scholarly journals Effectiveness of community-based treatment programs for treatment of uncomplicated severe acute malnourished children aged 6–59 months using locally produced nutrient dense foods: protocol for a multicentric longitudinal quasi-experimental study

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Praveen Kumar ◽  
Rajesh Kumar Sinha ◽  
Abner Daniel ◽  
Hemang Shah ◽  
Raja Sriswan ◽  
...  
Keyword(s):  
Experimental Study ◽  
Body Composition ◽  
Food Supplements ◽  
Fat Free Mass ◽  
Trial Registration ◽  
Acute Malnutrition ◽  
Consumption Pattern ◽  
Community Based ◽  
Malnourished Children ◽  
Quasi Experimental

Abstract Background Severe acute malnutrition (SAM) is a major underlying cause of mortality among children. Around one third of the world’s acutely malnourished children live in India. The WHO recommends community-based management of acute malnutrition (CMAM) for managing children with SAM. In India, different states are implementing community-based SAM treatment programme, hereinafter called CSAM, using varieties of locally produced nutrient dense food items with different nutrient compositions. The study will assess the effectiveness of these state specific CSAM interventions. Methods The longitudinal quasi-experimental study will be undertaken in two purposively selected blocks of one district each in the four intervention states and one comparison state. From each state, 200 SAM children identified using weight-for-length/height z-score (WHZ) < − 3 criteria will be enrolled in the study. Their anthropometric data and skinfold thickness will be taken on admission, at sixth week and at discharge by trained field investigators. Other child details, incidence of morbidity and socio-economic details will be collected on admission. To assess food consumption pattern including consumption of locally produced nutrient dense food supplements, dietary assessment, using 24-h dietary recall will be conducted on admission, at sixth week and at discharge. In addition, body composition parameters will be assessed for a sub-set of children using bio-electrical impedance analysis on admission and at discharge to analyse changes in total body water, fat-free mass, and fat mass. Post discharge, all study participants will be followed up monthly until 6 months. Atleast 10% of the sample will be checked for quality assessment. The study’s primary outcome is cure rate defined as children attaining WHZ ≥ -2. Secondary outcomes include mean weight gain, mean length of stay, body composition parameters, relapse and mortality rates. Additionally, process evaluation and cost effectiveness analysis will be conducted. Discussion There is a shortage of robust evidence regarding the effectiveness of locally produced nutrient dense food supplements provided as part of the CSAM intervention in India. This study will contribute to evidence on effective strategies to manage children with uncomplicated SAM in India. The study protocol has all necessary ethical approvals. Written informed consent will be obtained from caregivers of the children. Trial registration The study is registered with Clinical Trial Registration of India (Registration No.: CTRI/2020/09/028013) Date of registration 24/09/2020.

scholarly journals Personalized Diet in Obesity: A Quasi-Experimental Study on Fat Mass and Fat-Free Mass Changes

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1101
Author(s):  
Manuel Reig García-Galbis ◽  
Diego I. Gallardo ◽  
Rosa María Martínez-Espinosa ◽  
María José Soto-Méndez
Keyword(s):  
Experimental Study ◽  
Body Composition ◽  
Fat Mass ◽  
Overweight And Obesity ◽  
The Body ◽  
Fat Free Mass ◽  
Obese Adults ◽  
Quasi Experimental ◽  
Clinically Significant ◽  
Composition Changes

Considering that the prevalence of overweight and obesity in Southeast of Spain is high, the aim of this work was to analyze the relation between the adherence to a personalized diet and the effectiveness of changes in the body composition in overweight and obese adults in this region. This quasi-experimental study presents the following selection criteria: attendance at the consultation between 2006 and 2012, subjects ≥ 19 years of age with overweight or obesity. In total, 591 overweight or obese individuals were involved in this study, attending 4091 clinic consultations in total. Most of the sample consisted of subjects who attended >3 consultations (>1.5 months), and were females aged 19–64 years who obtained clinically significant changes in fat mass (FM, ≥5%) and recommended changes in fat-free mass (FFM, ≥0%). Based on the results obtained and the experience gained from this research, the following recommendations are established: (i) record fat mass and fat-free mass index as a complement to body mass index; (ii) use FM and FFM to evaluate effectiveness of interventions with the aim of obtaining body composition changes; (iii) use personalized diet to achieve significant changes in FM and avoid non-recommended changes in FFM.

scholarly journals Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  
Keyword(s):  
Experimental Study ◽  
Antiretroviral Therapy ◽  
Scale Up ◽  
Economic Evaluations ◽  
People Living With Hiv ◽  
Cad Model ◽  
Community Based ◽  
Quasi Experimental ◽  
Living With Hiv ◽  
Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

scholarly journals The Effectiveness of Community-Based Continuous Training on Promoting Positive Behaviors towards Birth Preparedness, Male Involvement, and Maternal Services Utilization among Expecting Couples in Rukwa, Tanzania: A Theory of Planned Behavior Quasi-Experimental Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Fabiola V. Moshi ◽  
Stephen M. Kibusi ◽  
Flora Fabian
Keyword(s):  
Experimental Study ◽  
Theory Of Planned Behavior ◽  
Male Involvement ◽  
Birth Preparedness ◽  
Continuous Training ◽  
Community Based ◽  
Services Utilization ◽  
Live Births ◽  
Positive Behaviors ◽  
Quasi Experimental

Background. Rukwa Region has the highest maternal mortality ratio, 860 deaths per 100,000 live births in Tanzania. The region has neonatal mortality rate of 38 deaths per 1,000 live births. Previous interventions to promote maternal and neonatal health targeted access to maternal services by removing financial barriers and increasing the number of health facilities. However, maternal service utilization remains very low, especially facility delivery. The proposed intervention was sought to address deep-rooted behavioral beliefs, normative beliefs, control beliefs, and knowledge empowerment to determine their effect on improving birth preparedness, male involvement, and maternal services utilization. The study tested the effectiveness of a Community-Based Continuous Training (CBCT) intervention that was based upon the theory of planned behavior and was sought to promote positive behaviors. Methods. The study used a quasi-experimental design. The design consisted of pre- and postintervention assessments of two nonequivalent groups. Two districts were selected conveniently using criteria of high home birth. A district to hold intervention was picked randomly. Study participants were expecting couples at gestation age of 24 weeks and below. After obtaining informed consents, participants were subjected to baseline assessment. Expecting couples in the intervention group had two training sessions and two encounter discussions. The three primary outcomes of the study were changes in the level of knowledge about birth preparedness, male involvement, and use of maternal services. Data were collected at preintervention, midintervention, and postintervention. Policy Implications of the Results. The aim of this paper was to describe the study protocol of a quasi-experimental study design to test the effectiveness of an interventional program on promoting positive behaviors on birth preparedness, male involvement, and maternal services utilization among expecting couples. This study has a potential to address the challenge of low birth preparedness, male involvement, and use of maternal health services in Rukwa Region.

Improved cookstoves and the prevalence of metabolic syndrome in the rural Peruvian Andes: a quasi-experimental study

2019 ◽  
Author(s):  
Giuliana Sanchez-Samaniego ◽  
Daniel Mäusezahl ◽  
Cesar Carcamo ◽  
Nicole Probst-Hensch ◽  
Héctor Verastegui ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Experimental Study ◽  
Air Pollution ◽  
High Altitude ◽  
Trial Registration ◽  
Biomass Fuel ◽  
Household Air Pollution ◽  
Improved Cookstove ◽  
Open Fire ◽  
Quasi Experimental

Abstract Background: Household air pollution increases the risk of non-communicable diseases, such as cardiovascular diseases and metabolic syndrome. This study hypothesised that the reduction of household air pollution through the installation of improved cookstoves is associated with the prevalence of metabolic syndrome. We compared the prevalence of metabolic syndrome between adults using open fire stoves and using improved cookstoves in high altitude provinces of Cajabamba and San Marcos in rural Peruvian Andes.Methods: This is a quasi experimental study nested within a randomised controlled trial (parent study) of 317 children randomised in four study arms. The parents study applied a 2x2 factorial design with three single intervention arms (improved cookstove (ICS), early child development (ECD) and Control) and one combined arm (ICS-ECD). This study was conducted 6-10 months after the ICS intervention was implemented and all parents of the 317 children in the parent study were eligible to participate. Ventilated improved cookstoves using biomass fuel were provided to intervention homes. All participants answered a 24-hour food recall and underwent a physical examination for metabolic syndrome diagnosis. Results: A total of 385 participants were allocated to two groups of improved cookstove users with 190 (112 women and 78 men) and open-fire stove users with 195 (123 women and 72 men). Metabolic syndrome was detected in 21% of all participants and more frequently in women than men (26% versus 13%). In women, the improved cookstove intervention was a protective factor for metabolic syndrome (Prevalence Ratio= 0.70 (0.46 to 1.08), p=0.11). In addition, PR increased with age in women. In both gender, significantly lower PR was found in participants living ≥2500 meters above sea level (PR=0.65 (0.42 to 1.00), p=0.051 in women; (PR=0.25 (0.07 to 0.71), p=0.009 in men).Conclusions: The improved cookstove intervention reducing household air pollution is associated with a lower prevalence of MetS in women users. In addition, residential altitude is an important risk factor for metabolic syndrome even in high altitude populations. Keywords: biomass fuel ventilated improved cookstove, household air pollution, metabolic syndrome, high altitude, Peru Trial registration: Trial registration number ISRCTN26548981 at www.srctn.com . Registered retrospectively, Jan. 15 2018.

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