Development and Piloting of a Home-Based Couples Intervention During Pregnancy and Postpartum in Southwestern Kenya.
Development and Piloting of a Home-Based Couples Intervention During Pregnancy and Postpartum in Southwestern Kenya.
复制标题
肯尼亚西南部孕期和产后家庭夫妻干预的开发和试点。
DOI：
10.1089/apc.2017.0285
复制
发表时间：
2018
影响因子：
4.9
通讯作者：
Bukusi,ElizabethA
中科院分区：
文献类型：
--
作者：
Turan,JanetM;Darbes,LynaeA;Musoke,PamelaL;Kwena,Zachary;Rogers,AnnaJoy;Hatcher,AbigailM;Anderson,JamiL;Owino,George;Helova,Anna;Weke,Elly;Oyaro,Patrick;Bukusi,ElizabethA
让怀孕夫妇双方都参与可以加强预防艾滋病毒母婴传播并促进家庭健康。我们制定并试点了一项干预措施，以促进肯尼亚西南部孕期和产后夫妇在健康方面的合作。我们利用形成性数据和利益相关者的意见来为家庭夫妻干预的发展提供信息。接下来，我们将孕妇随机分为干预组 (n= 64) 或标准护理组 (n= 63)，随后联系其男性伴侣进行登记。在干预组中，非专业卫生工作者对夫妇进行家访，包括健康教育、夫妻关系和沟通技巧，以及提供夫妇艾滋病毒检测和咨询（CHTC）服务。产后 3 个月进行随访调查问卷（n=114 名女性，86 名男性）。研究组使用 t 检验、卡方检验和回归分析来检查基线特征和健康行为。在随机分组的 127 名女性中，她们的 96 名伴侣参与了这项研究。在干预组的 52 对夫妇中，94% 的夫妇至少完成了一次家访。超过 93% 的接受夫妇家访的参与者表示满意，没有报告不良社会后果。随访时，与标准护理夫妇相比，干预夫妇在研究期间参加 CHTC 的相对风险为 2.78（95% 置信区间：1.63-4.75），并且在其他关键围产期健康行为中观察到显着关联。这项试点研究表明，对孕妇和男性伴侣进行家庭夫妻干预是可以接受的、可行的，并且有可能增强 CHTC 和围产期健康行为，从而改善健康结果。
Engaging both partners of a pregnant couple can enhance prevention of mother-to-child transmission of HIV and promote family health. We developed and piloted an intervention to promote couple collaboration in health during pregnancy and postpartum in southwestern Kenya. We utilized formative data and stakeholder input to inform development of a home-based couples intervention. Next, we randomized pregnant women to intervention (n= 64) or standard care (n= 63) arms, subsequently contacting their male partners for enrollment. In the intervention arm, lay health workers conducted couple home visits, including health education, couple relationship and communication skills, and offers of couple HIV testing and counseling (CHTC) services. Follow-up questionnaires were conducted 3 months postpartum (n= 114 women, 86 men). Baseline characteristics and health behaviors were examined by study arm usingt-tests, chi-square tests, and regression analyses. Of the 127 women randomized, 96 of their partners participated in the study. Of 52 enrolled couples in the intervention arm, 94% completed at least one couple home visit. Over 93% of participants receiving couple home visits were satisfied and no adverse social consequences were reported. At follow-up, intervention couples had a 2.78 relative risk of having participated in CHTC during the study period compared with standard care couples (95% confidence interval: 1.63–4.75), and significant associations were observed in other key perinatal health behaviors. This pilot study revealed that a home-based couples intervention for pregnant women and male partners is acceptable, feasible, and has the potential to enhance CHTC and perinatal health behaviors, leading to improved health outcomes.