CHV-NEO: Community-based digital communication to support neonatal health

CHV-NEO：基于社区的数字通信支持新生儿健康

• 批准号: 10393486
• 负责人: Keshet Ronen
• 金额: $ 55.14万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10393486
• 关键词: Access to Information; Address; Adopted; Adoption; Area; Behavioral; Birth; Breast Feeding; Caregivers; Caring; Cessation of life; Child; Client; Clinic; Clinic Visits; Clinical; Clinical Services; Cluster randomized trial; Communication; Communities; Community Health; Consultations; County; County Government; Data; Data Reporting; Education; Effectiveness; Enrollment; Federal Government; Friends; Goals; Health; Health Personnel; Home; Home visitation; Infant; Infant Care; Infrastructure; Intervention; Kenya; Knowledge; Late pregnancy; Life; Maternal Health; Medical; Metadata; Mothers; Motivation; Names; Neonatal; Neonatal Mortality; Nurses; Outcome; Participant; Patient Self-Report; Population Density; Postpartum Period; Postpartum Women; Pregnant Women; Preventive care; Preventive treatment; Primary Health Care; Public Health; Questionnaires; Randomized; Resource-limited setting; Risk; Role; Social support; Standardization; Time; Triage; Visit; Woman; arm; base; care seeking; care systems; cohort; design; digital; digital communication; health care delivery; high risk; human centered design; implementation fidelity; implementation outcomes; improved; innovation; intervention effect; mortality; neonatal death; neonatal health; neonatal outcome; neonatal period; neonate; postpartum care; prevent; preventable death; remote intervention; response; satisfaction; service delivery; skills; standard of care; success; text messaging intervention; theories; uptake; volunteer

PROJECT SUMMARY/ABSTRACT In 2017, 2.5 million children died in the first month of life. An estimated 2 million of these deaths could have been prevented by provision of essential newborn care at home and rapid identification of illness and care-seeking by the caregiver. Community health volunteers (CHVs) are a large cadre of lay health workers whose role is to promote access to preventative care and treatment in resource-limited settings. In Kenya, CHVs conduct monthly home visits to pregnant and postpartum women to provide education and screen for complications. Several counties in Kenya have adopted a digital community health toolkit (dCHT) that supports CHV workflow by tracking clients, managing tasks, and guiding home visits. Standardized CHV home visits expand mothers’ access to information and support, however the concentrated risk of neonatal illness in the first weeks of life and its potential to rapidly deteriorate mean that even monthly home visits leave mothers and neonates in need of on-demand support. Our team developed an interactive SMS text messaging intervention, Mobile WACh Neo (NEO), that connects mothers with healthcare workers remotely in the high-risk period immediately following birth to improve maternal and neonatal health. NEO sends automated, theory-based, actionable daily messages that systematically guide mothers to evaluate neonatal danger signs, and facilitates real-time dialogue with a healthcare worker to triage medical concerns and augment maternal social support. The overarching goal of this proposal is to integrate NEO interactive SMS into the existing digital infrastructure supporting CHV workflow in Western Kenya (dCHT) to enable remote communication by mothers with CHVs between home visits. We propose the following specific aims. Aim 1: Employ a human- centered design approach to develop a NEO interactive SMS module in the dCHT, named CHV-NEO. Aim 2: Evaluate CHV-NEO’s impact on neonatal mortality, clinic visit attendance, and caregiver provision of essential newborn care (cord care, thermal care and initiation of breastfeeding), in a pragmatic cluster-randomized trial. Aim 3: Determine the effect of CHV-NEO on CHV and supervisor workflow, and evaluate determinants of CHV- NEO’s acceptability, adoption and fidelity of use. We hypothesize that this innovative strategy will be successfully implemented within existing CHV infrastructure and will improve provision of at-home preventative care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. CHV-NEO has potential to address a critical gap in efforts to improve neonatal health in resource-limited settings. Completion of these aims will generate a ready-to-scale intervention and rigorous data on both its effectiveness and the enablers of its successful implementation.

项目摘要/摘要 2017年，有250万儿童在生命的第一个月死亡。估计有200万人死亡可能是 通过在家中提供必要的新生儿护理以及快速识别疾病和护理寻求护理，从而阻止 照料者。社区卫生志愿者（CHVS）是一大批外行卫生工作者，其作用是 在资源有限的环境中促进获得预防性护理和治疗的机会。在肯尼亚，CHV每月进行一次 对孕妇和产后妇女进行家庭访问，以提供并发症的教育和屏幕。一些 肯尼亚的县采用了数字社区健康工具包（DCHT），该工具包支持CHV工作流程 跟踪客户，管理任务和指导家庭访问。标准化的CHV家访扩大了母亲的 获取信息和支持，但是在最初几周的新生儿疾病风险 生命及其迅速侦探的潜力意味着即使每月的家庭访问也使母亲和 需要按需支持的新生儿。 我们的团队开发了交互式SMS文本消息干预，移动WACH NEO（NEO），它连接 出生后立即在高风险时期远程有医疗保健工人的母亲，以改善产妇 和新生儿健康。 Neo发送自动化的，基于理论的，可操作的每日消息，系统指导 母亲评估新生儿危险标志，并促进与医疗工作者进行实时对话进行分类 医疗问题和增加母校的社会支持。 该提案的总体目标是将Neo Interactive SMS整合到现有的数字中 支持肯尼亚西部CHV工作流的基础设施（DCHT），以实现远程通信 在家探访之间有CHV的母亲。我们提出以下特定目标。目标1：雇用人类 在DCHT中开发NEO Interactive SMS模块的中心设计方法，名为CHV-NEO。目标2： 评估CHV-NEO对新生儿死亡率，诊所访问的影响以及护理人员提供必需品 在一项务实的聚类随机试验中，新生儿护理（脐带护理，热保健和母乳喂养倡议）。 目标3：确定CHV-NEO对CHV和主管工作流的影响，并评估CHV-的确定词 Neo的可接受性，采用和使用的保真度。我们假设这种创新策略将成功 在现有的CHV基础设施内实施，并将改善在家预防保健的提供，增加 及时将新生儿疾病转诊至设施，并降低新生儿死亡率。 CHV-NEO有可能解决在改善资源有限环境中新生儿健康的努力方面的关键差距。 这些目标的完成将产生现成的干预措施和严格的数据 有效性及其成功实施的推动者。