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

项目总结： 孕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 它是撒哈拉以南非洲地区可预防的孕产妇死亡的主要原因。尽管事实证明 磺胺二甲嘧啶(间歇预防治疗疟疾)和 复方新诺明预防治疗HIV阴性和HIV阳性孕妇的疟疾 在乌干达，特别是在坎帕拉，坚持服用这些药物仍然是不可接受的。 据报道，对疟疾预防治疗的坚持程度不佳是由于缺乏教育或无知。 关于孕妇的这些干预措施，以及缺乏接触疟疾预防信息的情况 刺激行为改变。此外，由于坎帕拉人口过多和持续短缺 像在许多其他资源不足的环境中一样，卫生工作者通常没有足够的时间 充分教育孕妇关于所有产前护理程序，包括IPTp-SP剂量计划 对于HIV阴性孕妇，重新开始使用复方新诺明；对于HIV阳性孕妇，重新开始使用复方新诺明。致信地址 关于孕妇充分利用疟疾预防治疗的这一关键知识差距，我们 提出实施和传播相结合的干预方法。这将主要涉及 制定名为“预防”的干预措施(使用视频预防孕期疟疾 加强最佳疟疾预防治疗知识和吸收的教育)。 在本R03中，我们将开发、定制和改进视频，以解决疟疾预防治疗知识不足的问题 以客户为中心。预防干预将包括一段10分钟的视频来教育孕妇 关于ANC期间当前的IPTp-SP和复方新诺明的建议，然后是5分钟的问题和 与卫生工作者一起回答问题。我们将对预防干预的可行性进行定性评估， 可接受性和适宜性在城市公共卫生设施中进行的试点研究。获得的数据将是 用于准备R21拨款，我们将在其中严格评估干预措施的有效性 增加IPTp-SP和复方新诺明的最佳摄取。最终，这项进步的研究将导致 开发一种具有成本效益、循证和可扩展的干预措施，最终将减少疟疾- 与产妇和新生儿相关的不良后果。

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.