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: 10624223
• 负责人: Jennifer Unger
• 金额: $ 56.94万
• 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 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10624223
• 关键词: Address; Adherence; Africa South of the Sahara; Behavior; Caregiver support; Caring; Cessation of life; Clinic; Communication; Contraceptive methods; Counseling; Country; Education; Evaluation; Exclusive Breastfeeding; Family; Health Personnel; Health Services Accessibility; Health system; Home; Household; Income; Infant; Infant Care; Intervention; Kenya; Knowledge; Late pregnancy; Life; Live Birth; Mental Depression; Mental Health; Mothers; Motivation; Needs Assessment; Neonatal; Neonatal Mortality; Newborn Infant; Outcome; Pilot Projects; Postpartum Period; Pregnancy; Randomized; Randomized, Controlled Trials; Resources; Risk; Self Efficacy; Social support; System; Text Messaging; Time; Triage; Woman; World Health Organization; care seeking; depressive symptoms; health communication; improved; innovation; low and middle-income countries; mHealth; mortality risk; neonatal care; neonatal death; neonatal health; neonatal period; neonate; novel; novel strategies; patient engagement; postpartum care; prevent; remote interaction; service engagement; service intervention; stillbirth; uptake

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.

项目摘要/摘要 高影响力的基本新生儿护理做法和干预措施可用于支持新生儿存活，但 在撒哈拉以南非洲，覆盖率仍然是一项挑战，那里的新生儿死亡率高得令人无法接受。坚守 要接受这些做法和救生干预措施，母亲需要了解新生儿护理和 她说，她生病了，并得到了支持，以实施护理。据估计，高达80%的新生儿死亡发生在 由于母亲对婴儿疾病的认识和寻求护理的决定出现延误。双向移动健康 (MHealth)通信策略可使母亲与医护人员(HCW)进行远程交互 并接受实时教育、咨询、鼓励、激励和决策指导支持 新生儿健康。我们假设妊娠晚期和新生儿的双向短信交流 孕期可通过以下方式预防新生儿死亡：(1)支持产妇实施基本新生儿 护理(早期和纯母乳喂养、脐带护理和热疗)，(2)改进对 新生儿危险体征和寻求护理；(3)增加母亲的社会支持和自我效能。 并减少抑郁症状。我们开发了独特的双向短信平台(Mobile Wach) 它将自动群发短信和对话与HCW相结合。我们已将此方法调整为 加强新生儿支持和评估(Mobile Wach-neo)。Mobile Wach neo(MWN)增强了 通过让母亲参与短信通信并提供及时的信息和 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状况。 我们的首要目标是确定移动Wach neo对新生儿死亡率的影响，并了解 这一创新影响新生儿健康的机制。我们建议确定MWN的影响 关于新生儿死亡率、基本新生儿护理、寻求护理和产妇心理健康的前6项 产后几周，双臂随机对照试验。在目标1中，我们将确定移动设备的影响 Wach neo对新生儿死亡率的影响，与没有sms控制的比较。在AIM 2中，我们将考察Mobile的影响 Wach neo关于产妇实施基本新生儿护理和寻求护理的行为。在AIM 3中，我们将 考察Mobile Wach neo对母亲的社会支持、自我效能感和抑郁的影响。最后，我们 将探讨产妇心理健康、实施基本新生儿护理、 通过短信寻求新生儿护理和参与者参与。 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 新生儿并在需要时寻求护理，并有可能为世界作出重大贡献 卫生组织的每一名新生儿行动计划，以结束可预防的新生儿死亡和死产。