mHealth Tools to Improve Service Delivery Quality of an Evidence-Based Family Home Visiting Intervention to Prevent Family Violence among High Risk Families in Sierra Leone

项目摘要 拟议的探索性研究将试点以家庭为中心的行为健康干预，同时还 开发和试点创新和具有成本效益的移动医疗工具，以支持社区卫生工作者， 塞拉利昂西部农村地区服务不足。这一双重重点将有助于建设迫切需要的能力， 提供基于证据的心理健康服务，以减少家庭暴力和严厉的育儿做法， 以及有效利用移动医疗战略来改善医疗服务和质量。政府 塞拉利昂在其社区卫生工作者方案中投入了大量资金， 利用技术改进性能监测、监测数据收集和健康数据使用， 最高优先级这项研究将利用政府在社区卫生倡议和移动健康方面的投资 创新作为解决困扰证据提供的关键医疗保健劳动力限制的战略- 为冲突后塞拉利昂的弱势家庭提供基于基础的干预措施。该研究将试点移动健康支持 提供文化适应版的加强家庭的幼儿期干预措施 发展（FSI-ECD）。FSI-ECD在改善父母情绪方面表现出有效性 监管和减少家庭暴力和严厉的养育做法。研究目的是： 目标1。采用五阶段以用户为中心的设计方法来开发和测试移动健康工具，以改善 对社区卫生工作者进行培训、监督和忠诚度监测。 目标2.开展II类实施-有效性随机对照初探性研究，以评估 mHealth支持的FSI-ECD对父母心理健康的可行性、可接受性和初步影响 健康，情绪调节和家庭暴力的高风险家庭，6-36个月的儿童（n=40）， 与接受标准护理的对照家庭（n=40）进行比较。父母的心理健康，情绪调节， 家庭暴力和养育方式将在基线、干预后和6个月时进行评估 随访FSI-ECD和移动健康工具的可行性、可接受性和采用将通过 量化措施和关键线人访谈。试点研究还将纳入成本效益 分析，以评估移动医疗支持的FSI-ECD与标准护理的经济价值。 目标3。利用稳固的关系和政府伙伴加强能力， 塞拉利昂的移动健康研究和优质医疗服务。合作伙伴包括马克尼大学， 科学、技术和创新局以及卫生和环境卫生部。 这项研究将为扩大知识，促进合作和发展当地 塞拉利昂的研究专家。研究结果将为R 01资助的混合实施计划提供信息 研究mHealth支持的心理健康服务整合到现有交付平台的有效性试验 在资源匮乏的情况下，扩大移动保健支持的培训和对服务提供者的监督。

PROJECT SUMMARY The proposed exploratory research will pilot a family-focused, behavioral health intervention while also developing and piloting innovative and cost-effective mHealth tools to support Community Health Workers in Sierra Leone's underserved, rural Western region. This dual focus will help build urgently needed capacity both for delivery of evidence-based mental health services to reduce family violence and harsh parenting practices, and for effective use of mHealth strategies to improve healthcare delivery and quality. The Government of Sierra Leone has invested heavily in its Community Health Worker Programme and has identified innovative use of technology to improve performance monitoring, surveillance data collection, and health data usage as a high priority. This study will leverage government investments in community health initiatives and mHealth innovations as a strategy to address critical healthcare workforce limitations that plague delivery of evidence- based interventions to vulnerable families in post-conflict Sierra Leone. The study will pilot mHealth-supported delivery of a culturally adapted version of the Family Strengthening Intervention for Early Childhood Development (FSI-ECD). The FSI-ECD has demonstrated effectiveness in improving parental emotion regulation and reducing family violence and harsh parenting practices. Study aims are to: Aim 1. Employ a five-stage user-centered design approach to develop and test mHealth tools to improve training, supervision, and fidelity monitoring of Community Health Workers. Aim 2. Conduct a Type II Implementation-Effectiveness Randomized Controlled Pilot Study to assess feasibility, acceptability, and preliminary effects of mHealth-supported delivery of FSI-ECD on parent mental health, emotion regulation, and familial violence in high risk families with children aged 6–36 months (n=40) in comparison to control families (n=40) who receive standard care. Parental mental health, emotion regulation, household violence, and parenting practices will be assessed at baseline, post-intervention and 6-month follow-up. Feasibility, acceptability, and adoption of the FSI-ECD and mHealth tools will be assessed via quantitative measures and key informant interviews. The pilot study will also integrate a cost-effectiveness analysis to assess the economic value of the mHealth-supported delivery of the FSI-ECD vs. standard care. Aim 3. Leverage well-established relationships and government partners to strengthen capacity for mHealth research and quality healthcare delivery in Sierra Leone. Partners include the University of Makeni, the Directorate of Science, Technology and Innovation, and the Ministry of Health and Sanitation. This study will provide a foundation for expanding knowledge, fostering collaboration, and developing local research expertise in Sierra Leone. Study findings will inform a planned R01-funded Hybrid Implementation Effectiveness trial to study mHealth-supported mental health services integrated into existing delivery platforms and to scale up mHealth-supported training and supervision of service providers in low resource settings.