Promoting Footwear in Rural Ethiopia

在埃塞俄比亚农村推广鞋类

• 批准号: 8948385
• 负责人: Laura Koehly
• 金额: $ 33.49万
• 依托单位: NATIONAL HUMAN GENOME RESEARCH INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8948385
• 关键词: Adopted; Affect; Age; Appearance; Back; Baseline Surveys; Behavioral Medicine; Belief; CD36 gene; Case Study; Child; Church; Clinic; Collaborations; Communities; Computer software; Consent; Data; Data Collection; Development; Disease; Education; Educational Intervention; Effectiveness of Interventions; Enrollment; Ethiopia; Evaluation; Evidence based intervention; Exposure to; Faculty; Family; Focus Groups; Genetic; Genetic Risk; Group Structure; Habits; Health Campaign; Health education; Household; Individual; Inherited; Intervention; Intervention Trial; Interview; Joints; Learning Module; Length; Life; Manuscripts; Methods; National Human Genome Research Institute; Neighborhoods; Parents; Participant; Patient Self-Report; Patients; Perception; Phase; Preparation; Prevention; Procedures; Public Health; Qualitative Methods; Randomized; Reporting; Research; Research Personnel; Research Training; Risk; Role; Rural; Sampling; Schedule; Shoes; Silicon Dioxide; Societies; Soil; Structure; Surveys; Testing; Translating; United States National Institutes of Health; Universities; Visual; base; clinical research site; community intervention; design; enhancing factor; evidence base; experience; falls; follow-up; foot; forging; group intervention; high risk; indexing; member; nanoparticle; prevent; primary outcome; programs; prototype; role model; social stigma; teacher; treatment as usual

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, 3 and 12 month follow-up surveys. The study is now completed and analyses are underway to evaluate trial results. Two manuscripts are nearly completed based on analyses of the baseline surveys. Analyses thus far indicate that affected familiesbeliefs that podoconiosis is inherited are associated with perceptions of decreased value of shoe wearing. Families affected by podoconiosis perceive themselves to be at lower risk for the condition than unaffected families. This may be due to the efforts of a local NGO to educate affected families that podoconiosis is preventable. Unaffected households have not received this education. Additionally, study participants from neighboring households reported having enacted stigma on families affected by the conditions. Similarly, participants affected by the condition reported having experienced stigma. Lastly, reported stigma levels differed significantly across the six communities.

第1阶段的定性数据收集已在四个选定的村庄中完成。 对程序的定期审查表明，在访谈时间表中需要进行一些小的更改，以缩短焦点小组和结构化访谈的时间。 所有数据均已编译，翻译，反翻译，并通过NIH团队使用N-Vivo软件进行了分析。最初的发现于2011年4月在行为医学协会中提出。两个基于定性数据的手稿正在准备。 简而言之，结果表明，社区成员对遗传学作为造成遗传学的作用有多种信念。 有些人认为遗传学是疾病的唯一原因，而无需采取任何措施来防止这种疾病，另一些人则认为保护性鞋类即使在具有遗传风险的鞋类中也可以预防足球病，而另一些人则认为该疾病既是遗传性又具有感染性。下一步将是开发一种原型干预措施，该干预措施基于教堂和社区环境，涉及社区的榜样（例如，教师），他们将教育有关足球病的原因并鼓励始终如一的鞋类。 我们预计，在2011年结束时，团队将开发原型干预措施。使用快速评估和评估方法进行试点测试，以评估干预措施促进鞋类的可行性和可接受性。 2012年秋季将对最终干预进行正式评估。 第二轮试验活动于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。已将六个社区分配给了三种干预条件之一：（1）关于鞋类，（2）公共卫生运动和家庭健康教育以及（3）公共卫生运动，家庭健康教育，其中包括有关遗产土壤敏感性的信息。主要结果是索引儿童从当地的非政府组织那里获得鞋子的一致鞋子。进行了四项调查评估：（1）干预后3个月基线（2）干预后3个月，（3）10个MOS和（4）15 MOS。总共招募了1800户家庭，完成了基线，3个月和12个月的随访调查。 该研究现已完成，正在进行分析以评估试验结果。 根据基线调查的分析，几乎完成了两个手稿。 迄今为止的分析表明，受影响的家庭信仰遗传的遗传与对鞋子佩戴的价值下降的看法有关。 受到足球症影响的家庭认为，与未受影响的家庭相比，自己的病情风险较低。 这可能是由于当地非政府组织为教育受影响的家庭的努力，可以预防足球病。 未受影响的家庭尚未接受这种教育。 此外，来自邻近家庭的研究参与者报告说，对受条件影响的家庭制定了污名。 同样，受该病影响的参与者报告说经历了污名。 最后，在六个社区中，报道的污名水平差异很大。