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

一种新的基于视频的干预措施，以增强疟疾预防治疗的最佳吸收：妊娠期疟疾预防健康教育方法的试点研究

• 批准号: 10641780
• 负责人: Rita Nakalega
• 金额: $ 5.4万
• 依托单位: MU-JHU CARE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-09 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10641780
• 关键词: Address; Adherence; Adverse event; Affect; Africa South of the Sahara; Age; Anemia; Area; Behavioral; Capital; Caring; Client; Clinic; Cotrimoxazole; Country; Data; Developing Countries; Development; Dissemination and Implementation; Dose; Education; Educational Intervention; Effectiveness of Interventions; Exposure to; First Pregnancy Trimester; Focus Groups; Goals; Grant; HIV; HIV Seronegativity; HIV Seropositivity; Health; Health Benefit; Health Personnel; Health care facility; Health education; Intervention; Interview; Knowledge; Low Birth Weight Infant; Malaria; Malaria prevention; Maternal Mortality; Names; Neonatal; Outcome; Parasitemia; Pharmaceutical Preparations; Pilot Projects; Pregnancy; Pregnant Women; Prevalence; Prevention strategy; Prevention therapy; Preventive therapy; Preventive treatment; Procedures; Process; Production; Prophylactic treatment; Public Health; Pyrimethamine; Recommendation; Reporting; Resource-limited setting; Sampling; Schedule; Television; Time; Uganda; Woman; adverse outcome; antenatal care; behavior change; co-infection; cost effective; design; effectiveness evaluation; efficacious intervention; evidence base; fetal; health training; improved; literacy; novel; overpopulation; placental malaria; posters; prevent; preventive intervention; reproductive; therapy development; uptake; urban public health

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.

项目概要： 妊娠期疟疾仍然是一个主要的公共卫生问题，与母婴不良相关 尽管已被证实，但它仍然是撒哈拉以南非洲地区可预防的孕产妇死亡的主要原因。 磺胺多辛-乙胺嘧啶（疟疾间歇性预防治疗_IPTp_SP）的功效和 复方新诺明作为艾滋病毒阴性和艾滋病毒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。 据报道，由于缺乏教育或无知，疟疾预防治疗的依从性不佳 关于孕妇的这些干预措施，以及缺乏了解疟疾预防信息的情况 此外，由于坎帕拉人口过剩和劳动力持续短缺，刺激了行为改变。 与许多其他资源匮乏的环境一样，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 HIV 阴性孕妇和 HIV 阳性孕妇重新开始使用复方新诺明 解决这一问题。 对于孕妇充分利用疟疾预防疗法的这一关键知识差距，我们 提出实施和传播干预相结合的方法。 开发名为“PreVent”的干预措施（使用基于视频的妊娠期疟疾预防） 教育以增强最佳疟疾预防治疗知识和吸收）。 在此 R03 中，我们将开发、定制和完善视频，以解决疟疾预防治疗知识缺陷 以以客户为中心的方式进行 PreVent 干预，其中包括一段 10 分钟的视频来教育孕妇。 关于 ANC 期间当前的 IPTp-SP 和复方新诺明建议，然后是 5 分钟的问题和 我们将与卫生工作者进行回答会议，定性评估 PreVent 干预措施的可行性， 在城市公共卫生设施中进行试点研究的可接受性和适当性。 用于准备 R21 拨款，其中我们将严格评估干预措施的有效性 最终，这项研究和后续研究将导致 IPTp-SP 和复方新诺明的最佳摄取。 制定具有成本效益、基于证据且可扩展的干预措施，最终将减少疟疾 相关的孕产妇和新生儿不良后果。