact of user-centered counseling on women’s decision-making for family planning in urban Malawi. The causal effect of the interventions will be determined by comparing outcomes for respondents randomly assigned to three intervention arms (T1, T2, or T3) against outcomes from the control arm (T0). METHODS Married women aged 18-35 who were neither pregnant nor had given birth within the past 6 months were recruited and randomly assigned to one of the three intervention arms or a control arm characterized by two interventions: 1) an intervention that encouraged women to invite their husbands to family planning counseling; and 2) a tailored counseling session where women were counseled on a targeted range of 5 contraceptive methods based on women’s stated baseline preferences, in contrast to the standard range of 13 method that women were typically counseled on at public facilities. All women received a package of family planning services over a one-month period starting from the counseling day, which included: 1) free transportation to a clinic; and 2) financial reimbursement for family-planning-related services. Follow-up surveys were conducted with women either at the clinic or by phone/through home visits with those who did not visit the clinic over the service period. RESULTS A total of 785 women completed the baseline survey and 782 eligible respondents were randomized to one of the three intervention groups or a control group (T1: 223, T2: 225, T3: 228, and T0: 108). From November 2019 to February 2020, a total of 767 women were reached for follow-up surveys. Among these 767 reached women, 731 completed the follow-up survey, among which 435 were reached by phone, 254 received home surveys, and 67 women were followed up at the clinic. CONCLUSIONS Results from this trial seek to fill the current knowledge gaps on the effectiveness of: 1) tailored family planning counseling, and 2) male involvement in family planning, on women’s stated and realized contraceptive preferences. More generally, the study findings provide evidence that user-centered counseling could improve women’s willingness to use and continue contraceptive methods, facilitate realization of contraceptive preferences, and improve women’s well-being. CLINICALTRIAL This trial was registered at the American Economics Association Registry for randomized controlled trials (https://www.socialscienceregistry.org) on May 20, 2019 (AEARCTR-0004194) and at the Registry for International Development Impact Evaluations (RIDIE, ridie.3ieimpact.org/) on May 22, 2019 (RIDIE-STUDY-ID-5ce4f42bbc2bf).

A Community-based Addiction Rehabilitation Electronic System to Improve Recovery Outcomes in Patients with Drug Use Disorder: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Zhe WANG ◽  
Shujuan CHEN ◽  
Junning CHEN ◽  
Chunfeng XU ◽  
Zhikang CHEN ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Drug Use ◽  
Illicit Drug ◽  
Service Providers ◽  
Controlled Trial ◽  
Electronic System ◽  
Community Based ◽  
Randomized Controlled ◽  
Community Rehabilitation ◽  
Drug Use Disorder

BACKGROUND Relapse is very common in patients with illicit drug use disorder and contributes to a series of bad consequences that substantially impact their physical and social functions. Due to the limited existence of effective addiction treatment, the majority of patients with drug use disorder could not access help when needing. Mobile health (mHealth) offers a potential solution to improving recovery outcome for patients in community. OBJECTIVE This paper is a protocol for a randomized controlled trial (RCT) of a smart phone application called community-based addiction rehabilitation electronic system (CAREs). This interactive system consists of an APP for clients and a webpage for service providers, with the aim of teaching clients craving and emergency coping skills and helping service providers to improve their work efficiency and effectiveness in community. METHODS A randomized controlled trial (RCT) will be conducted. Sixty drug illicit users who are newly ordered to undergo community rehabilitation will be recruited from the community in Shanghai. Participants will be 1:1 randomly assigned to receive integrated community rehabilitation by using CAREs or only receiving routine community rehabilitation for 6 months. Corresponding anti-drug social workers will provide service and monitor their drug use behavior in accordance with the routine work-flow. Outcomes will be assessed at baseline and in the 6th month. The primary study outcome is the performance on illicit drug urine test which will be carried on regularly twice per week during the study period. Secondary study outcomes include longest duration of sustained abstinence, days that participants interact with anti-drug social workers, and the decrease rate of addiction-related issues severity index. RESULTS Recruitment is currently underway with the aim of recruiting 60 subjects with drug use disorder. Recruitment will continue until the end of 2018. CONCLUSIONS This is the first known trial of a smartphone-based psychotherapy program for improving recovery outcomes in illicit drug users in community. The study provides evidence for the feasibility and effectiveness of the "CAREs" system through comparing the results of the intervention group with the control group. This paper describes the design and methodology of the study. CLINICALTRIAL ClinicalTrials.gov NCT03451344, https://clinicaltrials.gov/ct2/show/NCT03451344

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