scholarly journals Effects of an mHealth voice message service (mMitra) on maternal health knowledge and practices of low-income women in India: findings from a pseudo-randomized controlled trial

2019 ◽  
Author(s):  
Nirmala Murthy ◽  
Subhashini Chandrasekharan ◽  
Prakash Muthuperumal ◽  
Aakash Ganju ◽  
Joanne Peter ◽  
...  

Abstract Background Mobile Health (mHealth) is becoming an important tool to improve health outcomes in maternal, newborn and child health (MNCH). Studies of mHealth interventions, have demonstrated their effectiveness in improving uptake of recommended maternal services such as antenatal visits. However, evidence of impact on maternal health outcomes is still limited.Methods A pseudo-randomized controlled trial was conducted to assess the impact of a voice-message based maternal intervention on maternal health knowledge, attitudes, practices and outcomes over time: Pregnancy (baseline/Time 1); Post-partum (Time 2) and when the infant turned one year old (Time 3). Women assigned to the mMitra intervention arm received gestational age- and stage-based educational voice messages via mobile phone in Hindi and Marathi, while those assigned to the control group did not. Both groups received standard care.Results 2,016 women were enrolled. Interviews were conducted with 1,516 women in the intervention group and 500 women in the control group at baseline and post-partum. The intervention group performed significantly better than controls on four maternal health practice indicators: receiving the tetanus toxoid injection (OR: 1.6, 95% Confidence Interval (CI): 1.05-2.4, p=0.028), consulting a doctor if spotting or bleeding (OR: 1.72, 95%CI: 1.07-2.75, p=0.025), saving money for delivery expenses (OR: 1.79, 95%CI: 1.38-2.33, p=0.0001), and delivering in hospital (OR: 2.5, 95%CI: 1.49-4.35, p=0.001). The control group performed significantly better than the intervention group on two practice indicators: resting regularly during pregnancy (OR: 0.7, 95%CI: 0.54-0.88, p=0.002) and having at-home deliveries attended by a skilled birth attendant (OR: 0.46, 95%CI: 0.23-0.91, p=0.027). Both groups’ knowledge improved from Time 1 to Time 2. Only one knowledge indicator, on seeking medical care during pregnancy, was statistically increased in the intervention group compared to controls. Anemia status at or near the time of delivery was unable to be assessed.Conclusions This study provides evidence that in low-resource settings, mobile voice messages providing tailored and timed information about pregnancy can positively impact maternal health care practices proven to improve maternal health outcomes. Additional research is needed to assess whether voice messaging can motivate behavior change better than text messaging, particularly in low literacy settings.

2020 ◽  
Author(s):  
Nirmala Murthy ◽  
Subhashini Chandrasekharan ◽  
Prakash Muthuperumal ◽  
Aakash Ganju ◽  
Joanne Peter ◽  
...  

Abstract Background: Mobile Health (mHealth) is becoming an important tool to improve health outcomes in maternal, newborn and child health (MNCH). Studies of mHealth interventions, have demonstrated their effectiveness in improving uptake of recommended maternal services such as antenatal visits. However, evidence of impact on maternal health outcomes is still limited. Methods: A pseudo-randomized controlled trial was conducted to assess the impact of a voice-message based maternal intervention on maternal health knowledge, attitudes, practices and outcomes over time: Pregnancy (baseline/Time 1); Post-partum (Time 2) and when the infant turned one year old (Time 3). Women assigned to the mMitra intervention arm received gestational age- and stage-based educational voice messages via mobile phone in Hindi and Marathi, while those assigned to the control group did not. Both groups received standard care. Results: 2,016 women were enrolled. Interviews were conducted with 1,516 women in the intervention group and 500 women in the control group at baseline and post-partum. The intervention group performed significantly better than controls on four maternal health practice indicators: receiving the tetanus toxoid injection (OR: 1.6, 95% Confidence Interval (CI): 1.05-2.4, p=0.028), consulting a doctor if spotting or bleeding (OR: 1.72, 95%CI: 1.07-2.75, p=0.025), saving money for delivery expenses (OR: 1.79, 95%CI: 1.38-2.33, p=0.0001), and delivering in hospital (OR: 2.5, 95%CI: 1.49-4.35, p=0.001). The control group performed significantly better than the intervention group on two practice indicators: resting regularly during pregnancy (OR: 0.7, 95%CI: 0.54-0.88, p=0.002) and having at-home deliveries attended by a skilled birth attendant (OR: 0.46, 95%CI: 0.23-0.91, p=0.027). Both groups’ knowledge improved from Time 1 to Time 2. One knowledge indicator, seeking medical care during pregnancy, was statistically increased in the intervention group compared to controls. Anemia status at or near the time of delivery was unable to be assessed due to missing maternal health cards. Conclusions: This study provides evidence that mobile voice messages providing tailored and timed information about pregnancy can positively impact maternal health care practices proven to improve maternal health outcomes. Additional research is needed to assess whether voice messaging can motivate behavior change better than text messaging, particularly in low literacy settings.


2017 ◽  
Author(s):  
Jiemin Zhu ◽  
Lyn Ebert ◽  
Xiangyu Liu ◽  
Di Wei ◽  
Sally Wai-Chi Chan

BACKGROUND Women undergoing chemotherapy for the treatment of breast cancer have frequently reported unmet supportive care needs. Moreover, easily accessible and innovative support is lacking. OBJECTIVE The purpose of this trial was to determine the effectiveness of an app-based breast cancer e-support program to address women’s self-efficacy (primary outcome), social support, symptom distress, quality of life, anxiety, and depression. Secondary objectives included exploring the association between women’s health outcomes and the breast cancer e-support usage data. METHODS A multicenter, single-blinded, randomized controlled trial was conducted. A total of 114 women with breast cancer, who were commencing chemotherapy and were able to access internet through a mobile phone, were recruited in the clinics from 2 university-affiliated hospitals in China. Women were randomized either to the intervention group (n=57) receiving breast cancer e-support plus care as usual or the control group (n=57) receiving care as usual alone. The health care team and research assistants collecting data were blinded to the women’s group allocation. Bandura’s self-efficacy theory and the social exchange theory guided the development of the breast cancer e-support program, which has 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum. Moderated by an experienced health care professional, the breast cancer e-support program supported women for 12 weeks covering 4 cycles of chemotherapy. Health outcomes were self-assessed through paper questionnaires in clinics at baseline before randomization (T0), after 3 (T1), and 6 months (T2) of follow-ups. RESULTS Fifty-five participants in the intervention group and 49 in the control group completed the follow-up assessments (response rate: 91.2%). During the 12-week intervention, the log-in frequency ranged from 0 to 774 times (mean 54.7; SD 131.4; median 11; interquartile range, IQR 5-27), and the total usage duration ranged from 0 to 9371 min (mean 1072.3; SD 2359.5; median 100; IQR 27-279). Repeated measures multivariate analysis of covariance (intention-to-treat) found that breast cancer e-support + care as usual participants had significant better health outcomes at 3 months regarding self-efficacy (21.05; 95% CI 1.87-40.22; P=.03; d=0.53), symptom interference (−0.73; 95% CI −1.35 to −.11; P=.02; d=−0.51), and quality of life (6.64; 95% CI 0.77-12.50; P=.03, d=0.46) but not regarding social support, symptom severity, anxiety, and depression compared with care as usual participants. These beneficial effects were not sustained at 6 months. Spearman rank-order correlation showed that the breast cancer e-support usage duration was positively correlated with self-efficacy (r=.290, P=.03), social support (r=.320, P=.02), and quality of life (r=.273, P=.04) at 3 months. CONCLUSIONS The breast cancer e-support program demonstrated its potential as an effective and easily accessible intervention to promote women’s self-efficacy, symptom interference, and quality of life during chemotherapy. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000639426; www.ANZCTR.org.au/ACTRN12616000639426.aspx (Archived by Webcite at http://www.webcitation.org/6v1n9hGZq)


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 428-428
Author(s):  
Jasmine Low ◽  
Jung Eun Kim ◽  
Ee Hock Kua ◽  
Johnson Fam

Abstract Objectives Dietary counselling is an effective nutritional strategy for improving dietary quality and cardiometabolic health, but these beneficial effects have not been well studied in older adults, especially in Asia. Therefore, this study aimed to assess the impact of dietary counselling on cardiometabolic health outcomes and dietary quality in older Singaporean adults. Methods This was a 12-week, parallel design, randomized controlled trial. Twenty-six women aged above 60 y were randomized where the intervention group received dietary counselling (n = 14) and the control group did not receive dietary counselling (n = 12). Anthropometric measurement, blood pressure, fasting lipid-lipoprotein, glucose and insulin levels were examined at baseline and week 12. The interactive dietary counselling sessions were conducted by a qualified nutritionist every week and each session took 60 minutes. The counselling topics included healthy eating pattern, proper food proportioning, food label reading and several age-related diseases. All participants completed a 3-day food record and the dietary quality was assessed using the Alternative Healthy Eating Index 2010 (AHEI-2010). All results were reported as least square means ± SD. Results A significant decrease in serum low density lipoprotein cholesterol level was detected in the intervention group (3.3 mmol/L ± 1.0 to 3.1 mmol/L ± 0.8, P < 0.05) whereas the control group unchanged (3.8 mmol/L ± 0.6 to 3.7 mmol/L ± 0.7). Moreover, although there was an increase in waist circumference in the control group (76 cm ± 7 to 80 cm ± 6, P < 0.05), no change was observed in the intervention group (76 cm ± 7 to 77 cm ± 9). Other anthropometric and cardiometabolic measurements were not changed after intervention. Both groups showed an increase in dietary quality based on the AHEI-2010 score after intervention however change was only significant in the intervention group (44.0 ± 9.1 to 48.9 ± 8.7, P < 0.05). l group, but a significant time effect was observed (P = 0.009). Conclusions The provision of dietary counselling confers the benefits in the cardiometabolic health outcomes and these benefits may be explained by the improvement in dietary quality in Singaporean older adults. Funding Sources National University of Singapore (NUS), NUS-Mind Science Centre.


2009 ◽  
Vol 48 (173) ◽  
Author(s):  
BC Mullany ◽  
B Lakhey ◽  
D Shrestha ◽  
MJ Hindin ◽  
S Becker

INTRODUCTION:A randomized controlled trial was designed to test the impact of involving husbands in antenatal health education on women's maternal health knowledge.METHODS:Total 442 women receiving antenatal services at a hospital in Kathmandu, Nepal were randomized into three groups: women who attended education sessions with their husbands, women who attended education sessions alone, and women who attended no education sessions (controls). At baseline and after delivery, women's maternal health knowledge and change in knowledge levels were compared between the groups.RESULTS:Compared to control group women, women educated with husbands increased their knowledge scores by an average of 0.61 points (95% CI=0.32-0.89, P<0.001), while women educated alone increased their scores by only 0.34 points (95% CI=0.04-0.65, P<0.05). Women educated with partners could identify more pregnancy complications and family planning methods than women in both other groups.CONCLUSIONS:These findings suggest that women learn and retain the most information when they are educated with their partnersKeywords:couples intervention; male involvement; maternal health; Nepal


MedPharmRes ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. 6-11
Author(s):  
Dieu-Thuong Thi Trinh ◽  
Minh-Man Pham Bui ◽  
Hong-Nhung Thi Le

Background and Objective: Chronic low back pain (CLBP) represents one of the major causes of increasing disability worldwide. Electroacupuncture with different frequencies at the Hua Tuo Jia Ji acupoints has been used to treat CLBP in patients with lumbar osteoarthritis. Basic studies demonstrate that 100 Hz or 2 Hz electroacupuncture has pain-relief effects on CLBP; however clinical evidence for choosing which frequency is still limited. Thus, our study aims to compare the effects of 100 Hz to 2 Hz electroacupuncture for CLBP on patients with lumbar osteoarthritis. Methods: A randomized controlled trial of 124 patients with lumbar osteoarthritis at the Traditional Medicine Hospital at Ho Chi Minh City from September 2018 to July 2019. Patients were randomly allocated to either intervention group (n = 62) with 100 Hz electroacupuncture or control group (n = 62) with 2 Hz electroacupuncture at the L2-S1 Hua Tuo Jia Ji acupoints for 14 days. Du Huo Ji Sheng Tang decoction was also administered in both groups. Primary trial outcomes were QDSA score and the proportion of patients who achieved pain relief thresholds. Results: After 14 days of treatment, QDSA score in intervention group decreased significantly compared to control group. 87% of patients in intervention group had pain relief of ≥70%, and only 45% patients in control group had such result. Lumbar flexion range of motion in 100 Hz group tended to be better than in 2 Hz group. Conclusion: 100 Hz electroacupuncture had superior analgesic effects on lumbar osteoarthritis to 2 Hz electroacupuncture.


Crisis ◽  
2020 ◽  
pp. 1-7
Author(s):  
Karien Hill ◽  
Shawn Somerset ◽  
Ralf Schwarzer ◽  
Carina Chan

Abstract. Background: The public health sector has advocated for more innovative, technology-based, suicide prevention education for the community, to improve their ability to detect and respond to suicide risk. Emerging evidence suggests addressing the bystander effect through the Bystander Intervention Model (BIM) in education material may have potential for suicide prevention. Aims: The current study aimed to assess whether BIM-informed tools can lead to improved readiness, confidence and intent in the community to detect and respond to suicide risk in others. Method: A sample of 281 adults recruited from the community participated in a randomized controlled trial comprising a factsheet designed according to the BIM (intervention group) and a standard factsheet about suicide and mental health (control group). Participants' self-reported detecting and responding to suicide risk readiness, confidence, and intent when presented with a suicidal peer was tested pre- and postintervention and compared across time and between groups. Results: The intervention group had significantly higher levels of detecting and responding to suicide risk readiness, confidence, and intent than the control group at postintervention (all p < .001) with moderate-to-large effect sizes. Limitations: The study was limited by a homogenous sample, too low numbers at follow-up to report, and self-report data only. Conclusion: This study demonstrates BIM-informed suicide prevention training may enhance the community's intervention readiness, confidence, and intent better than current standard material. Further testing in this area is recommended. While results were statistically significant, clinical significance requires further exploration.


2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Farokh Saljughi ◽  
Mitra Savabi-Esfahani ◽  
Shahnaz Kohan ◽  
Soheila Ehsanpour

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.


2018 ◽  
Vol 7 ◽  
Author(s):  
Azita Kamjoo

Background: Pain control is considered as the key issue in modern midwifery. Along with medical painkillers, reflexology is viewed as a non-medical and noninvasive method. Hence, we aimed to investigate the effect of reflexology on the intensity of pain and length of labor. Materials and Methods: In this clinical trial, participants included 240 Iranian primiparous women with term and singleton pregnancy. Having a 3-4 cm cervical dilatation once they visited the hospital. Through a convenient sampling method, they were selected and then randomly divided into two groups. In the intervention group, reflexology was performed, and the intensity of pain during the active phase of labor along with the length of labor in the active phase was measured by visual analog scale (VAS) and compared with the control group. Data were analyzed using descriptive statistics, t-test, and Mann-Whitney U-test. Result: Data analysis showed a statistically significant difference between the intensity of pain in the 5-7 and 8-10 cm dilatation in the two groups (P=0.01). Moreover, the labor length in the active phase was found to be significantly shorter in the intervention group (P<0.001). Conclusion: It appears that reflexology can lead to a reduction in the pain and length of labor. Therefore, through instructing this technique, a goal of midwifery, which is reducing labor pain and its length can be achieved. Keywords: Reflexology, Labor Pain, Labor Length, Primiparous Women


2018 ◽  
Author(s):  
Musheer Abdulwahid Al-Jaberi ◽  
Muhamad Hanafiah Juni ◽  
Hayati Kadir Shahar ◽  
Siti Irma Fadhilah Ismail ◽  
Murad Abdu Saeed ◽  
...  

BACKGROUND Universities around the world, including Malaysia, have attracted many international students from different countries. Research has reported that acculturative stress resulting from international students’ attempts to adjust to the cultures of host countries is one of the most challenging issues that affects their lives in general and academic lives in particular. OBJECTIVE This study aims to examine the effectiveness of an educational intervention on acculturative stress among new postgraduate international students joining Malaysian public universities. METHODS A cluster randomized controlled trial design with Malaysian public universities as the unit of randomization will be used in this study. Public universities will be randomized in a 1:1 ratio to be either in the intervention (educational program) or control group (waiting list). Participants in the intervention group will receive 7 sessions in 9 hours delivered by an expert in psychology and the researcher. The control group will receive the intervention once the 3-month follow-up evaluation is completed. RESULTS The data will be analyzed using the generalized estimation equation with a confidence interval value of 95%; significant differences between and within groups are determined as <i>P</i>&lt;.05. The results of the study underlie the effectiveness of educational program in decreasing acculturative stress of new international students and enabling them to cope with a new environment. The results of this study will contribute to previous knowledge of acculturative stress, acculturation, and adjustment of international students. Furthermore, such results are expected to play a role in raising university policy makers’ awareness of their postgraduate international students’ acculturative stress issues and how they can help them avoid such stress and perform well in their academic life. CONCLUSIONS We expect that the intervention group will score significantly lower than the wait-list group on the immediate and 3-month postintervention evaluation of acculturative stress and achieve a higher level of adjustment. Results will have implications for international students, policy makers at universities, the Malaysian Ministry of Higher Education, and future research. CLINICALTRIAL Clinical Trials Registry India CTRI/2018/01/011223; http://ctri.nic.in/Clinicaltrials/showallp.php?mid1= 21978&amp;amp;EncHid=&amp;amp;userName=Muhamad%20Hanafiah%20Juni INTERNATIONAL REGISTERED REPORT PRR1-10.2196/12950


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