scholarly journals Development and Feasibility of a Group, Household Level Intervention To Improve Preconception Health in Rural Nepal.

Author(s):  
Nadia G Diamond-Smith ◽  
Ashley Mitchell ◽  
Alia Cornell ◽  
Minakshi Dahal ◽  
Lakshmi Gopalakrishnan ◽  
...  

Abstract Background: In a setting such as Nepal with malnutrition and persistent poor maternal and infant health outcomes, developing interventions to improve the nutrition of preconception and pregnant women is essential. Aside from factors related to access and knowledge about diverse and adequate diets, inequitable gender norms and women’s low status and autonomy also feed into a lack of emphasis on women’s nutrition.Methods: In this paper we describe the three phases of the design of an intervention for newly married women, their husbands, and mothers-in-law in rural Nepal. We first discuss findings from a mixed methods formative phase, and how that fed into the design of the intervention itself, in close partnership with community members. We the describe the intervention, and findings from a mixed methods feasibility and acceptability pilot among 90 participants.Results: Our formative work highlighted not just lack of awareness about nutrition, but also how factors such as women eating last, and limited mobility, played into poor diets. Low lack of communication and household and community inequitable gender norms were also important factors. Thus we designed Sumadhur, an intervention that brought groups of households (newly married wife, husband, and mother-in-law) together weekly for 4 months to strengthen relationships and gain knowledge through interactive content. We found Sumadhur to be highly feasible and acceptable by all respondents, with most (83%) attending 80% of sessions or more, the majority (73%) of participants reported “no difficulties” in attending sessions, and 99% reporting that they would like it to continue. Pre/post surveys showed a decrease in the proportion of women of women eating last and increase in knowledge about nutrition in preconception and pregnant. Qualitative interviews suggested that respondents felt it made large impacts on their lives, in terms of strengthening relationships and trust, understanding each other, and changing behaviors.Conclusions: We show how a designing an intervention in close partnership with the target recipients and local stakeholders can lead to an intervention that is able to target complicated and culturally held practices and beliefs, positively benefit health and wellbeing, and that is very well received.Trial registration: ClinicalTrials.gov NCT04383847, registered 05/12/2020https://clinicaltrials.gov/ct2/show/results/NCT04383847?view=results

2021 ◽  
Author(s):  
Nadia Diamond-Smith ◽  
Ashley Mitchell ◽  
Alia Cornell ◽  
Lakshmi Gopalakrishnan ◽  
Mallory Johnson ◽  
...  

Abstract Background: In a setting such as Nepal with malnutrition and persistent poor maternal and infant health outcomes, developing interventions to improve the nutrition of preconception and pregnant women is essential. Aside from factors related to access and knowledge about diverse and adequate diets, inequitable gender norms and women’s low status and autonomy also feed into a lack of emphasis on women’s nutrition.Methods: In this paper we describe the three phases of the design of an intervention for newly married women, their husbands, and mothers-in-law in rural Nepal. We first discuss findings from a mixed methods formative phase, and how that fed into the design of the intervention itself, in close partnership with community members. We the describe the intervention, and findings from a mixed methods feasibility and acceptability pilot among 90 participants.Results: Our formative work highlighted not just lack of awareness about nutrition, but also how factors such as women eating last, and limited mobility, played into poor diets. Low lack of communication and household and community inequitable gender norms were also important factors. Thus we designed Sumadhur, an intervention that brought groups of households (newly married wife, husband, and mother-in-law) together weekly for 4 months to strengthen relationships and gain knowledge through interactive content. We found Sumadhur to be highly feasible and acceptable by all respondents, with most (83%) attending 80% of sessions or more, the majority (73%) of participants reported “no difficulties” in attending sessions, and 99% reporting that they would like it to continue. Pre/post surveys showed a decrease in the proportion of women of women eating last and increase in knowledge about nutrition in preconception and pregnant. Qualitative interviews suggested that respondents felt it made large impacts on their lives, in terms of strengthening relationships and trust, understanding each other, and changing behaviors.Conclusions: We show how a designing an intervention in close partnership with the target recipients and local stakeholders can lead to an intervention that is able to target complicated and culturally held practices and beliefs, positively benefit health and wellbeing, and that is very well received.Trial registration: ClinicalTrials.gov NCT04383847, registered 12/05/2020https://clinicaltrials.gov/ct2/show/results/NCT04383847?view=results


BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052545
Author(s):  
Michelle Kennedy ◽  
Ratika Kumar ◽  
Nicole M Ryan ◽  
Jessica Bennett ◽  
Gina La Hera Fuentes ◽  
...  

ObjectiveDescribe the development and pretest of a prototype multibehavioural change app MAMA-EMPOWER.DesignMixed-methods study reporting three phases: (1) contextual enquiry included stakeholder engagement and qualitative interviews with Aboriginal women, (2) value specification included user-workshop with an Aboriginal researcher, community members and experts, (3) codesign with Aboriginal researchers and community members, followed by a pretest of the app with Aboriginal women, and feedback from qualitative interviews and the user-Mobile Application Rating Scale (U-MARS) survey tool.SettingsAboriginal women and communities in urban and regional New South Wales, Australia.ParticipantsPhase 1: interviews, 8 Aboriginal women. Phase 2: workshop, 6 Aboriginal women. Phase 3: app trial, 16 Aboriginal women. U-MARS, 5 Aboriginal women.ResultsPhase 1 interviews revealed three themes: current app use, desired app characteristics and implementation. Phase 2 workshop provided guidance for the user experience. Phase 3 app trial assessed all content areas. The highest ratings were for information (mean score of 3.80 out of 5, SD=0.77) and aesthetics (mean score of 3.87 with SD of 0.74), while functionality, engagement and subjective quality had lower scores. Qualitative interviews revealed the acceptability of the app, however, functionality was problematic.ConclusionsDeveloping a mobile phone app, particularly in an Aboriginal community setting, requires extensive consultation, negotiation and design work. Using a strong theoretical foundation of behavioural change technique’s coupled with the consultative approach has added rigour to this process. Using phone apps to implement behavioural interventions in Aboriginal community settings remains a new area for investigation. In the next iteration of the app, we aim to find better ways to personalise the content to women’s needs, then ensure full functionality before conducting a larger trial. We predict the process of development will be of interest to other health researchers and practitioners.


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018454 ◽  
Author(s):  
Janique Fortier ◽  
Mariette Chartier ◽  
Sarah Turner ◽  
Nora Murdock ◽  
Frank Turner ◽  
...  

IntroductionHigh rates of mental health problems, such as suicidal behaviours, among First Nations youth in Canada are a major public health concern. The Good Behavior Game (GBG) is a school-based intervention that provides a nurturing environment for children and has been shown to promote positive outcomes. PAX Good Behavior Game (PAX GBG) is an adaptation and enhancement of the GBG. While PAX GBG has been implemented in Indigenous communities, little research exists examining the cultural and contextual appropriateness and effectiveness of the intervention in First Nations communities.Methods and analysisThe present paper describes a protocol of the mixed-methods approach guided by an Indigenous ethical engagement model adopted to implement, adapt and evaluate PAX GBG in First Nations communities in Manitoba, Canada. First, implementation outcomes (eg, acceptability, adoption) of PAX GBG will be evaluated using qualitative interviews with teachers, principals and community members from Swampy Cree Tribal Council (SCTC) communities. Second, by linking administrative databases to programme data from schools in 38 First Nations communities, we will compare PAX GBG and control groups to evaluate whether PAX GBG is associated with improved mental health and academic outcomes. Third, the qualitative results will help inform a cultural and contextual adaptation of PAX GBG called First Nations PAX (FN PAX). Fourth, FN PAX will be implemented in a few SCTC communities and evaluated using surveys and qualitative interviews followed by the remaining communities the subsequent year.Ethics and disseminationEthical approval was obtained from the University of Manitoba Health Research Ethics Board and will be obtained from the Health Information Privacy Committee and respective data providers for the administrative database linkages. Dissemination and knowledge translation will include community and stakeholder engagement throughout the research process, reports and presentations for policymakers and community members, presentations at scientific conferences and journal publications.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Britni L. Ayers ◽  
Cari A. Bogulski ◽  
Lauren Haggard-Duff ◽  
James P. Selig ◽  
Pearl A. McElfish

Abstract Background Arkansas has the largest population of Marshallese Pacific Islanders residing in the continental United States. Marshallese are disproportionately burdened by poorer maternal and infant health outcomes. Exclusive breastfeeding can prevent or help mitigate maternal and infant health disparities. However, exclusive breastfeeding among United States Marshallese communities remains disproportionately low, and the reasons are not well documented. This paper describes the protocol of a mixed-methods concurrent triangulation longitudinal study designed to explore the beliefs and experiences that serve as barriers and/or facilitators to exclusive breastfeeding intention, initiation, and duration among Marshallese mothers in northwest Arkansas. Methods The mixed-methods design collects qualitative and quantitative data during simultaneous data collection events, at third trimester, six weeks postpartum, and six months postpartum. Quantitative and qualitative data will be analyzed separately and then synthesized during the interpretation phase. The research team will disseminate results to study participants, research stakeholders, the broader Marshallese community, and fellow researchers. Discussion Findings and results will be presented in subsequent manuscripts upon completion of the study. This study will be an important first step to better understand beliefs and experiences to exclusive breastfeeding intention, initiation, and duration in this community and will inform tools and interventions to help improve health outcomes. The study will also aid in filling the gap in research and providing essential information on the infant feeding beliefs and barriers among a Marshallese community in Arkansas.


2021 ◽  
pp. 088626052098626
Author(s):  
Sarah Treves-Kagan ◽  
Amber Peterman ◽  
Nisha C. Gottfredson ◽  
Andrés Villaveces ◽  
Kathryn E. Moracco ◽  
...  

A high prevalence of intimate partner violence (IPV) has been documented among women living in conflict-affected and refugee-hosting areas, but why this occurs is not well understood. Conflict and displacement deteriorate communities’ social cohesion and community connectedness; these neighborhood social environments may influence individual IPV outcomes. We explored neighborhood-level social disorganization and cohesion as predictors of recent IPV in refugee-hosting communities in northern Ecuador by conducting multi-level logistic regression on a longitudinal sample of 1,312 women. Neighborhood social disorganization was marginally positively associated with emotional IPV (AOR: 1.17, 95% CI: .99, 1.38) and physical and/or sexual IPV (AOR: 1.20, 95% CI: .96, 1.51). This was partially mediated by neighborhood-level civic engagement in the case of emotional IPV. At the household level, perceived discrimination and experience of psychosocial stressors were risk factors for both types of IPV, whereas social support was protective. To our knowledge, this is one of the first studies to examine how neighborhood social factors influence IPV outcomes in refugee-hosting communities or in South America. As the world grapples with the largest number of displaced people in history, this research can inform prevention and response programming and reinforces the critical importance of promoting acceptance of refugees and immigrants and positively engaging all community members in civic life in refugee-hosting settings.


IFLA Journal ◽  
2021 ◽  
pp. 034003522110271
Author(s):  
Theresa L Adu ◽  
Thomas B van der Walt

This study investigated the copyright issues surrounding the management of e-resources in academic libraries in Ghana. Forty-seven library staff and head librarians from four academic libraries were engaged using questionnaires and qualitative interviews in a sequential mixed-methods approach to generate data for this study. The findings indicate that in all four institutions copyright issues arose with the provision of distance learning, online courses and e-reserves services. All the respondents stated that they or their colleagues had had faculty ask questions on copyright issues. However, the professional librarians indicated that the library was not consulted and the instructors for online courses or distance education programmes did not cooperate with librarians; rather, the department posting the materials made the decisions on copyright regarding the usage of digital resources for distance learning, online courses or e-reserves. This does not augur well for the management of copyright of e-resources in academic libraries in Ghana.


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