scholarly journals Effect of Maternal Education and Encouragement on Newborn Care Utilization: A Health System Intervention

2021 ◽  
Author(s):  
Ali-Asghar Kolahi ◽  
Mohsen Abbasi-Kangevari ◽  
Alireza Abadi
Keyword(s):  
Health System ◽  
Maternal Education ◽  
Intervention Group ◽  
Newborn Care ◽  
Screening Tests ◽  
Care Utilization ◽  
Control Group ◽  
Normal Birth ◽  
Catchment Areas ◽  
Health System Intervention

Abstract Background: The objective of this health system interventional study was to determine the effect of delivering newborn-care-oriented education and encouragement to receive newborn care on newborn care utilization.Methods: This study was performed in the urban health centers of the catchment area of Tehran Defined Population, which covered 10 of the 22 municipality districts of Tehran. The two catchment areas included 10,000 families in the intervention and 20,000 families in the control areas. As many as 4837 newborns (intervention=1544, control=3293) were enrolled and followed until the end of the second month of life. The utilization of newborn care was compared among the intervention and control groups. Results: Almost 99.6% in the intervention group and 99.5% in the control group did their screening tests. The mean number of newborn care visits was higher in the intervention group compared to the control group: 2.26 (0.99) versus 1.84 (1.07), p<0.001. Newborns' attendance in the first newborn care visit was more among newborns who were born through normal birth compared to those who were born through the caesarian section: 51.2% CI [48.1, 54.3] versus 38.6%; 95% CI [37.1, 40.2], p<0.001. Conclusions: The intervention improved newborn care utilization during the first two months after birth. It could be suggested that active follow-up be added to newborn care guidelines, and parents be informed of the necessity and benefits of newborn care and be encouraged to perform all three newborn care visits.

scholarly journals Effect of maternal education and encouragement on newborn care utilization: a health system intervention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali-Asghar Kolahi ◽  
Mohsen Abbasi-Kangevari ◽  
Alireza Abadi
Keyword(s):  
Health System ◽  
Maternal Education ◽  
Intervention Group ◽  
Newborn Care ◽  
Care Utilization ◽  
Control Group ◽  
National Guidelines ◽  
Catchment Areas ◽  
Health System Intervention ◽  
Care Guidelines

Abstract Background The objective of this health system interventional study was to determine the effect of delivering newborn-care-oriented education and encouragement on newborn care utilization. Methods This study was performed in the urban health centers of the catchment area of Tehran Defined Population, which covered 10 of the 22 municipality districts of Tehran. The two catchment areas included 10,000 families in the intervention and 20,000 families in the control areas. As many as 4837 newborns (intervention = 1544, control = 3293) were enrolled and followed until the end of the second month of life. The utilization of the three newborn care visits, as recommended by national guidelines, was compared among the intervention and control groups. Results As many as 877 (56.8%) newborns in the intervention group and 1214 (36.9%) in the control group received all their three newborn care visits. The mean number of newborn care visits was higher in the intervention group compared to the control group: 2.26 (0.99) versus 1.84 (1.07), p < 0.001. The number of newborns who did not attend any of their three newborn care visits was 143 (9.3%) in the intervention group and 468 (14.2%) in the control group. Conclusions The intervention improved newborn care utilization during the first 2 months after birth. It could be suggested that active follow-up be added to newborn care guidelines. Parents need to be informed of the necessity and benefits of newborn care and be encouraged to perform all three newborn care visits.

A Randomized Controlled Trial of Prenatal Pediatric Visits for Urban, Low-income Families

PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1069-1075
Author(s):  
Janet R. Serwint ◽  
Modena E. H. Wilson ◽  
Judith W. Vogelhut ◽  
John T. Repke ◽  
Henry M. Seidel
Keyword(s):  
Health Care ◽  
Low Income ◽  
Controlled Trial ◽  
Intervention Group ◽  
Care Utilization ◽  
Control Group ◽  
Health Maintenance ◽  
Car Safety ◽  
Low Income Families ◽  
Safety Seat

Background. Prenatal pediatric visits have been recommended by the American Academy of Pediatrics to allow the pediatrician to counsel parents on infant care issues, establish a supportive relationship, and provide pediatric practice information to parents. We hypothesized that prenatal pediatric visits would have an impact on breastfeeding decisions, health care behaviors, health care utilization, and the doctor-patient relationship. Methods. We conducted a randomized controlled trial of prenatal pediatric visits for urban, low-income families to measure the impact on breastfeeding decisions, infant car safety seat use, circumcision, health maintenance, and emergency room visits and the pediatrician's perception that he/she would know the mother better. Pregnant women were recruited prenatally from the obstetrics clinic. Outcomes were measured by maternal interview prenatally and when the infant was 2 months old, in addition to review of the nursery record. Physicians were interviewed after the 2-month visit. Health care utilization was measured by chart review at 7 months. Results. A total of 156 pregnant women were enrolled and randomized, 81 to the intervention group and 75 to the control group. Of mothers who breastfed, 45% in the intervention group changed their mind in favor of breastfeeding after enrollment compared with 14% in the control group. Mothers in the intervention group compared with the control group were more likely to make fewer emergency room visits, 0.58 compared with 1.0. Pediatricians were more likely to think that they knew mothers in the intervention group well, 54% versus 29% in the control group, yet 67% of mothers in both groups agreed their pediatrician knew them well. There were no differences between groups in initiation or duration of breastfeeding at 30 or 60 days, infant car safety seat use, circumcision, or health maintenance visits. Conclusions. Prenatal pediatric visits have potential impact on a variety of health care outcomes. Among urban, low-income mothers, we found beneficial effects on breastfeeding decisions, a decrease in emergency department visits, and an initial impact on the doctor-patient relationship. We suggest urban practices actively promote prenatal pediatric visits.

Effects of the augmented reality game Pokémon GO on fitness and fatness in secondary school students

2021 ◽  
pp. 001789692110478
Author(s):  
Emilio J Martínez-López ◽  
Sebastián López-Serrano ◽  
Manuel De La Torre-Cruz ◽  
Alberto Ruiz-Ariza
Keyword(s):  
Body Fat ◽  
Maternal Education ◽  
Intervention Group ◽  
Control Group ◽  
School Students ◽  
Confounding Variables ◽  
Home Computers ◽  
Weekly Physical Activity ◽  
Maternal Educational Level ◽  
Pokémon Go

Objective: The aim of this study was to analyse the effect of 8 weeks of Pokémon GO on physical fitness (cardiorespiratory fitness [CRF], Speed/Agility [S/A], and muscular strength [MS]) and fatness (body mass index [BMI], percentage of body fat [%BF], and waist-hip index), as well as possible differences between weekly physical activity (PA) levels, in Spanish adolescents between 12 and 15 years of age. Design, setting and method: Comparative design, with a control group ( n = 86) that did not participate in Pokémon GO, and an intervention group ( n = 78) which did so over an 8-week period. Age, sex, number of home computers, and maternal educational level were controlled for as possible confounding variables. Results: Results show that players walked a total of 52 km in 8 weeks. Moreover, they played the game for a mean of 40 min/day. Pokémon GO players showed improvements in CRF and BMI ( p < .05). Inactive young people showed a 22.2% increase in CRF and an 11.3% decrease in their %BF compared to non-players. Despite these results, less than half of the participants considered that Pokémon GO had improved their overall fitness and felt more encouraged to engage in PA. Conclusion: Pokémon GO increased PA and CRF levels and decreased BMI and %BF after 8 weeks of practice independently of age, sex, number of computers at home, and maternal education. The Pokémon GO app could be used in school and family contexts to increase the daily amount of MVPA, improve CRF, and to take advantage of the effects of loss of body fat.

Do Postpartum Nursery Visits by the Primary Care Provider Make a Difference?

PEDIATRICS ◽  
1991 ◽  
Vol 88 (3) ◽  
pp. 444-449
Author(s):  
Janet R. Serwint ◽  
Modena H. Wilson ◽  
Anne K. Duggan ◽  
E. David Mellits ◽  
Rosemary A. Baumgardner ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Utilization ◽  
Care Provider ◽  
Primary Care Provider ◽  
Intervention Group ◽  
Maternal Anxiety ◽  
Care Utilization ◽  
Control Group ◽  
Maternal Knowledge

A prospective, randomized, clinical trial was conducted to investigate whether a postpartum visit between a mother and her neonate's future primary care provider combined with telephone access would improve health care utilization, enhance identification of the provider as a source of advice, increase maternal knowledge of infant care, and decrease maternal anxiety and depression. Of 251 mother-neonate pairs, 122 were randomized to the control group and 129 to the intervention group. Outcome variables included health care utilization and results of maternal interviews. More mothers in the intervention group made a scheduled clinic visit in the first 30 days (P = .003), were more likely to seek some form of care at the clinic (P = .006), and tried to reach their physician by phone more often than the control group (P &lt;.001). There were no differences between the groups' emergency room utilization, the percent who received immunizations by 90 days of age, maternal knowledge of infant care, maternal anxiety, or postpartum depression. The intervention succeeded in improving some measures of health care utilization and results suggest that the relationship between the mother and clinician was strengthened.

scholarly journals Role of birth weight and predisposition for adverse body composition in early childhood: Findings from the ROLO study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Aisling A. Geraghty ◽  
Eileen C. O'Brien ◽  
Mary Horan ◽  
Jean Donnelly ◽  
Eleanor Molloy ◽  
...  
Keyword(s):  
Birth Weight ◽  
Childhood Obesity ◽  
Maternal Education ◽  
Intervention Group ◽  
Maternity Hospital ◽  
Randomised Control Trial ◽  
High Birth Weight ◽  
Normal Birth Weight ◽  
Smoking During Pregnancy ◽  
Normal Birth

AbstractIntroduction:The early fetal environment during pregnancy is extremely important and research indicates that weight at birth can have crucial impacts for the individual's health later in life. With rates of childhood obesity estimated to be as high as 21% in some European countries, it is vital that early risk factors are identified so that interventions can be developed. We aimed to investigate if children born macrosomic (birth weight > 4kg) remained larger than normal birth weight babies up to 5 years of age.Materials and Methods:This is a longitudinal follow-up of 387 five-year-old children (53% born with macrosomia, 47% normal birth weight) born into the ROLO randomised control trial in the National Maternity Hospital, Dublin (ISRCTN54392969). Birth weight was previously recorded then at 6 months, 2 years, and 5 years of age child height, weight, anthropometric and skinfold measurements were collected. Body Mass Index (kg/m2) and centiles were calculated. Student t-tests and Mann-Whitney U tests were used to compare the two groups with multiple linear regression modelling to control for confounders.Results:Children with a birth weight > 4 kg had consistently higher weights, lengths, and BMI centiles, along with increased head and chest circumferences, compared to normal birth weight children from 6 months up to 5 years of age (p < 0.05). After controlling for child sex, intervention group, smoking during pregnancy, maternal education status, and maternal BMI, children with macrosomia were 0.61 kg heavier than non-macrosomic infants at 5 years of age (95% CI: 0.04–1.18, p < 0.05).Discussion:Children born with a high birth weight remain heavier and larger into childhood. These individuals are at a higher risk of obesity which highlights the need for monitoring and potential interventions, both during pregnancy and in infancy, to curb the current childhood obesity crisis.

scholarly journals Proof-of-concept trial results of the HeartMan mobile personal health system for self-management in congestive heart failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Els Clays ◽  
Paolo Emilio Puddu ◽  
Mitja Luštrek ◽  
Giovanni Pioggia ◽  
Jan Derboven ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health System ◽  
Exercise Capacity ◽  
Illness Perception ◽  
Intervention Group ◽  
Self Care ◽  
Self Management ◽  
Personal Health ◽  
Control Group ◽  
Proof Of Concept

AbstractThis study tested the effectiveness of HeartMan—a mobile personal health system offering decisional support for management of congestive heart failure (CHF)—on health-related quality of life (HRQoL), self-management, exercise capacity, illness perception, mental and sexual health. A randomized controlled proof-of-concept trial (1:2 ratio of control:intervention) was set up with ambulatory CHF patients in stable condition in Belgium and Italy. Data were collected by means of a 6-min walking test and a number of standardized questionnaire instruments. A total of 56 (34 intervention and 22 control group) participants completed the study (77% male; mean age 63 years, sd 10.5). All depression and anxiety dimensions decreased in the intervention group (p < 0.001), while the need for sexual counselling decreased in the control group (p < 0.05). Although the group differences were not significant, self-care increased (p < 0.05), and sexual problems decreased (p < 0.05) in the intervention group only. No significant intervention effects were observed for HRQoL, self-care confidence, illness perception and exercise capacity. Overall, results of this proof-of-concept trial suggest that the HeartMan personal health system significantly improved mental and sexual health and self-care behaviour in CHF patients. These observations were in contrast to the lack of intervention effects on HRQoL, illness perception and exercise capacity.

scholarly journals Does Nursery-Based Intensified Anticipatory Guidance Reduce Emergency Department Use for Nonurgent Conditions in the First Month of Life? A Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Kelly Kamimura-Nishimura ◽  
Vikram Chaudhary ◽  
Folake Olaosebikan ◽  
Maryam Azizi ◽  
Sneha Galiveeti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Controlled Trial ◽  
Intervention Group ◽  
Newborn Care ◽  
Secondary Outcome ◽  
Control Group ◽  
Anticipatory Guidance ◽  
Guidance Program ◽  
Significant Difference ◽  
The Impact

Objective.We aimed to evaluate the impact of an intensified anticipatory guidance program in the nursery on Emergency Department (ED) use for nonurgent conditions (NUCs) in the neonatal period.Methods. Parturient mothers of healthy newborns were randomized to an intervention group or control group. Baseline and 1-month follow-up knowledge surveys regarding newborn care were conducted. The primary outcome was the proportion of neonates who used the ED for a NUC. Secondary outcome was change in caregivers’ knowledge on NUC.Results. Of a total of 594 mothers, 323 (54%) agreed to participate and were randomized to intervention (n=170) or control (n=153) group. Most were Hispanic (68%), single (61%), primiparous (39%), and without high school diploma (44%). 35 (21%) neonates in the intervention group and 41 (27%) in the control group were brought at least once for a NUC to the ED (p=0.12). There was no statistically significant difference in within subject change on knowledge scores between the two study arms.Conclusions. Neonatal ED visits for NUCs occur frequently. This nursery-based intensified anticipatory guidance program had no statistically significant impact on neonatal ED use for NUC, nor on neonatal care-relevant knowledge among parturient mothers. Alternative modalities and timing of parental educational intervention may need to be considered. This trial is registered with Clinical Trials NumberNCT01859065(Clinicaltrials.gov).

scholarly journals Impact of perioperative hemodynamic optimization therapies in surgical patients: Economic study and Meta-analysis

2020 ◽  
Author(s):  
João M Silva ◽  
Pedro Ferro L Menezes ◽  
Suzana M Lobo ◽  
Flavia Helena S Carvalho ◽  
Mariana Augusta N Oliveira ◽  
...  
Keyword(s):  
Health System ◽  
Meta Analysis ◽  
Hospital Costs ◽  
Intervention Group ◽  
Length Of Hospital Stay ◽  
Indirect Costs ◽  
Cardiovascular Complications ◽  
Surgical Patients ◽  
Control Group ◽  
Hemodynamic Optimization

Abstract Background: Several studies suggest that hemodynamic optimization therapies can reduce complication, length of hospital stay and costs. However, Brazilian data are scarce. Therefore, the objective of this analysis was to evaluate whether the improvement demonstrated by hemodynamic optimization therapy in surgical patients could result in lower costs from the perspective of the Brazilian public unified health system. Method: A meta-analysis was performed comparing surgical patients who underwent hemodynamic optimization therapy (intervention) with patients submitted to standard therapy (control) in terms of complications and hospital costs. The cost-effectiveness analysis evaluated the clinical and financial benefits of hemodynamic optimization protocols for surgical patients. The analysis considered the clinical outcomes of randomized studies published in the last 20 years that involved surgeries and hemodynamic optimization therapy. Indirect costs (equipment depreciation, estate and management activities) were not included in the analysis. Results: A total of 21 clinical trials with a total of 4872 surgical patients were selected. Comparison of the intervention and control groups showed lower rates of infectious (RR=0.66; 95% CI=0.58-0.74), renal (RR=0.68; 95% CI=0.54-0.87), and cardiovascular complications (RR=0.87; 95% CI=0.76-0.99) and a non-statistically significant lower rate of respiratory complications (RR=0.82; 95% CI=0.67-1.02). There was no difference in mortality (RR=1.02; 95% CI=0.80-1.3) between groups. In the analysis of total costs, the intervention group showed a cost reduction of R$396,024.83-BRL ($90,161.38-USD) for every 1000 patients treated compared to the control group. The patients in the intervention group showed greater effectiveness, with 1.0 fewer day in the ICU and hospital. In addition, there were 333 fewer patients with complications, with a consequent reduction of R$1,630,341.47-BRL ($371,173.27-USD) for every 1000 patients treated. Conclusions: Hemodynamic optimization therapy is cost-effective and would increase efficiency and decrease the burden of the Brazilian public health system.

scholarly journals Differences in post-placental intra uterine device acceptance with and without couples counseling in private practice midwifery clinics, West Denpasar

2018 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Putu Ayu Ratna Darmayanti ◽  
Dewa Nyoman Wirawan ◽  
Komang Ayu Kartika Sari ◽  
Mangku Karmaya ◽  
Ni Luh Putu Suariyani
Keyword(s):  
Maternal Education ◽  
Controlled Trial ◽  
Intervention Group ◽  
Primary Objective ◽  
Control Group ◽  
Base Line ◽  
Couples Counseling ◽  
Before And After ◽  
Post Placental ◽  
Iud Uptake

Background and purpose: The post-placental intra uterine device (IUD) program is one intervention  to increase IUD uptake however the acceptance remains low. Contraceptive counseling during pregnancy is expected to increase IUD uptake. The primary objective of this study is to determine the efficacy of counseling by involving the husband in order to improve post-placental IUD uptake. The secondary objective is to compare knowledge and perceptions of IUD before and after intervention.Methods: A randomized controlled trial was conducted with 58 pregnant women at 37-40 weeks' gestation in three private midwifery clinics in Denpasar, Bali. Subjects were divided into two groups: 29 intervention groups that were given couples counseling and 29 control groups that were given counseling without involving husbands. Base line interview was conducted during enrollment and follow up interview was carried out immediately after delivery.Results: Acceptance of post-placental IUD was found in 21 women (72.41%) in the intervention group and 10 women (34.48%) in the control group (RR=2.2; 95%CI: 1.23-3.84). The mean difference in pretest and post-test scores of knowledge, perceptions of susceptibility and benefits were found to be higher in the intervention group but not statistically significant. The result of multivariate analysis indicated that the variables influencing post-placental IUD acceptance were the child's gender (AOR=45.9, 95%CI: 4.53-465.25), couples counseling with husband (AOR=17.4, 95%CI: 2.55-119.56) and maternal education (AOR =7.1; 95%CI: 1.17-43.40).Conclusions: Couples counseling was found to increase post-placental IUD uptake. In addition, post-placental IUD acceptance is also influenced by the child's gender and maternal education levels. To increase uptake of post-placental IUDs there is a need for upscalling of couples counseling at the time of antenatal care.

scholarly journals Effect of Shared Decision-making on Decisional Conflict and Uptake of First-trimester Screening Tests

2022 ◽  
Vol 32 (1) ◽  
pp. 20-28
Author(s):  
Zahra Moudi ◽  
◽  
Raheleh Jam ◽  
Hossein Ansari ◽  
Mostafa Montazer Zohour ◽  
...  
Keyword(s):  
Intervention Group ◽  
First Trimester ◽  
Decisional Conflict ◽  
Routine Care ◽  
Screening Tests ◽  
Control Group ◽  
Shared Decision ◽  
Significant Difference ◽  
Trimester Screening ◽  
Consultation Session

Introduction: Several factors influence women’s decision to take First Trimester Screening (FTS) tests. These factors are associated with the ambivalence of women toward undergoing screening tests. Objective: This study aimed to investigate the effect of Shared Decision-Making (SDM) about undergoing FTS on Decisional Conflict (DC) immediately after consultation and uptake of FTS. Materials and Methods: This quasi-experimental study was conducted on 200 pregnant women (100 women in the intervention and 100 in the control groups) referred to health centers for prenatal care in 2019. They were selected by the block randomization sampling method. The control group received the routine care and the intervention group, in addition to routine care, attended a 90-min long consultation session based on SDM. The women were contacted via phone at 14 weeks of pregnancy to collect data on their undertaking prenatal screening tests. The demographic characteristics form and O’Conner’s decisional conflict scale were filled out immediately after the consultation session for the intervention group. The obtained data were analyzed by the Chi-square, Fisher exact-test, Mann-Whitney U, and linear regression tests. The P value less than 0.05 was considered statistically significant. Results: There was no significant difference between the two groups regarding women’s demographic characteristics, except for education level, job, and insurance coverage. The Mean±SD DC score was significantly lower in the intervention group (7.35±8.55) compared to the control group (27.32±13.81) (95%CI; 16.80-24.19, P=0.001). In addition, there was a significant difference between the two groups in terms of undergoing the offered FTS (P=0.04). The DC scores ≥25 were associated with a decreased chance of undergoing FTS (P=0.02). Women were less likely to undergo FTS when they were self-employed (OR=0.15, 95%CI; 0.03-0.71, P=0.01). Conclusion: The SDM consultation can help women experience significantly lower levels of DC. Furthermore, factors such as self-employment can prevent women from undergoing FTS despite lower levels of DC.

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