Outcomes of home visits for pregnant mothers and their infants: a cluster randomized controlled trial.
Outcomes of home visits for pregnant mothers and their infants: a cluster randomized controlled trial.
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DOI：
10.1097/qad.0b013e3283601b53
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发表时间：
2013-06-01
期刊：
影响因子：
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通讯作者：
Rotheram-Borus MJ
中科院分区：
文献类型：
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作者：
le Roux IM;Tomlinson M;Harwood JM;O'Connor MJ;Worthman CM;Mbewu N;Stewart J;Hartley M;Swendeman D;Comulada WS;Weiss RE;Rotheram-Borus MJ
评估社区卫生工作者家访对感染艾滋病毒的妇女和所有邻里母亲从怀孕到生命最初6个月期间母婴健康的影响。在开普敦乡镇的一项整群随机对照试验中，社区被随机分配到配对组中：1)标准护理，诊所的综合医疗保健（SC; n=12个社区；n=169名产妇产妇；n=594名母亲），或2)菲拉尼干预计划，除SC外由CHW家访（PIP; n=12个社区；n=185名产妇；n=644名母亲）。参与者在怀孕期间（2%拒绝）进行评估，并在出生后一周（92%）和六个月（88%）重新评估。我们使用随机效应回归模型分析了PIP对WLH和所有母亲的28项母婴健康指标的影响。对于每一组，使用相关结果的二项检验来评估PIP的总体有效性。在WLH和所有参与者中，与SC相比，PIP有显著的总体益处。其次，与SC相比，PIP WLH更有可能完成防止垂直传播的任务，使用一种喂养方法6个月，避免出生相关的医疗并发症，并且婴儿具有健康的年龄身高测量。在所有母亲中，与SC相比，PIP母亲更有可能始终使用避孕套，6个月完全母乳喂养，并且婴儿的身高与年龄相比是健康的。和平方案是面临艾滋病毒资金大幅减少的国家的一个模式，这些国家的家庭面临多重健康风险。
To evaluate the effect of home visits by Community Health Workers (CHW) on maternal and infant well-being from pregnancy through the first six months of life for women living with HIV (WLH) and all neighbourhood mothers. In a cluster randomised controlled trial in Cape Town townships, neighbourhoods were randomised within matched pairs to either: 1) Standard Care, comprehensive healthcare at clinics (SC; n=12 neighbourhoods; n=169 WLH; n=594 total mothers), or 2) Philani Intervention Program, home visits by CHW in addition to SC (PIP; n=12 neighbourhoods; n=185 WLH; n=644 total mothers). Participants were assessed during pregnancy (2% refusal) and reassessed at one week (92%) and six months (88%) post-birth. We analysed PIP’s effect on 28 measures of maternal and infant well-being among WLH and among all mothers using random effects regression models. For each group, PIP’s overall effectiveness was evaluated using a binomial test for correlated outcomes. Significant overall benefits were found in PIP compared to SC among WLH and among all participants. Secondarily, compared to SC, PIP WLH were more likely to complete tasks to prevent vertical transmission, use one feeding method for 6 months, avoid birth-related medical complications, and have infants with healthy height-for-age measurements. Among all mothers, compared to SC, PIP mothers were more likely to use condoms consistently, breastfeed exclusively for 6 months, and have infants with healthy height-for-age measurements. PIP is a model for countries facing significant reductions in HIV funding whose families face multiple health risks.