A Novel Video-Based Intervention to Enhance Optimal Uptake of Malaria Preventive Therapy: A Pilot Study of a Health Educational Approach to Malaria Prevention during Pregnancy

一种新的基于视频的干预措施，以增强疟疾预防治疗的最佳吸收：妊娠期疟疾预防健康教育方法的试点研究

• 批准号: 10452773
• 负责人: Rita Nakalega
• 金额: $ 5.4万
• 依托单位: MU-JHU CARE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-09 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10452773
• 关键词: Address; Adherence; Adverse event; Affect; Africa South of the Sahara; Age; Anemia; Area; Behavioral; Capital; Caring; Client; Clinic; Consultations; Cotrimoxazole; Country; Data; Developing Countries; Development; Dissemination and Implementation; Dose; Education; Educational Intervention; Effectiveness of Interventions; Exposure to; First Pregnancy Trimester; Focus Groups; Goals; Grant; HIV; HIV Seronegativity; HIV Seropositivity; Health; Health Benefit; Health Personnel; Health care facility; Intervention; Interview; Knowledge; Low Birth Weight Infant; Malaria; Malaria prevention; Maternal Mortality; Names; Neonatal; Outcome; Parasitemia; Pharmaceutical Preparations; Pilot Projects; Pregnancy; Pregnant Women; Prevalence; Prevention strategy; Prevention therapy; Preventive therapy; Preventive treatment; Procedures; Process; Production; Prophylactic treatment; Public Health; Pyrimethamine; Recommendation; Reporting; Resource-limited setting; Sampling; Schedule; Television; Time; Uganda; Woman; adverse outcome; antenatal care; base; behavior change; co-infection; cost effective; design; effectiveness evaluation; efficacious intervention; evidence base; fetal; health training; improved; literacy; novel; overpopulation; placental malaria; posters; prevent; preventive intervention; reproductive; therapy development; uptake; urban public health

PROJECT SUMMARY: Malaria in pregnancy remains a major public health concern that is associated with maternal and fetal adverse events and is the leading cause of preventable maternal deaths in sub-Saharan Africa. Despite the proven efficacy of Sulphadoxine-pyrimethamine (intermittent prophylaxis treatment of malaria_ IPTp_SP) and cotrimoxazole as prophylaxis treatment of malaria in HIV negative and HIV positive pregnant women respectively, adherence to these medications remains unacceptable in Uganda especially in Kampala. Sub-optimal adherence to malaria preventive therapy is reported to be due to lack of education or ignorance about these interventions among pregnant women, and the lack of exposure to malaria prevention messages to stimulate behavioral change. Additionally, due to overpopulation in Kampala and the persistent shortage of health workers like in many other low resource settings, health workers often don’t have adequate time to sufficiently educate pregnant women about all Antenatal care procedures including the IPTp-SP dosing schedule for HIV negative pregnant women and re initiation to cotrimoxazole for HIV positive pregnant women. To address this critical knowledge gap on adequate malaria preventive therapy utilization among pregnant women, we propose a combined implementation and dissemination interventional approach. This will primarily involve the development of the intervention named “PreVent” (PREvention of malaria in pregnancy using Video-based Education to eNhance opTimal malaria preventive therapy knowledge and uptake). In this R03, we will develop, tailor, and refine the video to address malaria preventive therapy knowledge deficits in a client-centered manner. The PreVent intervention will involve a 10 min video to educate pregnant women about current IPTp-SP and cotrimoxazole recommendations during ANC followed by a 5 min question and answer session with a health worker. We will qualitatively assess the PreVent intervention for feasibility, acceptability, and appropriateness using a pilot study in an urban public health facility. The obtained data will be used to prepare for an R21 grant in which we will rigorously evaluate the effectiveness of the intervention in increasing optimal IPTp-SP and cotrimoxazole uptake. Ultimately, this and progressive studies will result in the development of a cost-effective, evidence-based, and scalable intervention that will eventually reduce malaria- related maternal and neonatal adverse outcomes.

项目摘要： 怀孕的疟疾仍然是与母子和胎儿逆境有关的主要公共卫生问题 事件，是撒哈拉以南非洲可预防的孕产妇死亡的主要原因。尽管经过证明 磺胺毒素 - 甲胺的效率（疟疾_ IPTP_SP的间歇性预防治疗）和 共瑞唑唑作为对HIV阴性和HIV阳性孕妇的疟疾的预防治疗 在乌干达，尤其是在坎帕拉，对这些药物的遵守仍然是无法接受的。 据报道，对疟疾预防疗法的最佳依从性是由于缺乏教育或无知 关于孕妇中的这些干预措施，以及缺乏预防疟疾的信息 刺激行为改变。此外，由于坎帕拉人口过多以及持续的短缺 卫生工作者与许多其他低资源设置一样，卫生工作者通常没有足够的时间来 充分教育孕妇有关所有产前护理程序，包括IPTP-SP剂量时间表 HIV阴性孕妇，并向HIV阳性孕妇重新定位康德莫恶唑。解决 关于孕妇的充足疟疾预防治疗利用的这种关键知识差距，我们 提案一种联合实施和传播介入方法。这将主要涉及 开发名为“预防”的干预措施（使用基于视频的预防疟疾预防疟疾 教育以增强疟疾预防疗法知识和摄取）。 在此R03中，我们将开发，量身定制和完善视频以解决疟疾预防疗法知识缺陷 以以客户为中心的方式。预防干预将涉及10分钟的视频来教育孕妇 关于当前的IPTP-SP和Cotrimoxazole在ANC期间的建议，然后是5分钟的问题和 与卫生工作者的回答。我们将定性评估防止干预的可行性， 可接受性和适当性，使用城市公共卫生机构的试点研究。获得的数据将是 用于准备R21赠款，我们将严格评估干预措施的有效性 提高最佳IPTP-SP和共瑞唑唑的摄取。最终，这项和进步的研究将导致 开发具有成本效益，基于证据和可扩展的干预措施，最终将减少疟疾 相关的母校和新生儿广告结果。