Preschoolers Build Fundamental Motor Skills Critical to an Active Lifestyle: The All 4 Kids© Intervention Study

This pragmatic, real world study examined the effects of the All 4 Kids© intervention on preschoolers’ mastery of movement skills and determined whether the instruction had greater impact than natural development. Methods included a quasi-experimental intervention-comparison subsample of 379 children (COMPARISON) and a pretest-posttest design with convenience scale-up sampling of 2817 preschoolers (SCALE-UP). Children receiving education and dance instruction 3 times/week for 8 weeks were assessed using the Preschool Movement Assessment to evaluate skills pre and post intervention. Using repeated measures ANOVA, McNemar and Wilcoxon signed ranks tests, preschooler’s participation in the intervention resulted in greater improvement in 12 movement skills (F = 83.451, df = 1, p < 0.001, η p 2 = 0.555), balance (p = 0.028), hopping (t = −3.545, df = 112, p = 0.001) and crossing the midline (p < 0.001) than natural development (COMPARISON). In the SCALE-UP study, children significantly improved in all measures based on post-intervention scores. Significant differences were observed between Hispanic and non-Hispanic children for the 12-skills (b = −0.758, se = 0.161, p < 0.001) using hierarchical linear models; boys’ and girls’ scores were not differentially impacted by the intervention. Therefore, implementation of interventions focused on fundamental movement skill development have the potential to remediate secular motor skill decline in young children.

Download Full-text

Factors associated to functioning and health in relation to home rehabilitation in Sweden: a non-randomized pre-post intervention study

BMC Geriatrics ◽

10.1186/s12877-021-02360-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anette Johansson ◽

Marie Ernsth Bravell ◽

Eleonor I. Fransson ◽

Sofi Fristedt

Keyword(s):

Repeated Measures ◽

Linear Models ◽

Medical Condition ◽

Rehabilitation Program ◽

Community Dwelling ◽

Rehabilitation Service ◽

Post Intervention ◽

Factors Associated ◽

Rehabilitation Outcomes ◽

Self Rated Health

Abstract Background Home rehabilitation is a growing rehabilitation service in many countries, but scientific knowledge of its components and outcomes is still limited. The aim of this study was to investigate; 1) which changes in functioning and self-rated health could be identified in relation to a home rehabilitation program in a population of community-dwelling citizens, and 2) how socio-demographic factors, health conditions and home rehabilitation interventions were associated to change in functioning and self-rated health after the home rehabilitation program. Method The sample consisted of participants in a municipal home rehabilitation project in Sweden and consisted of 165 community-dwelling citizens. General Linear Models (ANOVA repeated measures) was used for identifying changes in rehabilitation outcomes. Logistic regressions analysis was used to investigate associations between rehabilitation outcomes and potential factors associated to outcome. Result Overall improvements in functioning and self-rated health were found after the home rehabilitation program. Higher frequencies of training sessions with occupational therapists, length of home rehabilitation, and orthopaedic conditions of upper extremities and spine as the main health condition, were associated with rehabilitation outcomes. Conclusion The result indicates that the duration of home rehabilitation interventions and intensity of occupational therapy, as well as the main medical condition may have an impact on the outcomes of home rehabilitation and needs to be considered when planning such programs. However, more research is needed to guide practice and policymaking.

Download Full-text

Effects of School-Based Exergaming on Urban Children’s Physical Activity and Cardiorespiratory Fitness: A Quasi-Experimental Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214080 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4080 ◽

Cited By ~ 2

Author(s):

Ye ◽

Pope ◽

Lee ◽

Gao

Keyword(s):

Physical Activity ◽

Cardiorespiratory Fitness ◽

Repeated Measures ◽

Intervention Group ◽

Control School ◽

Control Group ◽

Post Intervention ◽

School Based ◽

Quasi Experimental ◽

Over Time

Background: Modern-day technology is appealing to children. Few studies, however, have conducted longitudinal analyses of a school-based exergaming program’s effect on physical activity (PA) behaviors and fitness in children. Therefore, this study examined the longitudinal effect of an 8-month school-based exergaming intervention on children’s objectively-measured PA and cardiorespiratory fitness (CRF). Materials and Methods: Eighty-one fourth grade students (X̅age = 9.23 ± 0.62; 39 girls; 54.3% African American, 30.9% Non-Hispanic White, 14.8% other) participated in this study from 2014–2015. The intervention school’s children participated in a once-weekly 50-minute exergaming intervention during recess throughout the school year, while the control school continued regular recess. Children’s in-school PA and sedentary behavior (SB) were measured with ActiGraphGT3X+ accelerometers, with CRF assessed via the half-mile run. All measurements were taken at baseline, mid-intervention (four months) and post-intervention (eight months). Repeated-measures two-way ANCOVAs using age and race as covariates were conducted to examine between-school differences over time for SB, light PA (LPA), moderate-to-vigorous PA (MVPA), and CRF. Results: Significant time by group interactions were observed for LPA, F(1, 79) = 7.82, η2 = 0.09, p < 0.01, and MVPA, F(1, 79) = 4.58, η2 = 0.06, p < 0.05, as LPA increased among the control group, while MVPA increased among intervention group. Children in both groups experienced decreased SB during the intervention (intervention: −7.63 minutes; control: −17.59 minutes), but demonstrated lower CRF over time (intervention: +46.73 seconds; control: +61.60 seconds). Conclusions: Observations suggested that school-based exergaming implementation may be effective in increasing children’s MVPA and decreasing their SB over the course an academic year (i.e., ~eight months). More research is needed, however, to discern how modifications to school-based exergaming might also promote improved CRF in children.

Download Full-text

Promoting Heart Health in Women

AAOHN Journal ◽

10.1177/216507990705500703 ◽

2007 ◽

Vol 55 (7) ◽

pp. 271-276 ◽

Cited By ~ 11

Author(s):

Deborah E. Jones ◽

Michael T. Weaver ◽

Erika Friedmann

Keyword(s):

Health Disparities ◽

Heart Disease ◽

Health Education ◽

Repeated Measures ◽

Disease Risk ◽

Workplace Health ◽

Post Intervention ◽

Municipal Workers ◽

Quasi Experimental ◽

Heart Disease Risk Factors

The purpose of this study was to evaluate the effectiveness of a 5-week, 1 hour per week heart disease prevention program for sedentary female municipal workers with known heart disease risk factors. The program was designed to improve participants' knowledge and perceptions of their personal susceptibility to heart disease. In targeting an ethnically diverse, lower income working population, the researchers also sought to contribute to one of the goals of Healthy People 2010, the elimination of health disparities, specifically the reduction of health disparities in heart disease by 25% by the year 2010. A one-group, repeated measures, quasi-experimental design was employed. Forty-eight women 25 to 66 years old responded to the solicitation and participated in the program. Seventy-five percent were African American, 23% were White, and 2% were Latino. Participants completed a 33-item heart disease knowledge questionnaire, demographic questions, and a single visual analog scale statement to assess perceived susceptibility. Fifty-eight percent of the participants improved their knowledge of heart disease and 50% of the participants increased their perception of susceptibility to heart disease from pre- to post-intervention. The greatest improvement in knowledge and awareness of susceptibility occurred for those with limited knowledge and low perceptions of susceptibility. The gains from this workplace health education project for largely minority female municipal workers were modest, but notable. A workplace health education program for women targeted at increasing their knowledge of heart disease may also increase their perceptions of susceptibility to heart disease.

Download Full-text

Efektivitas Comprehensive Breastfeeding Education terhadap Keberhasilan Pemberian Air Susu Ibu Postpartum

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v1i2.56 ◽

1970 ◽

Vol 1 (2) ◽

Author(s):

Irma Nurbaeti ◽

Kustati Budi Lestari

Keyword(s):

Repeated Measures ◽

Breastfeeding Support ◽

Breastfeeding Practices ◽

Breastfeeding Education ◽

Repeated Measures Analysis ◽

Post Test ◽

Quasi Experimental ◽

The Mean ◽

Convenience Sampling ◽

Postpartum Mothers

Pemberian Air Susu Ibu (ASI) masih merupakan masalah bagi pemenuhan kebutuhan nutrisi bayi baru lahir. Dukungan agar ibu menyusui bayi merupakan hal penting dalam menginisiasi dan mempertahankan pemberian ASI. Strategi dibutuhkan untuk mendukung keberhasilan menyusui. Tujuan penelitian adalah menganalisis efektivitas comprehensive breastfeeding education terhadap keberhasilan pemberian (ASI) pada periode postpartum. Jenis penelitian ini menggunakan kuasi eksperimen one group pre post test repeated measured design. Jumlah sampel sebanyak 22 ibu dengan menggunakan teknik accidental sampling. Pengumpulan data dilaksanakan pada bulan September–Oktober 2013 di Puskesmas wilayah Kota Tangerang Selatan. Intervensi dilakukan selama 30 menit. Pengumpulan data dilakukan sebelum intervensi, 3 hari setelah intervensi (post1), dan 10 hari setelah intervensi (post 2). Pengumpulan data menggunakan kuesioner dan observasi. Keberhasilan pemberian ASI berdasar pada parameter pengetahuan, langkah menyusui, perlekatan bayi, dan kecukupan ASI. Analisis data menggunakan general linear model repeated measureANOVA. Hasil penelitian menunjukkan adanya signifikansi comprehensive breastfeeding education (p=0.001). Rata-rata keberhasilan pemberian ASI sebelum dan setelah intervensi meningkat. Sebesar 93,9% intervensi memengaruhi tingkat keberhasilan. Rata-rata sebelum intervensi 56,74 (SD 5,92), post 1 sebesar 60,83 (SD 6,38) dan post2 sebesar 74,55 (SD 5,32). Subvariabel yang memiliki efek secara signifikan setelah intervensi adalah pengetahuan (p=0.001) dan langkah menyusui (p=0.001), sedangkan subvariabel perlekatan bayi (p=0.061) dan kecukupan ASI (p=0.162) tidak secara signifikan berbeda antara sebelum dan setelah intervensi. Pelaksanaanbreastfeeding education disarankan pada ibu agar dapat melakukan posisi perlekatan bayi yang benar sehingga dapat mengurangi masalah-masalah berkaitan dengan perlekatan yang tidak sesuai seperti puting perih, lecet atau berdarah, dan bayi kurang puas dalam menyusu yang bisa mengakibatkan gagalnya program ASI ekslusif.Kata kunci:Menyusui, pendidikan, perlekatan, postpartum AbstractBreastfeeding have still been problem for adequate newborn nutrition. Adequate breastfeeding support is essential for mothers to initiate and maintain optimal breastfeeding practices. A strategic needed to support successful breastfeeding. The purpose of research is to analyze the effectiveness comprehensive breastfeeding education on successful breastfeeding at postpartum periods. A quasi-experimental one group pretest, post test, repeated mesaured was used. This study was conducted at public health in Tangerang Selatan municipality in September–October 2013 among 22 postpartum mothers, convenience sampling methods. Intervention was done 30 minute. Data were collected before intervention (pretest), third day after intervention (post 1) and tenth day after intervention (repeated/post 2) using four parameter, that are knowledge, breastfeeding steps, proper lacth-on and adequate breastmilk. Using repeated measures analysis of variance there was a significant increase (p=0.001) in the overall Successful breastfeeding mean. Around 93,9% the effectiveness of intervention influence on successful. The mean before intervention is 56,74 (SD 5,92), increased at post 1:60,83 (SD 6,38) and post 2:74,55 (SD 5,32). Subvariable which has effect significantly after intervention is knowledge (p=0.001) and breastfeeding steps (p=0.001), in contrary, proper latch-on (p=0,061) and adequate breastmilk (p=0.162) have no significant effect after intervention. Suggestion to support breastfeeding education and counselling proper latch-on adequately that can decrease the problem such as painful, creaks or bloody putting.Key words: Breastfeeding, education, latch-on, postpartum

Download Full-text

Effect of Different Dentifrices, Bleaching with 35% Hydrogen Peroxide, and Red Wine on Surface Color and Roughness of Bovine Enamel

Current Dentistry ◽

10.2174/2542579x02999200817112951 ◽

2020 ◽

Vol 02 ◽

Author(s):

RM Garcia ◽

WF Vieira-Junior ◽

JD Theobaldo ◽

NIP Pini ◽

GM Ambrosano ◽

...

Keyword(s):

Hydrogen Peroxide ◽

Generalized Linear Models ◽

Repeated Measures ◽

Red Wine ◽

Linear Models ◽

Artificial Saliva ◽

Surface Color ◽

Dental Bleaching ◽

Surface Alteration ◽

Bovine Enamel

Objective: To evaluate color and roughness of bovine enamel exposed to dentifrices, dental bleaching with 35% hydrogen peroxide (HP), and erosion/staining by red wine. Methods: Bovine enamel blocks were exposed to: artificial saliva (control), Oral-B Pro-Health (stannous fluoride with sodium fluoride, SF), Sensodyne Repair & Protect (bioactive glass, BG), Colgate Pro-Relief (arginine and calcium carbonate, AR), or Chitodent (chitosan, CHI). After toothpaste exposure, half (n=12) of the samples were bleached (35% HP), and the other half were not (n=12). The color (CIE L*a* b*, ΔE), surface roughness (Ra), and scanning electron microscopy were evaluated. Color and roughness were assessed at baseline, post-dentifrice and/or -dental bleaching, and after red wine. The data were subjected to analysis of variance (ANOVA) (ΔE) for repeated measures (Ra), followed by Tukey ́s test. The L*, a*, and b* values were analyzed by generalized linear models (a=0.05). Results: The HP promoted an increase in Ra values; however, the SF, BG, and AR did not enable this alteration. After red wine, all groups apart from SF (unbleached) showed increases in Ra values; SF and AR promoted decreases in L* values; AR demonstrated higher ΔE values, differing from the control; and CHI decreased the L* variation in the unbleached group. Conclusion: Dentifrices did not interfere with bleaching efficacy of 35% HP. However, dentifrices acted as a preventive agent against surface alteration from dental bleaching (BG, SF, and AR) or red wine (SF). Dentifrices can decrease (CHI) or increase (AR and SF) staining by red wine.

Download Full-text

Efficacy of one-dose intramuscular rabies vaccine as pre-exposure prophylaxis in travellers

Journal of Travel Medicine ◽

10.1093/jtm/taab059 ◽

2021 ◽

Author(s):

Deborah J Mills ◽

Colleen L Lau ◽

Christine Mills ◽

Luis Furuya-Kanamori

Keyword(s):

Immune System ◽

Rapid Development ◽

Age Groups ◽

Rabies Vaccine ◽

Post Exposure Prophylaxis ◽

Post Intervention ◽

Quasi Experimental ◽

Alternative Schedule ◽

Insufficient Time ◽

Exposure Prophylaxis

Abstract Background Current guidelines for rabies pre-exposure prophylaxis (PrEP) recommend multiple vaccine doses. Travellers sometimes present for pre-travel consultation with insufficient time to complete standard PrEP schedules. We investigated the efficacy of one-dose intramuscular (IM) vaccine in priming the immune system (as PrEP) by measuring antibody response to simulated post-exposure prophylaxis (PEP). Methods A quasi-experimental pre–post intervention clinical trial was conducted at a specialist travel clinic in Australia. Adults (≥18 years) without a history of rabies vaccination were included. At Visit 1, seronegative status was confirmed and one dose of 0.5 ml IM rabies vaccine (Verorab®) administered. At Visit 2 (≥60 days after Visit 1), serology was repeated and a simulated PEP dose (0.5 ml IM) given on this day and again 3 days later (Visit 3). Serology was repeated at Visit 4 (7 days after Visit 2). Results A total of 94 antibody-negative participants were included (<50 years [n = 50]; ≥50 years [n = 44]). At Visit 2, 38.0 and 31.8% of participants aged <50 and ≥50 years were antibody-positive (≥0.5 EU/ml). At Visit 4, all participants were antibody-positive; 82.0 and 47.7% of participants aged <50 and ≥50 years had antibody levels >4 EU/ml, respectively. Conclusions One-dose IM vaccine was effective as PrEP for priming the immune system in both age groups, resulting in rapid development of antibodies 7 days after commencing simulated PEP. If there is insufficient time to complete a standard PrEP schedule, one-dose IM could be considered as an alternative schedule for short trips, rather than not offering travellers any doses at all. Clinical trials registration: ACTRN12619000946112.

Download Full-text

Effectiveness of a vancomycin dosing protocol guided by area under the concentration-time curve to minimal inhibitory concentration (AUC/MIC) with multidisciplinary team support to improve hospital-wide adherence to a vancomycin dosing protocol: A pilot study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.296 ◽

2021 ◽

pp. 1-6

Author(s):

Panipak Katawethiwong ◽

Anucha Apisarnthanarak ◽

Kittiya Jantarathaneewat ◽

David J. Weber ◽

David K. Warren ◽

...

Keyword(s):

Mortality Rate ◽

Multidisciplinary Team ◽

Kidney Injury ◽

University Hospital ◽

Routine Practice ◽

Post Intervention ◽

Coagulase Negative Staphylococci ◽

Time Curve ◽

Concentration Time ◽

Quasi Experimental

Abstract Background: Limited data are available on the implementation of an area under the concentration-time curve (AUC)–based dosing protocol with multidisciplinary team (MT) support to improve adherence with vancomycin dosing protocol. Objective: To evaluate the effectiveness of an AUC-based dosing protocol with MT support intervention with adherence to a hospital-wide vancomycin dosing protocol at Thammasat University Hospital. Method: We conducted a quasi-experimental study in patients who were prescribed intravenous vancomycin. The study was divided into 2 periods; (1) the preintervention period when the vancomycin dosing protocol was already applied in routine practice and (2) the post-intervention period when the implementation of an AUC-based dosing protocol with MT support was added to the existing vancomycin dosing protocol. The primary outcome was the rate of adherence, and the secondary outcomes included acute kidney injury events, vancomycin-related adverse events, and 30-day mortality rate. Results: In total, 240 patients were enrolled. The most common infections were skin and soft-tissue infections (24.6%) and bacteremia (24.6%). The most common pathogens were coagulase-negative staphylococci (19.6%) and Enterococcus spp (15.4%). Adherence with the vancomycin dosing protocol was significantly higher in the postintervention period (90.8% vs 55%; P ≤ .001). By multivariate analysis, an AUC-based dosing protocol with MT support was the sole predictor for adherence with the vancomycin dosing protocol (adjusted odds ratio, 10.31; 95% confidence interval, 4.54–23.45; P ≤ .001). The 30-day mortality rate was significantly lower during the postintervention period (8.3% vs 20%; P = .015). Conclusions: AUC-based dosing protocol with MT support significantly improved adherence with vancomycin dosing protocol and was associated with a lower 30-day mortality rate.

Download Full-text

Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness and Leptin in Overweight/Obese Adolescents

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147267 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7267

Author(s):

Leticia Borfe ◽

Caroline Brand ◽

Letícia Schneiders ◽

Jorge Mota ◽

Claudia Cavaglieri ◽

...

Keyword(s):

Body Composition ◽

Physical Fitness ◽

Intervention Group ◽

Interleukin 10 ◽

Control Group ◽

Post Intervention ◽

Necrosis Factor Alpha ◽

Obese Adolescents ◽

Quasi Experimental ◽

Multicomponent Program

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

Download Full-text

Boxing vs Sensory Exercise for Parkinson’s Disease: A Double-Blinded Randomized Controlled Trial

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211023197 ◽

2021 ◽

pp. 154596832110231

Author(s):

Kishoree Sangarapillai ◽

Benjamin M. Norman ◽

Quincy J. Almeida

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Randomized Controlled Trial ◽

Repeated Measures ◽

Rating Scale ◽

Controlled Trial ◽

Motor Symptoms ◽

Post Intervention ◽

Randomized Controlled ◽

Double Blinded

Background. Exercise is increasingly becoming recognized as an important adjunct to medications in the clinical management of Parkinson’s disease (PD). Boxing and sensory exercise have shown immediate benefits, but whether they continue beyond program completion is unknown. This study aimed to investigate the effects of boxing and sensory training on motor symptoms of PD, and whether these benefits remain upon completion of the intervention. Methods. In this 20-week double-blinded randomized controlled trial, 40 participants with idiopathic PD were randomized into 2 treatment groups, (n = 20) boxing or (n = 20) sensory exercise. Participants completed 10 weeks of intervention. Motor symptoms were assessed at (week 0, 10, and 20) using the Unified Parkinson’s Disease Rating Scale (UPDRS-III). Data were analyzed using SPSS, and repeated-measures ANOVA was conducted. Results. A significant interaction effect between groups and time were observed F(1, 39) = 4.566, P = .036, where the sensory group improved in comparison to the boxing group. Post hoc analysis revealed that in comparison to boxing, the effects of exercise did not wear off at washout (week 20) P < .006. Conclusion. Future rehabilitation research should incorporate similar measures to explore whether effects of exercise wear off post intervention.

Download Full-text

Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

BMC Infectious Diseases ◽

10.1186/s12879-021-06414-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sovannary Tuot ◽

Alvin Kuo Jing Teo ◽

Kiesha Prem ◽

Pheak Chhoun ◽

Chamroen Pall ◽

...

Keyword(s):

Experimental Study ◽

Antiretroviral Therapy ◽

Scale Up ◽

Economic Evaluations ◽

People Living With Hiv ◽

Cad Model ◽

Community Based ◽

Quasi Experimental ◽

Living With Hiv ◽

Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

Download Full-text