Promoting Footwear in Rural Ethiopia

在埃塞俄比亚农村推广鞋类

• 批准号: 8948385
• 负责人: Laura Koehly
• 金额: $ 33.49万
• 依托单位: NATIONAL HUMAN GENOME RESEARCH INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8948385
• 关键词: Adopted; Affect; Age; Appearance; Back; Baseline Surveys; Behavioral Medicine; Belief; CD36 gene; Case Study; Child; Church; Clinic; Collaborations; Communities; Computer software; Consent; Data; Data Collection; Development; Disease; Education; Educational Intervention; Effectiveness of Interventions; Enrollment; Ethiopia; Evaluation; Evidence based intervention; Exposure to; Faculty; Family; Focus Groups; Genetic; Genetic Risk; Group Structure; Habits; Health Campaign; Health education; Household; Individual; Inherited; Intervention; Intervention Trial; Interview; Joints; Learning Module; Length; Life; Manuscripts; Methods; National Human Genome Research Institute; Neighborhoods; Parents; Participant; Patient Self-Report; Patients; Perception; Phase; Preparation; Prevention; Procedures; Public Health; Qualitative Methods; Randomized; Reporting; Research; Research Personnel; Research Training; Risk; Role; Rural; Sampling; Schedule; Shoes; Silicon Dioxide; Societies; Soil; Structure; Surveys; Testing; Translating; United States National Institutes of Health; Universities; Visual; base; clinical research site; community intervention; design; enhancing factor; evidence base; experience; falls; follow-up; foot; forging; group intervention; high risk; indexing; member; nanoparticle; prevent; primary outcome; programs; prototype; role model; social stigma; teacher; treatment as usual

Phase 1 qualitative data collection has been completed in the four selected villages. Periodic review of procedures indicated the need for some small changes in the interview schedules to shorten the length of the focus groups and structured interviews. All data has been compiled, translated, back-translated and is being analyzed by the NIH team using N-Vivo software. Initial findings were presented at the Society of Behavioral Medicine in April 2011. Two manuscripts based on the qualitative data are in preparation. Briefly, results indicated that community members have diverse beliefs about the role of genetics as a cause of podoconiosis. Some individuals believe that genetics is the sole cause of the disease and nothing can be done to prevent it, others see that protective footwear can prevent podoconiosis even among those at genetic risk, and others believe the disease is both genetic and contagious. The next steps will be to develop a prototype intervention that is based in church and neighborhood settings involving role models from the community (e.g., teachers) who will educate about the causes of podoconiosis and encourage consistent footwear. We expect that the prototype intervention will be developed by the team by the end of the 2011. Pilot testing using rapid assessment and evaluation methods will be conducted in early 2012 to assess the feasibility and acceptability of the intervention to promote footwear. Fall 2012 a formal evaluation of the final intervention will be initiated. A second round of pilot activities were completed in March, 2012. These results indicated the feasibility of our genetics education intervention. The community-based intervention trial commenced in January 2013. Six communities have been assigned to one of three intervention conditions: (1) Usual health education about footwear, (2) public health campaign and household-based health education and (3) public health campaign, household based health education that includes information about inherited soil sensitivity. The primary outcome is consistent shoe wearing by an index child who has received shoes from a local NGO. Four survey assessments are conducted: (1) baseline (2) 3 months after the intervention, (3) 10 mos and (4) 15 mos after the intervention. A total of 1800 households have been enrolled, completed the baseline, 3 and 12 month follow-up surveys. The study is now completed and analyses are underway to evaluate trial results. Two manuscripts are nearly completed based on analyses of the baseline surveys. Analyses thus far indicate that affected familiesbeliefs that podoconiosis is inherited are associated with perceptions of decreased value of shoe wearing. Families affected by podoconiosis perceive themselves to be at lower risk for the condition than unaffected families. This may be due to the efforts of a local NGO to educate affected families that podoconiosis is preventable. Unaffected households have not received this education. Additionally, study participants from neighboring households reported having enacted stigma on families affected by the conditions. Similarly, participants affected by the condition reported having experienced stigma. Lastly, reported stigma levels differed significantly across the six communities.

第一阶段的定性数据收集工作已经在选定的四个村庄完成。对程序的定期审查表明，需要对面谈日程进行一些小的改动，以缩短重点小组和结构化面谈的时间。所有数据都已被汇编、翻译、反向翻译，并由NIH团队使用N-Vivo软件进行分析。初步研究结果于2011年4月在行为医学会上公布。基于定性数据的两份手稿正在准备中。简而言之，结果表明，社区成员对遗传作为足癣病因的作用有不同的信念。一些人认为基因是这种疾病的唯一原因，无法采取任何措施来预防它，另一些人认为即使在有遗传风险的人中，防护鞋类也可以预防足癣，还有一些人认为这种疾病既是遗传的，也是传染性的。下一步将是开发一种基于教堂和邻里环境的原型干预措施，包括来自社区的榜样(例如，教师)，他们将教育足癣的原因并鼓励一致的鞋子。我们预计，该小组将在2011年底之前开发出干预原型。使用快速评估和评价方法的试点测试将于2012年初进行，以评估促进鞋类产品的干预措施的可行性和可接受性。2012年秋季将启动对最终干预措施的正式评估。 第二轮试点活动于2012年3月完成。这些结果表明，我们的遗传学教育干预是可行的。基于社区的干预试验于2013年1月开始。六个社区被分配到三种干预条件之一：(1)关于鞋类的常规健康教育，(2)公共健康运动和以家庭为基础的健康教育，(3)公共健康运动，以家庭为基础的健康教育，包括关于遗传土壤敏感性的信息。主要结果是，收到当地非政府组织鞋子的索引儿童一致地穿鞋。共进行了四次调查评估：(1)基线(2)干预后3个月，(3)干预后10个月和(4)15个月。共登记了1800户家庭，完成了基线、3个月和12个月的跟踪调查。这项研究现已完成，现正进行分析，以评估试验结果。根据对基线调查的分析，两份手稿即将完成。到目前为止的分析表明，受影响的家庭认为足癣是遗传的，与穿鞋价值下降的看法有关。受足癣影响的家庭认为自己患这种疾病的风险比未受影响的家庭低。这可能是由于当地一个非政府组织努力教育受影响的家庭，使他们知道足癣是可以预防的。未受影响的家庭没有接受过这种教育。此外，来自邻近家庭的研究参与者报告说，他们对受疾病影响的家庭实施了耻辱。同样，受这种情况影响的参与者报告说经历了耻辱。最后，报告的污名程度在六个社区中差异很大。