A mixed-methods evaluation of the impact of a person-centered family planning intervention for community health workers on family planning outcomes in India

Abstract Background: Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this, or measured associations between person-centered quality for family planning and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods: In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planning in a community health worker population and find it to be valid. Higher person-centered family planning scores are associated with family planning uptake. Results: Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planning scores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention.Conclusions: More research is needed on how to intervene to change behaviors related to person-centered family planning. This study received IRB approval from the University of California, San Francisco (IRB # 15-25950) and was retrospectively registered at clinicaltrials.gov (NCT04206527)

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A mixed-methods evaluation of the impact of a person-centered family planning intervention for community health workers on family planning outcomes in India

10.21203/rs.3.rs-29183/v3 ◽

2020 ◽

Author(s):

Nadia Diamond-Smith ◽

Claire McDonell ◽

Ananta Basudev Sahu ◽

Kali Prasad Roy ◽

Katie Giessler

Keyword(s):

Mixed Methods ◽

Family Planning ◽

Community Health ◽

San Francisco ◽

Health Workers ◽

Qualitative Interviews ◽

Centered Care ◽

The University ◽

Care Worker ◽

The Impact

Abstract Background: Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this, or measured associations between person-centered quality for family planning and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods: In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planning in a community health worker population and find it to be valid. Higher person-centered family planning scores are associated with family planning uptake. Results: Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planning scores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention.Conclusions: More research is needed on how to intervene to change behaviors related to person-centered family planning. This study received IRB approval from the University of California, San Francisco (IRB # 15-25950) and was retrospectively registered at clinicaltrials.gov (NCT04206527)

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A mixed-methods evaluation of the impact of a person-centered family planning intervention for community health workers on family planning outcomes in India

10.21203/rs.3.rs-29183/v2 ◽

2020 ◽

Author(s):

Nadia Diamond-Smith ◽

Claire McDonell ◽

Ananta Basudev Sahu ◽

Kali Prasad Roy ◽

Katie Giessler

Keyword(s):

Mixed Methods ◽

Family Planning ◽

Community Health ◽

San Francisco ◽

Health Workers ◽

Qualitative Interviews ◽

Centered Care ◽

The University ◽

Care Worker ◽

The Impact

Abstract Background: Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this, or measured associations between person-centered quality for family planning and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods: In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planning in a community health worker population and find it to be valid. Higher person-centered family planning scores are associated with family planning uptake. Results: Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planning scores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention.Conclusions: More research is needed on how to intervene to change behaviors related to person-centered family planning. This study received IRB approval from the University of California, San Francisco (IRB # 15-25950) and was retrospectively registered at clinicaltrials.gov (NCT04206527)

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A Mixed-methods Evaluation of a Person-centered Family Planning Intervention for Community Health Workers in India on Family Planning Outcomes

10.21203/rs.3.rs-29183/v1 ◽

2020 ◽

Author(s):

Nadia Diamond-Smith ◽

Claire McDonell ◽

Ananta Basudev Sahu ◽

Kali Prasad Roy ◽

Katie Giessler

Keyword(s):

Mixed Methods ◽

Family Planning ◽

Community Health ◽

San Francisco ◽

Health Workers ◽

Qualitative Interviews ◽

Mixed Methods Evaluation ◽

Centered Care ◽

The University ◽

Care Worker

Abstract Background: Person-centered quality for family planning has been gaining increased attention, yet few interventions have focused on this,or measured associations between PCFP and family planning outcomes (uptake, continuation, etc.). In India, the first point of contact for family planning is often the community health care worker, in this case, Accredited Social Health Activists (ASHAs). Methods: In this study, we evaluate a training on person-centered family planning as an add-on to a training on family planning provision for urban ASHAs in Varanasi, India in 2019 using mixed methods. We first validate a scale to measure person-centered family planningin a community health worker population, and find it to be valid. Higher person-centered family planningscores are associated with family planning uptake. Results: Comparing women who saw intervention compared to control ASHAs, we find that the intervention had no impact on overall person-centered family planningscores. Women in the intervention arm were more likely to report that their ASHA had a strong preference about what method they choose, suggesting that the training increased provider pressure. However, qualitative interviews with ASHAs suggest that they value person-centered care for their interactions and absorbed the messages from the intervention.Conclusions: More research is needed on how to intervene to change behaviors related to person-centered family planning.This study received IRB approval from the University of California, San Francisco (IRB # 15-25950) and was retrospectively registered at clinicaltrials.gov (NCT04206527) on 20 December 2019.https://clinicaltrials.gov/ct2/show/NCT04206527?term=NCT04206527&draw=2&rank=1

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063097 ◽

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.

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Factor Affecting the Utilization of Family Planning Program Services

Journal La Medihealtico ◽

10.37899/journallamedihealtico.v2i2.315 ◽

2021 ◽

Vol 2 (2) ◽

pp. 41-50

Author(s):

Melda Andriani ◽

Megawati Megawati ◽

Asriwati Asriwati ◽

Lucia Lastiur

Keyword(s):

Family Planning ◽

Community Health ◽

Health Center ◽

Mixed Methods Research ◽

Quantitative Methods ◽

Family Planning Program ◽

Health Workers ◽

Community Health Center ◽

Planning Program

Family planning to spacing or planning the number and distance of pregnancies using contraception. Data on active family planning participants based on the type of contraception at the Pasie Raya Community Health Center in 2019 was 39.4%, there was no increase in the coverage of active KB participants based on the type of contraception in 2018 of 49.4%. The aim is to find out what are the factors that influence the use of family planning program services for women in the working area of the Pasie Raya Community Health Center. This type of research is a combination research (mixed methods research) combining or combining quantitative methods and qualitative methods with Accidental Sampling sampling techniques on 90 samples and 5 informants. Quantitative data were analyzed using univariate, bivariate and multivariate logistic regression tests. The results of the study showed the influence of knowledge, information sources, culture, family support and support from health workers on the utilization of family planning program services. Based on the multivariate analysis, the support variable for health workers is the dominant variable, while the results of the qualitative analysis on key informants and supporters can be concluded that women have taken advantage of the Kb service program, but most of the women do not understand and understand the benefits that are obtained from the family planning program. The conclusion from the health workers is very important in the utilization of family planning program services. It is recommended that the Health Office conduct more evaluations of family planning services at the Puskesmas. It is necessary to improve the quality of Kb services by including health workers in training.

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Digital Health-Enabled Community-Centered Care (D-CCC): A Scalable Model to Empower Future Community Health Workers utilizing Human-in-the-Loop AI

10.1101/2021.03.03.21252873 ◽

2021 ◽

Author(s):

Sarah M. Rodrigues ◽

Anil Kanduri ◽

Adeline M. Nyamathi ◽

Nikil Dutt ◽

Pramod P. Khargonekar ◽

...

Keyword(s):

Community Health ◽

Community Health Workers ◽

Closed Loop ◽

Health Workers ◽

Digital Health ◽

Human In The Loop ◽

Collaborative Community ◽

Health And Social Care ◽

The Future ◽

Centered Care

AbstractDigital Health-Enabled Community-Centered Care (D-CCC) represents a pioneering vision for the future of community-centered care. Utilizing an artificial intelligence-enabled closed-loop digital health platform designed for, and with, community health workers, D-CCC enables timely and individualized delivery of interventions by community health workers to the communities they serve. D-CCC has the potential to transform the current landscape of manual, episodic and restricted community health worker-delivered care and services into an expanded, digitally interconnected and collaborative community-centered health and social care ecosystem which centers around a digitally empowered community health workforce of the future.

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

10.20944/preprints202103.0097.v1 ◽

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 ‘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 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.

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The Burden of COVID-19 Infection in a Rural Tamil Nadu Community

10.21203/rs.3.rs-289385/v1 ◽

2021 ◽

Author(s):

Rita Isaac ◽

Biswajit Paul ◽

Madelon Finkel ◽

Mahesh Moorthy ◽

Seshasailam Venkateswaran ◽

...

Keyword(s):

Community Health ◽

Tamil Nadu ◽

Health Workers ◽

Extended Family ◽

Community Health Center ◽

Vulnerable Groups ◽

Severe Illness ◽

Suspected Case ◽

Antibody Testing ◽

The Impact

Abstract Background: There are almost 11 million cases of COVID-19 in India. Transmission rates vary from region to region, and are influenced by many factors including population susceptibility, travel and uptake of preventive measures. To date there have been relatively few studies examining the impact of the pandemic in poor, rural regions of India. We report on a study examining COVID-19 burden in a rural community in Tamil Nadu.Methods: The study was undertaken in a population of approximately 130000 people, served by the Rural Unit of Health and Social Affairs (RUHSA), a community health center of CMC, Vellore. We established and evaluated a COVID-19 PCR-testing programme for symptomatic patients – testing was offered to 350 individuals, and household members of test-positive cases were offered antibody testing. We also undertook two COVID-19 seroprevalence surveys in the same community, amongst 701 randomly-selected individuals. Results: There were 182 positive tests in the symptomatic population (52.0%). Factors associated with test-positivity were older age, male gender, higher socioeconomic status (SES, as determined by occupation, education and housing), a history of diabetes, contact with a confirmed/suspected case and attending a gathering (such as a religious ceremony, festival or extended family gathering). Amongst test-positive cases, 3 (1.6%) died and 16 (8.8%) suffered a severe illness. Amongst 129 household contacts 40 (31.0 %) tested positive. The two seroprevalence surveys showed positivity rates of 2.2% (July/Aug 2020) and 22.0% (Nov 2020). 40 tested positive (31.0%, 95% CI: 23.02 -38.98). Our estimated infection-to-case ratio was 31.7.Conclusions: A simple approach using community health workers and a community-based testing clinic can readily identify significant numbers of COVID-19 infections in Indian rural population. There appear, however, to be low rates of death and severe illness, although vulnerable groups may be under-represented in our sample. It’s vital these poor, rural populations aren’t overlooked in ongoing pandemic monitoring and vaccine roll-out in India.

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REPORT OF THE A.A.P.-A.N.A. CONFERENCE ON UTILIZATION OF ALLIED HEALTH WORKERS IN MEETING THE MANPOWER CRISIS

PEDIATRICS ◽

10.1542/peds.47.6.1080 ◽

1971 ◽

Vol 47 (6) ◽

pp. 1080-1084

Author(s):

Abraham B. Bergman ◽

La Verne Fakkema ◽

John P. Connelly

Keyword(s):

American Academy ◽

San Francisco ◽

Nurse Practitioners ◽

Allied Health ◽

Health Workers ◽

Pediatric Nurse ◽

American Academy Of Pediatrics ◽

Nursing Organizations ◽

The University ◽

Pediatric Nurse Practitioner

On October 22, 1970 a portion of the annual meeting of the American Academy of Pediatrics in San Francisco was devoted to a conference on the utilization of allied health workers in meeting the manpower crisis. It was jointly sponsored by the American Academy of Pediatrics and the American Nurses' Association and was the third and most successful of similar meetings. The first one, held at the Academy's Chicago meeting in October, 1969, provided an introduction to the concept of pediatric nurse practitioners. The second, held at the Washington meeting of the Academy in April, 1970, resulted in a frank exchange of views of the official nursing organizations and academy representatives and pointed to the need for open discussion and collaboration on the subject. The San Francisco meeting got down to the business of a more objective analysis of issues, and though there was much heated discussion most of it was constructive. An attempt was made by the planning committee to include on the program different models of allied health workers in pediatrics. The program highlighted discussion about discharged medical corpsmen, laboratory technologists, pediatric assistants, as well as the more familiar pediatric nurse practitioner. Of the 418 persons in attendance, 294 were nurses, 43 physicians, and 81 were other interested persons. When one of the nurses criticized the fact that there were so few physicians in attendance, Donald Frank of Cincinnati, a member of the Academy's Manpower Committee, pointed out that there was a fivefold improvement in physician attendance since the first conference. The opening keynote address was given by Philip R. Lee, M.D., former HEW official, now Chancellor of the University of California at San Francisco, who refreshingly offered no simple solutions.

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