Effectiveness of an mHealth Interactive Education and Social Support Intervention for Improving Postnatal Health

移动医疗互动教育和社会支持干预措施对改善产后健康的有效性

基本信息

批准号：
10671088
负责人：
NADIA GRIFFI DIAMOND-SMITH
金额：
$ 58.48万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10671088
关键词：
Attention Behavior Caring Community Health Aides Continuity of Patient Care Cost Analysis Cost Effectiveness Analysis Drops Education Effectiveness Effectiveness of Interventions Ensure Equation Excision Exclusive Breastfeeding Family Planning Family health status Geography Goals Health Health Services Accessibility Health behavior Health behavior and outcomes India Infant Infant Health Infant Mortality International Intervention Knowledge Late pregnancy Live Birth Maternal Health Maternal Mortality Maternal and Child Health Mediation Mental Health Methods Modeling Modernization Mothers Nurse Midwives Outcome Pathway interactions Patient Recruitments Perinatal Perinatal Care Personal Satisfaction Persons Pilot Projects Postnatal Care Postpartum Depression Postpartum Period Postpartum Women Provider Randomized Randomized, Controlled Trials Research Personnel Resources Risk Rural Self Efficacy Social Network Social Values Social stratification Social support South Asian Support Groups Testing Text Well in self Woman acceptability and feasibility behavior change care costs care seeking comparison intervention cost cost effective cost effectiveness cost-effectiveness ratio disparity reduction effectiveness evaluation effectiveness outcome effectiveness testing evidence base group intervention health knowledge improved incremental cost-effectiveness mHealth maternal outcome mobile computing neglect neonatal health neonatal outcome opportunity cost peri-urban perinatal health perinatal women pilot test postnatal postnatal period postpartum care postpartum contraception postpartum health prenatal primary outcome provider communication rural area rural dwellers scale up secondary outcome social social culture sociodemographics standard care standard of care symposium urban area virtual

项目摘要

Abstract Perinatal care continuity across the full continuum is essential for optimizing maternal and infant health; however, a stark gap occurs postpartum, with less than one half of Indian mothers receiving postpartum care due to significant logistical and sociocultural barriers, particularly for peri-urban and rural residents. To overcome these barriers and reduce women’s postpartum isolation, our international team of maternal and infant health clinicians and researchers developed and pilot-tested a culturally-tailored mobile interactive education and support group intervention: Maa Shishu Swasthya Sahayak Samooh (maternal and child health support group: MeSSSSage). MeSSSSage uses a provider-moderated group approach to increase women’s communication with providers, refer to in-person care, and connect them with a virtual social support group. Participants are recruited in late pregnancy and have 26 education and support sessions via audioconference facilitated by nurse-midwives (2 prenatal and weekly postpartum sessions through 6 months), plus engage in a text chat group. Pilot results indicated high acceptability and feasibility and suggest preliminary effectiveness. We propose to test the effectiveness of the MeSSSSage intervention compared to standard care on maternal and neonatal health-related behaviors and health outcomes in a randomized controlled trial among 2100 perinatal Indian women. Primary outcomes of exclusive breastfeeding, unmet need for postpartum contraceptives and postpartum depression will be assessed at 6 months. Our specific aims are to: estimate the effectiveness of a mobile interactive education and support group intervention (MeSSSSage) on postpartum behaviors for optimizing maternal and neonatal health in India (Aim 1), characterize the mechanisms of impact of the MeSSSSage intervention on maternal and neonatal health in India (Aim 2), and determine the cost-effectiveness of the MeSSSSage intervention in improving postpartum maternal and neonatal health as compared to the standard of care. We hope to positively impact women’s postnatal health knowledge and behaviors and improve health outcomes for women and their infants in the first six months postpartum. This study of a scaleable intervention will have an important contribution to the evidence base on mHealth for maternal and perinatal health and group care models for postnatal care, contributing to reducing disparities in women’s access to care through the removal of geographic and social barriers. 1

抽象的整个连续性的围产期护理连续性对于优化母子和婴儿健康至关重要。然而，产后发生鲜明的差距，不到一半的印度母亲因产后护理而受到重大的后勤和社会文化障碍，尤其是对于郊区和农村居民而言。克服这些障碍和减少妇女产后隔离，我们的国际孕产妇和婴儿卫生临床医生团队研究人员开发并进行了试点测试的文化限制的移动互动教育和支持小组干预：Maa Shishu Swasthya Sahayak Samooh（母婴健康支持小组：Messssage）。 MessSage使用提供者修改的小组方法来增加妇女与妇女的沟通提供者是指面对面的护理，并将其与虚拟社会支持小组联系起来。参与者被招募在怀孕晚期，通过护士阵营准备的录音会议进行了26次教育和支持会议（6个月至6个月的产后和每周一次的产后会议），再参与文本聊天组。飞行员结果表明高可接受性和可行性，并提出初步效力。我们建议与母亲的标准护理相比，测试梅斯史干预的有效性在2100年的一项随机对照试验中，与新生儿健康相关的行为和健康结果围产期印度妇女。独家母乳喂养的主要结果，未满足的产后需求避孕药和产后抑郁症将在6个月后评估。我们的具体目的是：估计移动互动教育和支持小组干预（MessSage）的有效性在印度优化母校和新生儿健康的产后行为（AIM 1），是特征杂物干预对印度孕产妇和新生儿健康影响的影响机制（AIM 2），并确定改善产后孕产后的梅斯萨奇干预措施的成本效益与护理标准相比，新生儿健康。我们希望对妇女的产后健康知识和行为产生积极影响，并改善健康产后最初六个月，妇女及其婴儿的结果。这项可扩展干预的研究将为孕产妇和围产期健康的MHealth的证据基础做出重要贡献产后护理的护理模型，有助于减少妇女通过消除地理和社会障碍。 1