A USSD-Based mHealth App providing on-demand sexual reproductive health Information for adolescents: A Randomized Control Trial. (Preprint)

2021 ◽  
Author(s):  
Paul Macharia ◽  
Antoni Pérez-Navarro ◽  
Irene Inwani ◽  
John Kinuthia ◽  
Ruth Nduati ◽  
...  
Keyword(s):  
Decision Making ◽  
Reproductive Health ◽  
Mobile Phone ◽  
Randomized Control Trial ◽  
Ease Of Use ◽  
P Value ◽  
Sexually Transmitted ◽  
On Demand ◽  
Sexual Reproductive Health ◽  
Randomized Control

BACKGROUND : Adolescents transitioning from childhood to adulthood need to be equipped with sexual reproductive health (SRH) knowledge, skills, attitudes, and values that empower them. Accessible, reliable, appropriate, and friendly information can be provided through mobile phone-based health interventions. OBJECTIVE This study will investigate the effectiveness and impact of an Unstructured Supplementary Service Data (USSD)-based mobile phone app in: i) increasing adolescents’ knowledge about contraceptives, gender-based stereotypes, sexually-transmitted infections (STIs), abstinence, and perceived vulnerability; and ii) helping adolescents make informed decisions about their sexual reproductive health. METHODS A randomized control trial (RCT) methodology was applied to investigate the potential of a USSD-based app for providing on-demand SRH information to adolescents in Kibra, Nairobi County, Kenya. RESULTS During the RCT, 62 (54.9%) adolescents used the USSD-based app at least once; 30 (48.4%) of these were male and 32 (51.6%) female participants. The intervention improved knowledge of contraceptives to p-value 0.1411. Information on STIs was of particular interest, with 27.0% (20) of the adolescents seeking information in this area; 55% (11) of these were female. In relation to improved decision making, 21.6% (29) of the adolescents were able to identify STIs and likely to seek treatment; 51.7% (15) of these were female. Ease of use was the most important feature of the app for 28.3% (54) of the participants. CONCLUSIONS Adolescents require accurate and up-to-date SRH information to guide their decision making and improve health outcomes. As adolescents already use mobile phones in their day-to-day life, apps provide an ideal platform for this information.

Developing a USSD-based mobile phone app to provide adolescents with sexual reproductive health information: A human-centered design approach (Preprint)

2021 ◽  
Author(s):  
Paul Macharia ◽  
Antoni Pérez-Navarro ◽  
Irene Inwani ◽  
Ruth Nduati ◽  
Carme Carrion
Keyword(s):  
Reproductive Health ◽  
Mobile Phone ◽  
Health Information ◽  
Mobile App ◽  
Resource Limited Settings ◽  
Human Centered Design ◽  
On Demand ◽  
Sexual Reproductive Health ◽  
Resource Limited ◽  
Adolescent Reproductive Health

BACKGROUND Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information in resource-limited settings can often be due to cultural and societal attitudes to adolescent sexual reproductive health. Innovative approaches, including mobile phone technologies, are needed to address the need for adolescent reproductive health information. OBJECTIVE To design and develop a mobile app prototype to provide confidential adolescent reproductive health information on demand and evaluate its usability and user experience. METHODS A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. Field usability testing enabled the adolescents to provide feedback on the functionality, usability, and usefulness of the app. RESULTS During the usability test, 62 (54.9%) of the adolescents that were followed-up had used the app at least once, 30 (48.4%) of these were male participants and 32 (51.6%) female. The app was described as ‘very interesting’ to use by 44 (70.9%) participants, 20 male and 24 female. The content was deemed to be either ‘perfectly’ or ‘well targeted’ on sexual reproductive health by 60 (96.7%) adolescents, and the app was rated ‘best app’ by 45 (72.6%) adolescents, 27 female and 18 male, with a p-value = 0.011. CONCLUSIONS A mobile phone app is a feasible and acceptable way to deliver adolescent sexual reproductive health information in resource-limited settings. The USSD mobile phone technology could deliver confidential information on demand.

scholarly journals A feasibility trial of Power Up: A smartphone app to support patient activation and shared decision making for mental health in young people (Preprint)

2018 ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Chloe Edridge ◽  
Phoebe Averill ◽  
Louise Delane ◽  
Michael P Craven ◽  
...  
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Young People ◽  
Shared Decision Making ◽  
Randomized Control Trial ◽  
Patient Activation ◽  
Shared Decision ◽  
Cluster Randomized Control Trial ◽  
Randomized Control ◽  
Cluster Randomized

BACKGROUND Digital tools have the potential to support patient activation and shared decision making in the face of increasing levels of mental health problems in young people. There is a need for feasibility trials of digital interventions to determine the usage and acceptability of interventions. In addition, there is a need to determine the ability to recruit and retain research participants to plan rigorous effectiveness trials and therefore, develop evidence-based recommendations for practice. OBJECTIVE To determine the feasibility of undertaking a cluster randomized control trial to test the effectiveness of a smartphone app, Power Up, co-designed with young people to support patient activation and shared decision making for mental health. METHODS Overall, 270 young people were screened for participation and 53% (N = 142) were recruited and completed baseline measures across eight specialist child mental health services (n = 62, mean (SD) age = 14.66 (1.99) years, 52% female) and two mainstream secondary schools (n = 80; mean (SD) age = 16.88 (0.68) years, 46% female). Young people received Power Up in addition to management as usual or received management as usual only. Post-trial interviews were conducted with 11 young people from the intervention arms (specialist services n = 6; schools n = 5). RESULTS Usage data showed that there were an estimated 50 (out of 64) users of Power Up in the intervention arms. Findings from the interviews indicated that young people found Power Up to be acceptable. Young people reported: 1) their motivation for use of Power Up, 2) the impact of use, and 3) barriers to use. Out of the 142 recruited participants, 45% (64/142) completed follow up measures, and the approaches to increase retention agreed by the steering group are discussed. CONCLUSIONS The findings of the present research indicate that the app is acceptable and it is feasible to examine the effectiveness of Power Up in a prospective cluster randomized control trial. CLINICALTRIAL ISRCTN: ISRCTN77194423, ClinicalTrials.gov NCT02552797

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

scholarly journals Therapeutic Effect of Micro-Ecologics Combined with Blue Light Irradiation on Neonatal Jaundice: Randomized Control Trial

2021 ◽  
Vol 15 (8) ◽  
pp. 2294-2296
Author(s):  
Gao KE ◽  
Syed Haider Abbas ◽  
Ali Faheem ◽  
Muhammad Zeeshan ◽  
Rizwan Masud ◽  
...  
Keyword(s):  
Blue Light ◽  
Bilirubin Level ◽  
Randomized Control Trial ◽  
Neonatal Jaundice ◽  
Post Treatment ◽  
Light Irradiation ◽  
Control Group ◽  
P Value ◽  
Randomized Control ◽  
Observational Group

Abnormal bilirubin metabolism results in abnormally raised serum bilirubin level thus presenting as yellowing of face, skin and mucosa to varying degrees. Purpose: To observe clinical effects on neonatal jaundice of micro-ecological preparation combined with blue light irradiation. Study Design: Randomized control trial. Methodology: Enrolled 100 neonatal jaundiced children (50 each group). Control group received blue light irradiation while observation group was given probiotics on the basis of blue light irradiation. Percutaneous bilirubin levels, clinical efficacy and the incidence of side effects were compared between pre and post-treatment groups. Statistical analysis: Data analyzed by SPSS 20.0v. Results: Post-treatment, levels of percutaneous bilirubin were significantly lower than pre-treatment. Observational group had significantly lower levels than the control group, having significant p-value (P<0.05). However, total effective rate of the observational group was significantly higher than control group with statistically significant p-value (P<0.05).The difference in incidence of ADR was significant (P<0.05). Conclusion: This study concluded that microecological preparation combined with blue light irradiation had a definite effect on the treatment of neonatal jaundice, not only effectively reduced the bilirubin level of children, but also reduced adverse reactions hence the safety was high. Therefore, it was worthy of application and promotion. Key Words: Neonatal Jaundice, Micro-ecological Preparations, Blue Light Exposure

scholarly journals Sexually Transmitted Infections and Behavioral Determinants of Sexual and Reproductive Health in the Allahabad District (India) Based on Data from the ChlamIndia Study

2019 ◽  
Vol 7 (11) ◽  
pp. 557 ◽  
Author(s):  
Pierre P. M. Thomas ◽  
Jay Yadav ◽  
Rajiv Kant ◽  
Elena Ambrosino ◽  
Smita Srivastava ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Sexually Transmitted Infections ◽  
Sexual And Reproductive Health ◽  
Uttar Pradesh ◽  
Positive Association ◽  
Vaginal Swab ◽  
P Value ◽  
Behavioral Determinants ◽  
Sexually Transmitted ◽  
Adverse Pregnancy

Background: Sexually transmitted infections (STIs), like Chlamydia trachomatis and Neisseria gonorrhoeae (CT and NG, respectively) are linked to an important sexual and reproductive health (SRH) burden worldwide. Behavior is an important predictor for SRH, as it dictates the risk for STIs. Assessing the behavior of a population helps to assess its risk profile. Methods: Study participants were recruited at a gynecology outpatient department (OPD) in the Allahabad district in Uttar Pradesh India, and a questionnaire was used to assess demographics, SRH, and obstetric history. Patients provided three samples (urine, vaginal swab, and whole blood). These samples were used to identify CT and NG using PCR/NAAT and CT IgG ELISA. Results: A total of 296 women were included for testing; mean age was 29 years. No positive cases of CT and NG were observed using PCR/NAAT. A 7% (22/296) positivity rate for CT was observed using IgG ELISA. No positive association was found between serology and symptoms (vaginal discharge, abdominal pain, dysuria, and dyspareunia) or adverse pregnancy outcomes (miscarriage and stillbirth). Positive relations with CT could be observed with consumption of alcohol, illiteracy, and tenesmus (p-value 0.02–0.03). Discussion: STI prevalence in this study was low, but a high burden of SRH morbidity was observed, with a high symptomatic load. High rates of miscarriage (31%) and stillbirth (8%) were also observed among study subjects. No associations could be found between these ailments and CT infection. These rates are high even for low- and middle-income country standards. Conclusion: This study puts forward high rates of SRH morbidity, and instances of adverse reproductive health outcomes are highlighted in this study, although no associations with CT infection could be found. This warrants more investigation into the causes leading to these complaints in the Indian scenario and potential biases to NAAT testing, such as consumption of over-the-counter antimicrobials.

Shared decision-making and patient engagement program during acute exacerbation of COPD hospitalization: A randomized control trial

2020 ◽  
Vol 103 (4) ◽  
pp. 702-708 ◽  
Author(s):  
María Granados-Santiago ◽  
Marie Carmen Valenza ◽  
Laura López-López ◽  
Esther Prados-Román ◽  
Janet Rodríguez-Torres ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Exacerbation ◽  
Shared Decision Making ◽  
Patient Engagement ◽  
Randomized Control Trial ◽  
Shared Decision ◽  
Acute Exacerbation Of Copd ◽  
Randomized Control ◽  
Exacerbation Of Copd

scholarly journals Additional Effects of Xbox Kinect Training on Upper Limb Function in Chronic Stroke Patients: A Randomized Control Trial

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 242
Author(s):  
Qurat Ul Ain ◽  
Sara Khan ◽  
Saad Ilyas ◽  
Amna Yaseen ◽  
Iqbal Tariq ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Randomized Control Trial ◽  
Training Group ◽  
P Value ◽  
Stroke Patients ◽  
Upper Limb Rehabilitation ◽  
Xbox Kinect ◽  
Randomized Control ◽  
Limb Rehabilitation

Background: Xbox Kinect-based virtual reality, being a novel approach, has therapeutic benefits in rehabilitation and its use is encouraged in stroke rehabilitation of upper extremities. Objective: Primary aim of the current study is to investigate the additional effects of Xbox Kinect training in combination with routine physiotherapy exercises based on each component of Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE). Moreover, effect of upper limb rehabilitation on cognitive functions was also assessed. Methods: This study was a parallel arm randomized control trial. Fifty-six participants were recruited and randomly allocated to either an Xbox Kinect training group (XKGT) or exercise training group (ETG). Measures of concern were recorded using FMA-UE, Box and Block Test (BBT), and Montreal Cognitive Assessment (MOCA). Evaluation was conducted at baseline and after completion of intervention at the sixth week. Results: There were significant differences from pre- to post-intervention scores of FMA-UE and BBT (p < 0.001) in both groups, whereas no difference was observed for MOCA (XKTG p value 0.417, ETG p value 0.113). At six-week follow-up there were significant differences between both groups in FMA-UE total score (p < 0.001), volitional movement within synergies (p < 0.001), wrist (p = 0.021), hand (p = 0.047), grasp (p = 0.006) and coordination/speed (p = 0.004), favoring the Xbox Kinect training group. Conclusion: To conclude, results indicate repetitive use of the hemiparetic upper extremity by Xbox Kinect-based upper limb rehabilitation training in addition to conventional therapy has a promising potential to enhance upper limb motor function for stroke patients.

scholarly journals Healthcare Priority-Setting in Essential Health Packages for Sexual Reproductive Health: Going Beyond the Commonly Prioritised Services

2021 ◽  
Author(s):  
Warren Simangolwa ◽  
Kaymarlin Govender
Keyword(s):  
Decision Making ◽  
Reproductive Health ◽  
Priority Setting ◽  
Sexuality Education ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Health Coverage ◽  
Gender Based Violence ◽  
Safe Abortion ◽  
Sexual Reproductive Health

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI&rsquo;s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher&ndash;Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

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