scholarly journals A community-based randomized trial for the prevention and control of brucellosis among rural populations in Iran: application of the PRECEDE planning model

2020 ◽  
Author(s):  
Leila Jahangiry ◽  
Maryam Khazaee-Pool ◽  
Towhid Babazadeh ◽  
Parvin Sarbakhsh ◽  
Koen Ponnet

Abstract Background: Brucellosis is one of the most frequently occurring zoonotic diseases of veterinary and a public health problem in developing countries. It affects human and animal health and has measurable effects on the productive and reproductive performance of livestock. Therefore, the main purpose of this study was to develop a community-based intervention program for brucellosis prevention and control. A two-arm parallel cluster randomized controlled trial investigated the effectiveness of the program over six months in a rural population in Ahar, East Azerbaijan, Iran. A total of 16 village health houses were randomly allocated to the intervention and the control groups (eight per arm), and 400 participants were recruited via household health records in the health houses. The PRECEDE model, which is an acronym for Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation, was used to design, implement, and evaluate the brucellosis prevention and control program. Knowledge, attitudes, self-efficacy, social support, environmental enabling, and behavioral factors were measured at the baseline and the six-month follow-up. A generalized mixed effects model was used to analyze data. Results: The mean ages (SD) of the intervention and control group respondents were 35.9 (11.87) and 37.28 (11.04) years, respectively. After the six-month intervention, significant between-group differences were found on all PRECEDE variables, adjusted for education, history of brucellosis, and family history of brucellosis. Conclusion: There is a need to consolidate collaborative health and veterinary sector efforts, as well as increase regular vaccination practices and financial resources to support farmers willing to slaughter animals and/or offer slaughter facilities. The present study was able to demonstrate which educational and ecological factors influence behaviors and environments related to brucellosis and, as such, provide evidence of the effectiveness of interventions based on the PROCEDE model.

2020 ◽  
Author(s):  
Leila Jahangiry ◽  
Maryam Khazaee-Pool ◽  
Towhid Babazadeh ◽  
Parvin Sarbakhsh ◽  
Koen Ponnet

Abstract Background: Brucellosis is one of the most frequently occurring zoonotic diseases of veterinary and a public health problem in developing countries. It affects human and animal health and has measurable effects on the productive and reproductive performance of livestock. Therefore, the main purpose of this study was to develop a community-based intervention program for brucellosis prevention and control. A two-arm parallel cluster randomized controlled trial investigated the effectiveness of the program over six months in a rural population in Ahar, East Azerbaijan, Iran. A total of 16 village health houses were randomly allocated to the intervention and the control groups (eight per arm), and 400 participants were recruited via household health records in the health houses. The PRECEDE model, which is an acronym for Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation, was used to design, implement, and evaluate the brucellosis prevention and control program. Knowledge, attitudes, self-efficacy, social support, environmental enabling, and behavioral factors were measured at the baseline and the six-month follow-up. A generalized mixed effects model was used to analyze data. Results: The mean ages (SD) of the intervention and control group respondents were 35.9 (11.87) and 37.28 (11.04) years, respectively. After the six-month intervention, significant between-group differences were found on all PRECEDE variables, adjusted for education, history of brucellosis, and family history of brucellosis. Conclusion: There is a need to consolidate collaborative health and veterinary sector efforts, as well as increase regular vaccination practices and financial resources to support farmers willing to slaughter animals and/or offer slaughter facilities. The present study was able to demonstrate which educational and ecological factors influence behaviors and environments related to brucellosis and, as such, provide evidence of the effectiveness of interventions based on the PROCEDE model.


2019 ◽  
Author(s):  
Leila Jahangiry ◽  
Maryam Khazaee-Pool ◽  
Towhid Babazadeh ◽  
Parvin Sarbakhsh

Abstract Background: Brucellosis is one of the most frequently-occurring zoonotic diseases of veterinary and public health in developing countries. It affects human and animal health and has measurable effects on productive and reproductive performance of livestock. Thus the main purpose of this study is to develop a community-based intervention program for prevention and control of brucellosis. The two-arm parallel cluster randomized controlled trial investigated the effectiveness of an integrated prevention program over six months on brucellosis in a rural population in Ahar, East Azerbaijan, Iran. Health houses were selected of villages and randomly allocated into the intervention and the control groups (16 Health Houses in all, eight per arm). Participants were recruited via household health records in the health houses presented in the villages. The PRECEDE-PROCEED model was used to design, implement and evaluate of brucellosis prevention and control program. The appropriate strategy and intervention were matched with the project priority changes according to policies, resources, and organizational situations. Social support, knowledge, attitudes, self-efficacy, behavioral and environmental factors were measured at the baseline and 6-months follow-up. Generalized mixed effects-model was used to analyze data. Results: A total of 400 individuals from the study answered the questions in the present study. The mean age (SD) of the respondents in the intervention and control groups were 35.9 (11.87) and 37.28 (11.04) years, respectively. There were significant differences between intervention and control group for Precede model-base variables after six month of intervention program adjusted for adjusted for education, history of brucellosis and family history of brucellosis. Conclusion: there is a need to consolidate collaborative efforts from the health and veterinary sectors, as well as to strengthen regular vaccination and financial resources to support farmers willing to compensate or offering slaughter facilities. This diagnostic study of educational and ecological factors influencing behaviors and environments related to brucellosis will identify where and how interventions can be most effective.


Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yogeshwar Kalkonde ◽  
Mahesh Deshmukh ◽  
Sindhu Nila ◽  
Sunil Jadhao ◽  
Abhay Bang

Abstract Background Stroke has emerged as a leading cause of death in rural India. However, well-tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India. Methods The study is a two-arm, parallel group, cluster randomised controlled trial in which 32 villages will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screened individuals who are positive will be referred to a mobile outreach clinic which will visit the intervention villages periodically. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco use and steps to quit it. Individuals from both the arms will have access to the government’s national programme for the prevention and control of non-communicable diseases, where treatment for hypertension, diabetes and preventive treatment after stroke is available at the nearest primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be a reduction in stroke mortality in the last 2.5 years of the intervention. Discussion This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in the rural regions of India and other countries. Trial registration Clinical Trials Registry of India: CTRI/2015/12/006424. Registered on 8 December 2015.


2019 ◽  
Author(s):  
Yogeshwar Kalkonde ◽  
Mahesh Deshmukh ◽  
Sindhu Nila ◽  
Sunil Jadhao ◽  
Abhay Bang

Abstract Background Stroke has emerged as a leading cause of death in rural India. However, well tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India. Methods The study is a two-arm, parallel group, cluster randomised controlled trial where 32 villages each will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥ 50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screen positive individuals will be referred to a mobile outreach clinic which will visit intervention villages. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients at periodic intervals. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco and steps to quit it. Individuals from both the arms will have access to government’s national programme for prevention and control of non-communicable diseases where treatment for hypertension, diabetes and preventive treatment after stroke is available, nearest at the primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be reduction in stroke mortality in the last 2.5 years of the intervention. Discussion This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in rural regions of India and other countries.


2019 ◽  
Author(s):  
Yogeshwar Kalkonde ◽  
Mahesh Deshmukh ◽  
Sindhu Nila ◽  
Sunil Jadhao ◽  
Abhay Bang

Abstract Background Stroke has emerged as a leading cause of death in rural India. However, well tested healthcare interventions to reduce stroke mortality in rural under-resourced settings are lacking. The aim of this study is to evaluate the effect of a community-based preventive intervention on stroke mortality in rural Gadchiroli, India. Methods The study is a two-arm, parallel group, cluster randimised controlled trial where 32 villages each will be randomised to the intervention and the enhanced usual care (EUC) arm. In the intervention arm, individuals ≥ 50 years of age will be screened for hypertension, diabetes and stroke by trained Community Health Workers (CHWs). Screen positive individuals will be referred to a mobile outreach clinic which will visit intervention villages. A physician in the clinic will confirm the diagnosis, provide guideline-based treatment and follow up patients at periodic intervals. The CHWs will make home visits once a month to ensure medication compliance and counsel patients to reduce salt consumption and quit tobacco and alcohol. In the EUC arm, households will be provided information on the ill effects of tobacco and steps to quit it. Individuals from both the arms will have access to government’s national programme for prevention and control of non-communicable diseases where treatment for hypertension, diabetes and stroke is available at the primary health centres (PHCs). The intervention will be implemented for 3.5 years. The primary outcome will be reduction in stroke mortality in the last 2.5 years of the intervention. Discussion This trial will provide important information regarding the feasibility and effect of a community-based preventive intervention package on stroke mortality in a rural under-resourced setting and can inform India’s non-communicable diseases prevention and control programme. If successful, such an intervention can be scaled up in rural regions of India and other countries.


2020 ◽  
Vol 20 (2) ◽  
pp. 101-120
Author(s):  
Ayça Aktaç Gürbüz ◽  
Orçun YORULMAZ ◽  
Gülşah DURNA

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.


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.


2017 ◽  
pp. 53-58
Author(s):  
Lam Huong Le

Objectives: Molar pregnancy is the gestational trophoblastic disease and impact on the women’s health. It has several complications such as toxicity, infection, bleeding. Molar pregnancy also has high risk of choriocarcinoma which can be dead. Aim: To assess the risks of molar pregnancy. Materials and Methods: The case control study included 76 molar pregnancies and 228 pregnancies in control group at Hue Central Hospital. Results: The average age was 32.7 ± 6.7, the miximum age was 17 years old and the maximum was 46 years old. The history of abortion, miscarriage in molar group and control group acounted for 10.5% and 3.9% respectively, with the risk was higher 2.8 times; 95% CI = 1.1-7.7 (p<0.05). The history of molar pregnancy in molar pregnancy group was 9.2% and the molar pregnancy risk was 11.4 times higher than control group (95% CI = 2.3-56.4). The women having ≥ 4 times births accounted for 7.9% in molar group and 2.2% in control group, with the risk was higher 3.8 times, 95% CI= 1.1-12.9 (p<0.05). The molar risk of women < 20 and >40 years old in molar groups had 2.4 times higher than (95% CI = 1.1 to 5.2)h than control group. Low living standard was 7.9% in molar group and 1.3% in the control group with OR= 6.2; 95% CI= 1.5-25.6. Curettage twice accounted for 87.5%, there were 16 case need to curettage three times. There was no case of uterine perforation and infection after curettage. Conclusion: The high risk molar pregnancy women need a better management. Pregnant women should be antenatal cared regularly to dectect early molar pregnancy. It is nessecery to monitor and avoid the dangerous complications occuring during the pregnancy. Key words: Molar pregnancy, pregnancy women


Sign in / Sign up

Export Citation Format

Share Document