scholarly journals Health equity impact of community-initiated kangaroo mother care: a randomized controlled trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tarun Shankar Choudhary ◽  
Sarmila Mazumder ◽  
Øystein Ariansen Haaland ◽  
Sunita Taneja ◽  
Rajiv Bahl ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Vulnerable Groups ◽  
Randomized Controlled ◽  
Beneficial Impact ◽  
The Difference ◽  
And Control ◽  
Concentration Indices

Abstract Background Kangaroo mother care (KMC) can substantially enhance overall survival of low birthweight babies. In a large randomized controlled trial, we recently showed that supporting mothers to provide community initiated KMC (ciKMC) can reduce mortality among infants up to 180 days of life by 25% (hazard ratio (HR) 0.75). With the current analysis, we aimed to explore if ciKMC promotion leads to increased inequity in survival. Methods In the trial we randomized 8402 low birthweight babies to a ciKMC (4480 babies) and a control (3922 babies) arm, between 2015 and 2018 in Haryana, India. We estimated the difference in concentration indices, which measure inequality, between babies in the ciKMC and control arms for survival until 180 days of life. Further, we compared the effect of ciKMC promotion across subgroups defined by socioeconomic status, caste, maternal literacy, infant’s sex, and religion. Results Our intervention did not increase survival inequity, as the concentration index in the ciKMC arm of the trial was 0.05 (95% CI -0.07 to 0.17) lower than in the control arm. Survival impact was higher among those belonging to the lower two wealth quintiles, those born to illiterate mothers and those belonging to religions other than Hindu. Conclusions We found that ciKMC promotion did not increase inequity in survival associated with wealth. The beneficial impact of ciKMC tended to be larger among vulnerable groups. Supporting mothers to provide KMC at home to low birthweight babies will not increase and could indeed reduce inequities in infant survival. Trial registration ClinicalTrials.gov, NCT02653534. Registered January 12, 2016—Retrospectively registered.

scholarly journals Health equity impact of community-initiated kangaroo mother care: A randomized controlled trial

2021 ◽  
Author(s):  
Tarun Shankar Choudhary ◽  
Sarmila Mazumder ◽  
Oystein Ariansen Haaland ◽  
Sunita Taneja ◽  
Rajiv Bahl ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Vulnerable Groups ◽  
Randomized Controlled ◽  
Poor Families ◽  
Beneficial Impact ◽  
The Difference ◽  
And Control ◽  
Concentration Indices

Abstract BackgroundKangaroo mother care (KMC) can substantially enhance overall survival of low birthweight babies. In a large randomized controlled trial, we recently showed that supporting mothers to provide community initiated KMC (ciKMC) can reduce early infant mortality by 25% (hazard ratio (HR) 0.75). With the current analysis we aimed to explore if ciKMC promotion leads to increased inequity in survival.MethodsIn the trial we randomised 8402 low birthweight babies to a ciKMC (4480 babies) and a control (3922 babies) arm, between 2015 and 2018 in Haryana, India. The main outcome of interest was the difference in concentration indices between babies in the ciKMC and control arms for survival until 180 days of life.ResultsOur intervention did not increase survival inequity, as reflected in a reduction of the concentration index by 0.05 (95% CI -0.07 to 0.17). Survival impact tended to be higher among those born to illiterate mothers (HR 0.65, 95% CI 0.47 to 0.89), and those in poor families (HR 0.69, 95% CI 0.51 to 0.93).ConclusionsWe found that ciKMC promotion did not increase inequity in survival associated with wealth. The beneficial impact of ciKMC tended to be larger among vulnerable groups. Supporting mothers to provide KMC at home to low birthweight babies will not increase and could indeed reduce inequities in infant survival.Trial registrationClinicalTrials.gov, NCT02653534. Registered January 12, 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02653534

Effectiveness of Mobile Phone-Based Support on Exclusive Breastfeeding and Infant Growth in Nigeria: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Daprim S Ogaji ◽  
Adaku O Arthur ◽  
Innocent George
Keyword(s):  
Randomized Controlled Trial ◽  
Mobile Phone ◽  
Usual Care ◽  
Exclusive Breastfeeding ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
The Difference ◽  
And Control

Abstract Background This study examined whether mobile phone-based support improve the rates, duration of exclusive breastfeeding (EBF) as well as infant growth patterns in Nigeria. Methods A 6-month prospective randomized controlled trial with 75 participants assigned to receive ‘usual care’ or ‘mobile phone-based support in addition to usual care’ EBF rates and duration as well as anthropometric measurements of infants before and after intervention were compared using proportions and mean differences. Results Attrition rates of 10.7% and 14.7% were observed in the intervention and control groups, respectively. Treatment groups were identical in all baseline characteristics and participants in the intervention group showed a slower rate of decline in the practice of EBF. The mean difference of 0.6 months (95% confidence interval: −0.22, 1.42) in EBF duration between intervention and control groups was not statistically significant (t = 1.45; p = 0.149). Similarly, the difference in the EBF rates at the 6th month for the intervention (55.2%) and control (46.8%) groups was not statistically significant (χ2 = 0.623; p = 0.430). Although the intervention group had significantly higher mean weight (p = 0.030) and length (p = 0.044) at the 6th month, the difference in the gain in weight and length of these infants over the period was only significant for the weight (p = 0.044). Although the incidence of adverse clinical nutritional status was more in the control group, these differences were not statistically significant. Conclusion Mobile phone-based intervention has positive effects on the rate and duration of EBF as well as the growth of young infants. Sustaining this simple and cheap technology will improve infant wellbeing especially in resource-constrained settings.

scholarly journals The Effectiveness of Behavioral Counseling with Modeling Techniques to Improve Student Self-Achievement

2021 ◽  
Vol 5 (1) ◽  
pp. 44
Author(s):  
I Ketut Dharsana ◽  
Wayan Eka Paramartha
Keyword(s):  
Randomized Controlled Trial ◽  
Random Sampling ◽  
Controlled Trial ◽  
Simple Random Sampling ◽  
Behavioral Counseling ◽  
Randomized Controlled ◽  
Modeling Techniques ◽  
Before And After ◽  
The Difference ◽  
And Control

This study aims to determine the difference between before and after treatment and to determine the effect of behavioral counseling with modeling techniques to improve student self-achievement. The research was conducted at SMK Negeri 1 Singaraja in class X, and used a randomized controlled trial (RCT) research design. Sampling in this study through simple random sampling which took 2 research samples, namely the experimental and control classes. The results of this study indicate the influence of behavioral counseling with modeling techniques to increase self-achievement through the effect size test. Based on these results, the researcher recommends behavioral counseling with modeling techniques to increase self-achievement in school.

scholarly journals Kangaroo mother care for low birthweight infants: a randomized controlled trial in different settings

2007 ◽  
Vol 87 (9) ◽  
pp. 976-985 ◽  
Author(s):  
A Cattaneo ◽  
R Davanzo ◽  
B Worku ◽  
A Surjono ◽  
M Echeverria ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Randomized Controlled

scholarly journals Effect of community-based kangaroo mother care package on neonatal mortality among preterm and low birthweight infants in rural Pakistan: Protocol for a cluster randomized controlled trial (Preprint)

2021 ◽  
Author(s):  
Sajid Soofi
Keyword(s):  
Randomized Controlled Trial ◽  
Neonatal Mortality ◽  
Low Birthweight ◽  
Controlled Trial ◽  
Kangaroo Mother Care ◽  
Community Based ◽  
Randomized Controlled ◽  
Breastfeeding Practices ◽  
Care Package ◽  
Cluster Randomized

BACKGROUND Neonatal mortality, due to preterm birth and low birthweight, remains a major challenge for Pakistan. Kangaroo mother care is a unique, low-cost intervention proven to reduce neonatal mortality and morbidity and increase exclusive breastfeeding rates. Kangaroo mother care has not been tried in community settings in Pakistan. We aim to implement and evaluate the effectiveness of community-based kangaroo mother care package to reduce neonatal morbidity and mortality among preterm/low birthweight infants. This will provide evidence for policy development and large-scale implementation of KMC across the country to reduce neonatal. OBJECTIVE The primary objective of this trial is to reduce neonatal mortality among preterm/low birthweight infants. The secondary objectives are growth measured as weight gain, reduction in incidence of possible serious bacterial infection (PSBI), increased exclusive breastfeeding and continued breastfeeding practices. METHODS We designed a community-based cluster randomized controlled trial in one rural district of Pakistan. Stable, low birth weight babies ≥1200-<2500 grams are included in the study. Kangaroo mother care package adopted after formative research consisting of KMC kit, information and counseling material, and community mobilization using KMC champions (volunteers) is implemented in the intervention clusters. The standard essential newborn care offered in the control clusters. Infants would be recruited and followed up by independent teams of data collectors. Data is collected on the duration of skin to skin contact, growth breastfeeding practices, the incidence of possible serious bacterial infection, neonatal mortality and impact on neurodevelopment. RESULTS The study protocol was approved by the Ethics Review Committee of Aga Khan University, Pakistan on February 2017. Data collection began in August 2019 and will be completed in December 2021. Data analyses are yet to be completed. Data analysis will be by intention to treat principle. The cox regression model will be used for the primary outcome of neonatal mortality, to calculate hazard ratios. The secondary outcomes will be assessed using linear or logistic regression. We expect the results to be published in peer-reviewed journals presentations at relevant conferences by autumn of 2022. CONCLUSIONS This intervention, if effective, has the “potential to be translated into a safe, effective, affordable, and widely utilized intervention” to prevent sepsis and subsequently improve survival in LBW neonates in Pakistan, and other low-and middle-income countries. CLINICALTRIAL Clinicaltrials.gov: NCT03545204

The Effect of a Spiritual Care on Hope in Patients Undergoing Hemodialysis: A Randomized Controlled Trial

2020 ◽  
Vol 16 (1) ◽  
pp. 68-75
Author(s):  
Khodayar Oshvandi ◽  
Shilla Amini ◽  
Abbas Moghimbeigi ◽  
Efat Sadeghian
Keyword(s):  
Randomized Controlled Trial ◽  
Spiritual Care ◽  
Controlled Trial ◽  
Care Program ◽  
Psychological Problem ◽  
Hemodialysis Patients ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Difference ◽  
And Control

Background: The most common psychological problem in hemodialysis patients is low hope. Hope is an important source of adaptation for the survival of the patients with a chronic disease. Objective: This study aimed to evaluate the effect of spiritual care on hope in patients undergoing hemodialysis. Methods: In this randomized controlled trial conducted in Iran in 2017, 60 hemodialysis patients with ending-stage of renal disease under hemodialysis treatment were randomly assigned into two experimental (n=30) and control (n=30) groups. The spiritual care program consisting of protectionist care, supporting the patient's rituals and using support systems was administered in four sessions of 60 minutes individually, twice a week, morning or evening in hemodialysis ward. Snyder’s Hope Questionnaire was completed before and after the intervention in both groups. Data were analyzed in SPSS software version 16. Results: Prior to the intervention, there was no significant difference between the experimental and control groups (p=0.262); however, following the intervention, the difference was statistically significant with regard to the mean scores of hope in the experimental (36.43 ± 3.37) and control (35.20 ± 7.00) groups (p=0.04). Conclusion: According to the findings of the present study, spiritual care promotes hope in Muslim patients undergoing hemodialysis; therefore, nurses can adopt the spiritual care to this end.

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