Exploring change over time in community mobilization domains: results from a maternity waiting home intervention in rural Zambia

Abstract Background Community mobilization (CM) is recommended as a best practice intervention for low resource settings to reduce maternal mortality. Measurement of process outcomes are lacking and little is known about how CM impacts individuals or how community members perceive its function. Given the complex and recursive nature of CM interventions, research that describes the CM process at multiple levels is needed. This study examines change in CM domains at baseline and endline in rural Zambia. Methods This secondary analysis uses data from a large maternity waiting homes intervention in rural Zambia that employed CM over 3 years as part of a package of interventions. A 19-item CM survey was collected from three groups (women with babies < 1, health workers, community members; n = 1202) with focus groups (n = 76) at two timepoints from ten intervention and ten comparison sites. Factor analysis refined factors used to assess temporal change through multivariable regression. Independent covariates included time (baseline vs endline), intervention vs comparison site, group (women with babies, healthworkers, community members), and demographic variables. Interaction effects were checked for time and group for each factor. Results Final analyses included 1202 individuals from two districts in Zambia. Factor analysis maintained domains of governance, collective efficacy, self-efficacy, and power in relationships. CM domains of self-efficacy, power in relationships, and governance showed significant change over time in multivariable models. All increases in the self-efficacy factor were isolated within intervention communities (b = 0.34, p < 0.001) at endline. Between groups comparison showed the women with babies groups consistently had lower factor scores than the healthworkers or community member groups. Conclusions Community mobilization interventions increase participation in communities to address health as a human right as called for in the 1978 Alma Ata Declaration. Grounded in empowerment, CM addresses socially prescribed power imbalances and health equity through a capacity building approach. These data reflect CM interventions function and have impact in different ways for different groups within the same community. Engaging directly with marginalized groups, using the community action cycle, and simultaneous quality improvement at the facility level may increase benefit for all groups, yet requires further testing in rural Zambia.

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409 - Trends in Involvement, Perceived Role, Role Overload and Self-efficacy of Family Carers of People with Dementia in Care Homes

International Psychogeriatrics ◽

10.1017/s1041610220002628 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 125-125

Author(s):

Marleen Prins ◽

Bernadette Willemse ◽

Marlous Tuithof ◽

Henriëtte van der Roest ◽

Anne Margriet Pot

Keyword(s):

Self Efficacy ◽

Care Home ◽

Care Homes ◽

Role Overload ◽

Family Carers ◽

Change Over Time ◽

Person Centered Care ◽

People With Dementia ◽

Centered Care ◽

Over Time

IntroductionThe quality of long-term care provided to people with dementia (PwD) in care homes can be improved by implementing person-centered care. Family carers of PwD living in care homes are an important part of person-centered care. However, they often experience high levels of burden, even when a family member with dementia lives in a care home. This study examines trends in the involvement of family carers and their perceived role, role overload and self-efficacy.MethodsData from the Living Arrangements for People with Dementia study, a cross-sectional monitoring study that evaluates developments in care for PwD in care homes in the Netherlands, with four measurement cycles between 2008-2017 was used. Data from the three most current measurement cycles were used, with respectively 144, 47 and 49 participating care homes and 888, 392 and 401 participating family carers. Family involvement was measured by the number of hours per week that family carers visited the PwD and the type of activities they undertook. Perceived caregiving role was measured with the Family Perceptions of Caregiving Role instrument. We used the Self-Perceived Pressure by Informal Care to measure role overload and a 37-item questionnaire was used to measure self-efficacy. We investigated the changes over time (e.g., measurement cycles) of these measures.ResultsThe number of hours that family carers visited the PwD did not change over time. However, there was a trend towards an increase in the variety of activities they undertook. Their perceived caregiving role did not change over time. Self-efficacy of family carers increased over time and they reported more feelings of role overload.ConclusionsDuring the past decade, there has been an increasing trend towards family carers doing more diverse activities with PwD in carer homes. Family carers did feel more competent in their caring role, although their feelings of role overload also increased. Continuing attention is therefore needed for the psychological well-being of family carers after a person with dementia moves to a care home.

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Abstract: Assessing the Reliability of Within-Person Change Over Time: A Dynamic Factor Analysis Approach

Multivariate Behavioral Research ◽

10.1080/00273171.2010.534380 ◽

2010 ◽

Vol 45 (6) ◽

pp. 1027-1027 ◽

Cited By ~ 5

Author(s):

Sean P. Lane ◽

Patrick E. Shrout

Keyword(s):

Factor Analysis ◽

Analysis Approach ◽

Dynamic Factor Analysis ◽

Dynamic Factor ◽

Change Over Time ◽

Over Time

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Turkish adaptation of the postpartum hemorrhage-specific self-efficacy scale; validity; and reliability

Zeynep Kamil Medical Journal ◽

10.14744/zkmj.2021.47855 ◽

2021 ◽

pp. 38-45

Author(s):

Dilek COŞKUNER POTUR

Keyword(s):

Factor Analysis ◽

Collective Efficacy ◽

Postpartum Hemorrhage ◽

Self Efficacy ◽

Test Methods ◽

Middle Level ◽

Fit Indices ◽

Validity And Reliability ◽

Turkish Version ◽

Nurses And Midwives

Objective: The aim of the study is to define the validity and reliability of the Turkish version of postpartum hemorrhage-specific self-efficacy scale. Material and Methods: The study was conducted in methodological type. The sam- ple of the study consisted of 238 physicians, nurses, and midwives, working in the delivery room, postnatal, and birth emergency areas for at least 2 years. The data were collected by introductory information form, generalized self-efficacy scale, and postpartum hemorrhage-specific self-efficacy scale in February-December 2018. The structural validity of the scale was evaluated by exploratory factor analysis. In the context of reliability analyses, Cronbach’s alpha, the item-total score correlation and the parallel test methods were used. Results: According to the factor analysis results, it was found that the two-factor structure explained 69.38% of total variance and that item loads ranged between 0.31 and 0.88. Item total score correlations were found to be between 0.42 and 0.77. Cron- bach’s alpha value was 0.92 for the whole scale. Positive and middle level correlation was found between both scales as a result of parallel testing (r=0.301; p=0.000). It was determined that the self-efficacy sub-dimension of the scale consisted of eight items and the collective efficacy sub-dimension of 13 items, and a total of 21 items. Fit indices were found to be at an acceptable level as a result of the confirmatory factor analysis (χ2/df=3.08, RMSEA=0.09, GFI=0.91, AGFI=0.77, IFI=0.92, CFI=0.92, NFI=0.89, RFI=0.87). Conclusion: The Turkish version of the Postpartum Hemorrhage-Specific Self-Effica- cy Scale was found valid and reliable. The scale can be used to evaluate physicians, nurses, and midwives’ self-efficacy perception specific to postpartum hemorrhage.

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