Promoting Footwear in Rural Ethiopia

第一阶段的定性数据收集工作已在四个选定的村庄完成。 对程序的定期审查表明，需要对面谈时间表作一些小的改动，以缩短重点小组和结构化面谈的时间。 所有数据均已编译、翻译、回译，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月在行为医学学会发表。 目前正在编写两份基于定性数据的手稿。 简而言之，结果表明，社区成员有不同的信念遗传学的作用，作为一个原因的podoconiosis。 有些人认为遗传是疾病的唯一原因，没有什么可以做，以防止它，其他人认为，保护鞋可以防止足尘病，即使在那些遗传风险，和其他人认为这种疾病是遗传和传染性。接下来的步骤将是开发一种基于教会和社区环境的原型干预，其中包括社区的榜样（例如，教师）谁将教育有关的原因足病，并鼓励一致的鞋类。 我们预计，该小组将在2011年底前开发出干预措施原型。 2012年初将采用快速评估和评价方法进行试点测试，以评估促进鞋类的干预措施的可行性和可接受性。2012年秋季，将开始对最终干预措施进行正式评价。 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的可行性。 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个干预条件之一：（1）关于鞋类的家庭健康教育，（2）公共卫生运动和以家庭为基础的健康教育和（3）公共卫生运动，以家庭为基础的健康教育，包括遗传土壤敏感性的信息。 主要结果是一个从当地非政府组织得到鞋子的索引儿童的一致穿鞋。 进行四项调查评估：（1）基线（2）干预后3个月，（3）干预后10个月和（4）干预后15个月。 共有1 800户家庭参加了调查，完成了基线调查和3个月的跟踪调查。 我们已经完成了两个手稿，现已出版。 初步调查的数据分析将于2013年10月开始。

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 and 3 month follow-up surveys. We have completed 2 manuscripts that are now published. Data analysis on the initial surveys will begin in October 2013.