Mobile WACh NEO: Mobile Solutions for Neonatal Health and Maternal Support

Mobile WACh NEO：新生儿健康和孕产妇支持的移动解决方案

• 批准号: 10506411
• 负责人: Jennifer Unger
• 金额: $ 44.14万
• 依托单位: WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10506411
• 关键词: Mobile; WACh; NEO; Solutions; Neonatal

PROJECT SUMMARY/ ABSTRACT High-impact essential newborn care practices and interventions are available to support neonatal survival, but coverage remains a challenge in sub-Saharan Africa, where neonatal mortality is unacceptably high. Adherence to these practices and uptake of life-saving interventions requires that a mother understands neonatal care and illness and that she is supported to implement care. It is estimated that up to 80% of neonatal deaths occur as a result of delays in mothers’ recognition of infant illness and decision to seek care. Two-way mobile health (mHealth) communication strategies can enable mothers to remotely interact with a healthcare worker (HCW) and receive real-time education, counseling, encouragement, motivation and decisional guidance to support neonatal health. We hypothesize that two-way SMS communication in late pregnancy and the neonatal period can prevent neonatal mortality by (1) supporting maternal implementation of essential newborn care (early and exclusive breastfeeding, cord care, and thermal care), (2) improving identification of neonatal danger signs and care seeking, and (3) augmenting maternal social support and self-efficacy, and reducing depressive symptoms. We have developed a unique two-way SMS platform (Mobile WACh) that combines automated bulk SMS messaging and dialogue with a HCW. We have adapted this approach for intensive neonatal support and evaluations (Mobile WACh-NEO). Mobile WACh NEO (MWN) enhances the benefits of SMS messaging by engaging mothers with SMS communication and bringing timely information and support - asking critical questions at crucial times in order to assess the needs and health of newborns. Our overarching aim is to determine the effect of Mobile WACh NEO on neonatal mortality and understand the mechanisms by which this innovation impacts neonatal health. We propose to determine the effect of MWN on neonatal mortality, essential newborn care, care seeking, and maternal mental health in the first 6 weeks postpartum, in a 2-armed randomized controlled trial. In AIM 1 we will determine the effect of Mobile WACh NEO on neonatal mortality, compared to no SMS control. In AIM 2, we will examine the effect of Mobile WACh NEO on maternal implementation of essential newborn care and care seeking behavior. In AIM 3 we will examine the effects of Mobile WACh NEO on maternal social support, self-efficacy and depression. Finally, we will explore the associations between maternal mental health, implementation of essential newborn care, neonatal care seeking and participant engagement by SMS. This study will evaluate a novel intervention to address a crucial gap in supporting mothers to care for their neonates and seek care when needed, and has the potential to make a significant contribution to the World Health Organization’s Every Newborn Action Plan to end preventable neonatal death and stillbirth.

项目总结/摘要 高影响力的基本新生儿护理实践和干预措施可用于支持新生儿存活，但 在撒哈拉以南非洲，覆盖率仍然是一个挑战，那里的新生儿死亡率高得不可接受。粘附 这些做法和采取拯救生命的干预措施要求母亲了解新生儿护理， 疾病，并支持她实施护理。据估计，高达80%的新生儿死亡发生在 这是由于母亲在认识婴儿疾病和决定寻求护理方面的延误。双向移动的健康 （mHealth）通信策略可以使母亲与医疗保健工作者（HCW）进行远程交互 并接受实时教育，咨询，鼓励，激励和决策指导，以支持 新生儿健康我们假设，在怀孕后期和新生儿的双向短信通信 通过（1）支持产妇实施基本新生儿营养计划， 护理（早期和纯母乳喂养，脐带护理和热护理），（2）改善识别 新生儿危险信号和寻求护理，和（3）增加母亲的社会支持和自我效能， 减少抑郁症状。我们开发了独特的双向短信平台（移动的WACh） 它将自动批量SMS消息和对话与HCW相结合。我们采用这种方法， 新生儿强化支持和评估（移动的WACh-NEO）。移动的WACh NEO（MWN）增强了 短信的好处，让母亲与短信沟通，并带来及时的信息， 支持-在关键时刻提出关键问题，以评估新生儿的需求和健康。 我们的首要目标是确定移动的WACh近地天体对新生儿死亡率的影响， 这一创新影响新生儿健康的机制。我们建议确定MWN的效果 新生儿死亡率、新生儿基本护理、寻求护理和孕产妇心理健康 在一项2组随机对照试验中，在AIM 1中，我们将确定移动的的效果 WACh NEO对新生儿死亡率的影响，与无SMS对照相比。在AIM 2中，我们将检查移动的的效果 WACh NEO对产妇实施新生儿基本护理和寻求护理行为的影响。在AIM 3中， 探讨移动的WACh NEO对母亲社会支持、自我效能和抑郁的影响。最后我们 将探讨产妇心理健康，实施基本新生儿护理， 新生儿护理寻求和参与者参与的短信。 这项研究将评估一种新的干预措施，以解决支持母亲照顾孩子的关键差距。 新生儿和寻求照顾时，需要，并有可能作出重大贡献，世界 卫生组织的每一个新生儿行动计划，以结束可预防的新生儿死亡和死产。