A Novel Video-Based Intervention to Enhance Optimal Uptake of Malaria Preventive Therapy: A Pilot Study of a Health Educational Approach to Malaria Prevention during Pregnancy

项目概要： 妊娠期疟疾仍然是一个主要的公共卫生问题，与孕产妇和胎儿的不良反应有关。 在撒哈拉以南非洲，这是可预防的孕产妇死亡的主要原因。尽管事实证明 磺胺嘧啶-乙胺嘧啶（疟疾间歇性预防治疗_ IPTp_SP）和 复方新诺明用于HIV阴性和HIV阳性孕妇的疟疾预防治疗 在乌干达，特别是在坎帕拉，坚持使用这些药物仍然是不可接受的。 据报告，由于缺乏教育或无知，对疟疾预防治疗的坚持程度不够理想 关于孕妇中的这些干预措施，以及缺乏接触疟疾预防信息， 刺激行为改变。此外，由于坎帕拉人口过多， 卫生工作者像在许多其他低资源环境中一样，卫生工作者往往没有足够的时间 对孕妇进行有关所有产前护理程序的充分教育，包括IPTp-SP给药方案 对HIV阴性孕妇重新开始服用复方新诺明。解决 在孕妇充分利用疟疾预防疗法方面存在着严重的知识差距， 提出一种实施和传播相结合的干预办法。这将主要涉及 制定名为“PreVent”的干预措施（使用基于视频的 教育以提高最佳疟疾预防治疗知识和采用率）。 在本R 03中，我们将开发、定制和完善视频，以解决疟疾预防治疗知识不足的问题 以客户为中心。PreVent干预将包括一个10分钟的视频，以教育孕妇 关于ANC期间当前IPTP-SP和复方新诺明的建议，随后是5分钟的问题， 与卫生工作者的对话。我们将定性评估预防干预的可行性， 可接受性和适当性，在城市公共卫生机构进行试点研究。获得的数据将是 用于准备R21赠款，我们将严格评估干预措施的有效性， 增加最佳IPTP-SP和复方新诺明吸收。最终，这项研究和渐进的研究将导致 制定具有成本效益、循证和可扩展的干预措施，最终减少疟疾- 相关的孕产妇和新生儿不良后果。

PROJECT SUMMARY: Malaria in pregnancy remains a major public health concern that is associated with maternal and fetal adverse events and is the leading cause of preventable maternal deaths in sub-Saharan Africa. Despite the proven efficacy of Sulphadoxine-pyrimethamine (intermittent prophylaxis treatment of malaria_ IPTp_SP) and cotrimoxazole as prophylaxis treatment of malaria in HIV negative and HIV positive pregnant women respectively, adherence to these medications remains unacceptable in Uganda especially in Kampala. Sub-optimal adherence to malaria preventive therapy is reported to be due to lack of education or ignorance about these interventions among pregnant women, and the lack of exposure to malaria prevention messages to stimulate behavioral change. Additionally, due to overpopulation in Kampala and the persistent shortage of health workers like in many other low resource settings, health workers often don’t have adequate time to sufficiently educate pregnant women about all Antenatal care procedures including the IPTp-SP dosing schedule for HIV negative pregnant women and re initiation to cotrimoxazole for HIV positive pregnant women. To address this critical knowledge gap on adequate malaria preventive therapy utilization among pregnant women, we propose a combined implementation and dissemination interventional approach. This will primarily involve the development of the intervention named “PreVent” (PREvention of malaria in pregnancy using Video-based Education to eNhance opTimal malaria preventive therapy knowledge and uptake). In this R03, we will develop, tailor, and refine the video to address malaria preventive therapy knowledge deficits in a client-centered manner. The PreVent intervention will involve a 10 min video to educate pregnant women about current IPTp-SP and cotrimoxazole recommendations during ANC followed by a 5 min question and answer session with a health worker. We will qualitatively assess the PreVent intervention for feasibility, acceptability, and appropriateness using a pilot study in an urban public health facility. The obtained data will be used to prepare for an R21 grant in which we will rigorously evaluate the effectiveness of the intervention in increasing optimal IPTp-SP and cotrimoxazole uptake. Ultimately, this and progressive studies will result in the development of a cost-effective, evidence-based, and scalable intervention that will eventually reduce malaria- related maternal and neonatal adverse outcomes.