A Mobile Education and Social Support Group Intervention for Improving Postpartum Health in Northern India: Development and Usability Study.
A Mobile Education and Social Support Group Intervention for Improving Postpartum Health in Northern India: Development and Usability Study.
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DOI：
10.2196/34087
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发表时间：
2022-06-29
影响因子：
2.2
通讯作者：
Diamond-Smith, Nadia G.
中科院分区：
文献类型：
--
作者：
El Ayadi, Alison M.;Duggal, Mona;Bagga, Rashmi;Singh, Pushpendra;Kumar, Vijay;Ahuja, Alka;Kankaria, Ankita;Basavarajappa, Darshan Hosapatna;Kaur, Jasmeet;Sharma, Preetika;Gupta, Swati;Pendse, Ruchita S.;Weil, Laura;Swendeman, Dallas;Diamond-Smith, Nadia G.
结构和文化障碍限制了印度妇女获得适当的产后护理和支持，尽管这对孕产妇和新生儿健康很重要。通过移动的健康干预措施提供有针对性的产后教育和支持，可改善产后恢复、新生儿护理做法、营养状况、知识和寻求护理以及心理健康。我们试图了解我们的第一个试点阶段的可行性和可接受性，一个灵活的6周产后移动的健康干预提供给3组妇女在旁遮普，印度，并调整我们的干预，我们的下一个试点阶段，这将正式评估干预的可行性，可接受性和初步疗效。我们的干预原型旨在通过提供者主持的，基于语音和文本的小组方法提供文化上量身定制的教育计划，将新妈妈与其他新妈妈的社会支持小组联系起来，增加他们与提供者的健康相关沟通，并将他们转介到所需的护理。我们的目标是使用功能手机进行部署，以包括来自不同社会经济群体的参与者。我们每周举行一次有节制的小组电话会议，传播教育音频，并创建短信组。我们改变了内容交付，小组讨论参与和聊天审核。通过社区卫生工作者招募了来自旁遮普的三组产后妇女参加试点。在基线时收集社会人口统计学数据。通过每周参与者签到（N=29），每周主持人报告，参与者亚组（15/29，52%）的结构化终点线深入访谈和后端技术数据评估干预的可行性和可接受性。参与者年龄为24至28岁，产后1至3个月。在29名参与者中，17人（59%）拥有自己的手机。一半的参与者（14/29，48%）参加了6个电话中的≥3个;主要障碍是儿童保育和家庭责任以及网络或电话问题。大多数参与者对干预非常满意（16/19，84%），并认为教育内容（20/20，100%）和小组讨论（17/20，85%）非常有用。参与者使用短信聊天，特别是当主持人主持。持续参与和促进群体互动受到技术和社会文化挑战的限制。认为干预措施总体上是可行和可接受的，并确定了方案调整，以改善干预措施的实施和参与。为了解决技术问题，我们聘请了一家基于云的群组呼叫服务提供商和一家交互式语音响应服务提供商进行教育录音，并为参与者开发了一款智能手机应用程序。我们寻求通过增加群体参与的新战略来克服社会文化挑战，包括将中级女性社区保健提供者作为主持人。我们的第二个试点将在6个月时评估干预措施的可行性、可接受性和初步有效性。最终，我们寻求通过制定高效，可接受和有效的干预策略来支持南亚及其他地区产后妇女及其婴儿的健康和福祉。
Structural and cultural barriers limit Indian women’s access to adequate postnatal care and support despite their importance for maternal and neonatal health. Targeted postnatal education and support through a mobile health intervention may improve postnatal recovery, neonatal care practices, nutritional status, knowledge and care seeking, and mental health. We sought to understand the feasibility and acceptability of our first pilot phase, a flexible 6-week postnatal mobile health intervention delivered to 3 groups of women in Punjab, India, and adapt our intervention for our next pilot phase, which will formally assess intervention feasibility, acceptability, and preliminary efficacy. Our intervention prototype was designed to deliver culturally tailored educational programming via a provider-moderated, voice- and text-based group approach to connect new mothers with a social support group of other new mothers, increase their health-related communication with providers, and refer them to care needed. We targeted deployment using feature phones to include participants from diverse socioeconomic groups. We held moderated group calls weekly, disseminated educational audios, and created SMS text messaging groups. We varied content delivery, group discussion participation, and chat moderation. Three groups of postpartum women from Punjab were recruited for the pilot through community health workers. Sociodemographic data were collected at baseline. Intervention feasibility and acceptability were assessed through weekly participant check-ins (N=29), weekly moderator reports, structured end-line in-depth interviews among a subgroup of participants (15/29, 52%), and back-end technology data. The participants were aged 24 to 28 years and 1 to 3 months postpartum. Of the 29 participants, 17 (59%) had their own phones. Half of the participants (14/29, 48%) attended ≥3 of the 6 calls; the main barriers were childcare and household responsibilities and network or phone issues. Most participants were very satisfied with the intervention (16/19, 84%) and found the educational content (20/20, 100%) and group discussions (17/20, 85%) very useful. The participants used the SMS text messaging chat, particularly when facilitator-moderated. Sustaining participation and fostering group interactions was limited by technological and sociocultural challenges. The intervention was considered generally feasible and acceptable, and protocol adjustments were identified to improve intervention delivery and engagement. To address technological issues, we engaged a cloud-based service provider for group calls and an interactive voice response service provider for educational recordings and developed a smartphone app for the participants. We seek to overcome sociocultural challenges through new strategies for increasing group engagement, including targeting midlevel female community health care providers as moderators. Our second pilot will assess intervention feasibility, acceptability, and preliminary effectiveness at 6 months. Ultimately, we seek to support the health and well-being of postpartum women and their infants in South Asia and beyond through the development of efficient, acceptable, and effective intervention strategies.
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影响因子：
2.3
作者：
Iwata, Hiroko;Mori, Emi;Tamakoshi, Koji
通讯作者：
Tamakoshi, Koji
DOI：
10.1016/s2214-109x(21)00079-6
发表时间：
2021-06
期刊：
The Lancet. Global health
影响因子：
--
作者：
Chmielewska B;Barratt I;Townsend R;Kalafat E;van der Meulen J;Gurol-Urganci I;O'Brien P;Morris E;Draycott T;Thangaratinam S;Le Doare K;Ladhani S;von Dadelszen P;Magee L;Khalil A
通讯作者：
Khalil A
DOI：
10.1007/s10459-012-9352-5
发表时间：
2013-03
期刊：
Advances in health sciences education : theory and practice
影响因子：
--
作者：
Claramita M;Nugraheni MD;van Dalen J;van der Vleuten C
通讯作者：
van der Vleuten C
DOI：
10.1111/j.1464-0597.2008.00341.x
发表时间：
2008-10-01
影响因子：
7.2
作者：
Michie, Susan;Johnston, Marie;Eccles, Martin
通讯作者：
Eccles, Martin
影响因子：
3.1
作者：
Eluwa, George, I;Adebajo, Sylvia B.;Chiegli, Robert
通讯作者：
Chiegli, Robert