scholarly journals eRegCom – Quality Improvement Dashboard for healthcare providers and Targeted Client Communication to pregnant women using data from an electronic health registry to improve attendance and quality of antenatal care: study protocol for a multi-arm cluster randomized trial

2020 ◽  
Author(s):  
Kjersti Mørkrid ◽  
Binyam Bogale ◽  
Eatimad Abbas ◽  
Khadija Abu Khader ◽  
Itimad Abu Ward ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Health Systems Strengthening ◽  
Trial Registration ◽  
Client Communication ◽  
Cluster Randomized

Abstract Background: This trial evaluates interventions that utilize data entered at point-of-care in the Palestinian maternal and child eRegistry to generate Quality Improvement Dashboards (QID) for healthcare providers and Targeted Client Communication (TCC) via short message service (SMS) to clients. The aim is to assess the effectiveness of the automated communication strategies from the eRegistry on improving attendance and quality of care for pregnant women.Methods: This four-arm cluster randomized controlled trial will be conducted in the West Bank and the Gaza Strip, Palestine, and includes 138 clusters (primary healthcare clinics) enrolling from 45 to 3000 pregnancies per year. The intervention tools are the QID and the TCC via SMS, automated from the eRegistry built on the District Health Information Software 2 (DHIS2) Tracker. The primary outcomes are appropriate screening and management of anemia, hypertension, and diabetes during pregnancy; and timely attendance to antenatal care. Primary analysis, at the individual-level taking the design effect of the clustering into account, will be done as intention-to-treat.Discussion: This trial, embedded in the implementation of the eRegistry in Palestine, will inform the use of digital health interventions as a health systems strengthening approach.Trial registration: ISRCTN, trial registration number: 10520687, registered 18 October 2018, http://www.isrctn.com/ISRCTN10520687

scholarly journals eRegCom – Quality Improvement Dashboard for healthcare providers and Targeted Client Communication to pregnant women using data from an electronic health registry to improve attendance and quality of antenatal care: study protocol for a multi-arm cluster randomized trial

2020 ◽  
Author(s):  
Kjersti Mørkrid ◽  
Binyam Bogale ◽  
Eatimad Abbas ◽  
Khadija Abu Khader ◽  
Itimad Abu Ward ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Healthcare Providers ◽  
Health Systems Strengthening ◽  
Trial Registration ◽  
Client Communication ◽  
Cluster Randomized

Abstract Background This trial evaluates interventions that utilize data entered at point-of-care in the Palestinian maternal and child eRegistry to generate Quality Improvement Dashboards (QID) for healthcare providers and Targeted Client Communication (TCC) via short message service (SMS) to clients. The aim is to assess the effectiveness of the automated communication strategies from the eRegistry on improving attendance and quality of care for pregnant women. Methods This four-arm cluster randomized controlled trial will be conducted in the West Bank and the Gaza Strip, Palestine, and includes 138 clusters (primary healthcare clinics) enrolling from 45 to 3000 pregnancies per year. The intervention tools are the QID and the TCC via SMS, automated from the eRegistry built on the District Health Information Software 2 (DHIS2) Tracker. The primary outcomes are appropriate screening and management of anemia, hypertension, and diabetes during pregnancy; and timely attendance to antenatal care. Primary analysis, at the individual-level taking the design effect of the clustering into account, will be done as intention-to-treat. Discussion This trial, embedded in the implementation of the eRegistry in Palestine, will inform the use of digital health interventions as a health systems strengthening approach. Trial registration: ISRCTN, trial registration number: 10520687, registered 18 October 2018, http://www.isrctn.com/ISRCTN10520687

scholarly journals An Electronic Registry for Improving the Quality of Antenatal Care in Rural Bangladesh (eRegMat): Protocol for a Cluster Randomized Controlled Trial

10.2196/26918 ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. e26918
Author(s):  
Anisur Rahman ◽  
Ingrid K Friberg ◽  
Akuba Dolphyne ◽  
Ingvild Fjeldheim ◽  
Fatema Khatun ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Health Worker ◽  
Controlled Trial ◽  
Health Facilities ◽  
Cluster Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Cluster Randomized

Background Digital health interventions (DHIs) can alleviate several barriers to achieving better maternal and child health. The World Health Organization’s guideline recommendations for DHIs emphasize the need to integrate multiple DHIs for maximizing impact. The complex health system of Bangladesh provides a unique setting for evaluating and understanding the role of an electronic registry (eRegistry) for antenatal care, with multiple integrated DHIs for strengthening the health system as well as improving the quality and utilization of the public health care system. Objective The aim of this study is to assess the effect of an eRegistry with DHIs compared with a simple digital data entry tool without DHIs in the community and frontline health facilities. Methods The eRegMat is a cluster-randomized controlled trial conducted in the Matlab North and Matlab South subdistricts in the Chandpur district, Bangladesh, where health facilities are currently using the eRegistry for digital tracking of the health status of pregnant women longitudinally. The intervention arm received 3 superimposed data-driven DHIs: health worker clinical decision support, health worker feedback dashboards with action items, and targeted client communication to pregnant women. The primary outcomes are appropriate screening as well as management of hypertension during pregnancy and timely antenatal care attendance. The secondary outcomes include morbidity and mortality in the perinatal period as well as timely first antenatal care visit; successful referrals for anemia, diabetes, or hypertension during pregnancy; and facility delivery. Results The eRegistry and DHIs were co-designed with end users between 2016 and 2018. The eRegistry was implemented in the study area in July 2018. Recruitment for the trial started in October 2018 and ended in June 2020, followed by an 8-month follow-up period to capture outcome data until February 2021. Trial results will be available for publication in June 2021. Conclusions This trial allows the simultaneous assessment of multiple integrated DHIs for strengthening the health system and aims to provide evidence for its implementation. The study design and outcomes are geared toward informing the living review process of the guidelines for implementing DHIs. Trial Registration ISRCTN Registry ISRCTN69491836; https://www.isrctn.com/ISRCTN69491836 International Registered Report Identifier (IRRID) DERR1-10.2196/26918

scholarly journals An Electronic Registry for Improving the Quality of Antenatal Care in Rural Bangladesh (eRegMat): Protocol for a Cluster Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Anisur Rahman ◽  
Ingrid K Friberg ◽  
Akuba Dolphyne ◽  
Ingvild Fjeldheim ◽  
Fatema Khatun ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Antenatal Care ◽  
Health System ◽  
Pregnant Women ◽  
Health Worker ◽  
Controlled Trial ◽  
Health Facilities ◽  
Cluster Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Cluster Randomized

BACKGROUND Digital health interventions (DHIs) can alleviate several barriers to achieving better maternal and child health. The World Health Organization’s guideline recommendations for DHIs emphasize the need to integrate multiple DHIs for maximizing impact. The complex health system of Bangladesh provides a unique setting for evaluating and understanding the role of an electronic registry (eRegistry) for antenatal care, with multiple integrated DHIs for strengthening the health system as well as improving the quality and utilization of the public health care system. OBJECTIVE The aim of this study is to assess the effect of an eRegistry with DHIs compared with a simple digital data entry tool without DHIs in the community and frontline health facilities. METHODS The eRegMat is a cluster-randomized controlled trial conducted in the Matlab North and Matlab South subdistricts in the Chandpur district, Bangladesh, where health facilities are currently using the eRegistry for digital tracking of the health status of pregnant women longitudinally. The intervention arm received 3 superimposed data-driven DHIs: health worker clinical decision support, health worker feedback dashboards with action items, and targeted client communication to pregnant women. The primary outcomes are appropriate screening as well as management of hypertension during pregnancy and timely antenatal care attendance. The secondary outcomes include morbidity and mortality in the perinatal period as well as timely first antenatal care visit; successful referrals for anemia, diabetes, or hypertension during pregnancy; and facility delivery. RESULTS The eRegistry and DHIs were co-designed with end users between 2016 and 2018. The eRegistry was implemented in the study area in July 2018. Recruitment for the trial started in October 2018 and ended in June 2020, followed by an 8-month follow-up period to capture outcome data until February 2021. Trial results will be available for publication in June 2021. CONCLUSIONS This trial allows the simultaneous assessment of multiple integrated DHIs for strengthening the health system and aims to provide evidence for its implementation. The study design and outcomes are geared toward informing the living review process of the guidelines for implementing DHIs. CLINICALTRIAL ISRCTN Registry ISRCTN69491836; https://www.isrctn.com/ISRCTN69491836 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/26918

scholarly journals The effect of a digital targeted client communication intervention on pregnant women’s worries and satisfaction with antenatal care in Palestine–A cluster randomized controlled trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249713
Author(s):  
Binyam Bogale ◽  
Kjersti Mørkrid ◽  
Eatimad Abbas ◽  
Itimad Abu Ward ◽  
Firas Anaya ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Antenatal Care ◽  
Controlled Trial ◽  
Unintended Consequences ◽  
Cluster Randomized Controlled Trial ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
Client Communication ◽  
Cluster Randomized ◽  
And Control

Background The eRegCom cluster randomized controlled trial assesses the effectiveness of targeted client communication (TCC) via short message service (SMS) to pregnant women, from a digital maternal and child health registry (eRegistry) in Palestine, on improving attendance and quality of care. In this paper, we assess whether this TCC intervention could also have unintended consequences on pregnant women’s worries, and their satisfaction with antenatal care (ANC). Methods We interviewed a sub-sample of Arabic-speaking women attending ANC at public primary healthcare clinics, randomized to either the TCC intervention or no TCC (control) in the eRegCom trial, who were in 38 weeks of gestation and had a phone number registered in the eRegistry. Trained female data collectors interviewed women by phone from 67 intervention and 64 control clusters, after securing informed oral consent. The Arabic interview guide, pilot-tested prior to the data collection, included close-ended questions to capture the woman’s socio-demographic status, agreement questions about their satisfaction with ANC services, and the 13-item Cambridge Worry Scale (CWS). We employed a non-inferiority study design and an intention-to-treat analysis approach. Results A total of 454 women, 239 from the TCC intervention and 215 from the control arm participated in this sub-study. The mean and standard deviation of the CWS were 1.8 (1.9) for the intervention and 2.0 (1.9) for the control arm. The difference in mean between the intervention and control arms was -0.16 (95% CI: -0.31 to -0.01) after adjusting for clustering, which was below the predefined non-inferiority margin of 0.3. Women in both groups were equally satisfied with the ANC services they received. Conclusion The TCC intervention via SMS did not increase pregnancy-related worries among recipients. There was no difference in women’s satisfaction with the ANC services between intervention and control arms.

EFFECTIVENESS OF USING MCH BOOKS AND MONSCA APPLICATIONS IN THE IMPLEMENTATION OF 14 T ANTENATAL SERVICE STANDARDS

2020 ◽  
Vol 12 (1) ◽  
pp. 68-73
Author(s):  
Rahmawati Rahmawati ◽  
Syarif Syafruddin ◽  
Nontji Wena
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Continuity Of Care ◽  
Control Design ◽  
Sampling Technique ◽  
Limited Time ◽  
Control Groups ◽  
Post Test ◽  
Service Standards

The component of antenatal care received by pregnant women is classified as incomplete because the implementation of standard pregnancy services is still using conventional methods. There are obstacles faced by midwives, such as the limited time in a recording, which has an impact on the declining quality of antenatal care standards. This research aims to compare the effectiveness of the use of KIA books and MONSCA applications in midwives in the application of the standard Antenatal service 14 T. This research was conducted in Puskesmas Tanete and Puskesmas Bontobangun Bulukumba District. The method used in the study is experimental quasi (pre-test post-test nonequivalent control design). Using a sample of midwives in this study, as many as 36 people were divided into two groups (18 intervention groups and 18 control groups). The sampling technique in this study used purposive sampling. Data were analyzed using the Mann-Whitney Test. The results showed that there was a difference in the effectiveness of using KIA books with MONSCA applications, MOSCA's applications were easier to use, faster, safer, and more accurate than KIA books. It can be concluded that the MONSCA application is more effective than KIA books. Key words: Effectiveness, Android-based Smart Continuity of Care application, KIA book, Antenatal service 14 T

scholarly journals A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

2021 ◽  
pp. 1-13
Author(s):  
Julie L. O’Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

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