Patient-centered mobile technology interventions to improve maternal health in Uganda

以患者为中心的移动技术干预措施改善乌干达的孕产妇健康

基本信息

批准号：
10112320
负责人：
Esther Cathyln Atukunda
金额：
$ 10.84万
依托单位：
MBARARA UNIVERSITY/SCIENCE/ TECHNOLOGY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-16 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10112320
关键词：
Adopted Adoption Africa South of the Sahara Age Anxiety Area Award Birth Caring Categories Cessation of life Child Child Mortality Communication Country Data Data Analyses Decision Making Detection Development Emotional Enabling Factors Ensure Epidemiologic Methods Epidemiology Evaluation Feedback Fostering Gestational Age Goals Health Services Accessibility Health Status Health Technology Health behavior Health care facility High Risk Woman Home Income Intervention Interview Knowledge Manuscripts Maternal Health Maternal Mortality Maternal and Child Health Mediating Mental Depression Mentors Mentorship Methodology Methods Modeling Outcome Participant Pattern Perinatal Perinatal mortality demographics Positioning Attribute Predisposing Factor Pregnancy Pregnant Women Public Health Publications Qualitative Methods Randomized Recommendation Reproductive Health Research Research Design Research Methodology Research Personnel Research Support Resources Rural Science Secure Services Social Network Social support Technology Testing Text Messaging Training Transportation Uganda United States National Institutes of Health Universities Vaccination Visit Woman Work Writing acceptability and feasibility antenatal care base care systems career career development comorbidity comparison intervention contextual factors coping mechanism cost design effectiveness evaluation epidemiology study experience experimental study family structure food insecurity health belief health care service utilization health seeking behavior improved improved outcome intervention effect lecturer low and middle-income countries mHealth maternal morbidity mobile computing multidisciplinary novel novel strategies patient oriented perinatal morbidity perinatal outcomes perinatal period preference prenatal prevent primary outcome professor public health relevance routine care secondary outcome service delivery service intervention service utilization skills social social factors socioeconomics standard of care successful intervention theories therapy development treatment arm

项目摘要

PROJECT SUMMARY Background: Antenatal care (ANC) is a mainstay of preventing maternal and perinatal morbidity and mortality but utilization of these services in Uganda remains low. Consequently, maternal and perinatal mortality rates are among the highest in the world. Short message service (SMS) and other mobile health (mHealth) interventions have been proposed to promote positive health behavior and strengthen informed decision- making for women in the perinatal period. Such interventions are hypothesized to improve outcomes through knowledge transfer and strengthened access to social support. However, few evaluations of mHealth interventions to improve maternal care have been conducted in sub-Saharan Africa, where social and contextual factors that drive successful interventions differ, and the public health impact of such interventions is likely to be great. Few studies have also examined theory-informed methods to develop interventions to maximize end-user acceptability. Candidate: I am a lecturer at Mbarara University of Science and Technology with basic training in epidemiology, research methods and data analysis, resulting in 12 publications (6 first- authored). I am applying for this K43 award to secure training and mentorship in developing and adopting low cost, context-specific novel interventions to improve maternal-child health in low resource settings. Mentoring: To accomplish this goal, I have identified a strong mentorship team with expertise in reproductive health (Drs. Matthews & Mugyenyi), mHealth, methodology and epidemiology (Dr. Siedner), qualitative methods (Dr. Ware), career development and project implementation (Professor. Obua). Leveraging this strong team of multidisciplinary mentors and formal didactics in the identified focus areas of training will enable me to obtain requisite skills and hands-on experience to inform, design, adopt and test novel intervention strategies to improve maternal-child health in low resource settings. Training: I require additional experience, mentorship and training in: 1) qualitative methods to elicit end-user feedback for development of interventions, 2) technology acceptance for patient-centered intervention development and evaluation, and 3) experimental study designs to evaluate interventions in pregnant women. Research: I propose to 1) conduct a qualitative study to identify barriers and facilitators to women’s engagement in ANC, decisions to deliver in health facilities, and characterize their preferences for an mHealth-based, social support intervention; 2) develop and iteratively evaluate the intervention based on these qualitative results; 3) pilot test the intervention to assess feasibility, acceptability and preliminary efficacy to improve ANC utilization and skilled births. This training and results will position me to write an R01 application in year 5 of this award to evaluate the effectiveness of an mHealth-based social support intervention compared to routine care to improve maternal and child health outcomes in Uganda. My ultimate goal is to become an independent investigator, with expertise in development and evaluation of culturally informed solutions to reduce maternal-child mortality.

项目摘要背景：产前护理（ANC）是预防母乳和围产期发病率和死亡率的主要支柱但是在乌干达对这些服务的利用仍然很低。因此，母亲和围产期死亡率是世界上最高的。简短消息服务（SMS）和其他移动健康（MHealth）已经提出了干预措施来促进积极的健康行为，并加强了知情的决策 - 在围产期制造女性。假设此类干预措施通过知识转移并加强获得社会支持的机会。但是，对MHealth的评估很少改善孕产妇护理的干预措施已在撒哈拉以南非洲进行，社会和推动成功干预措施的上下文因素，这种干预措施的公共卫生影响是可能很棒。很少有研究还研究了理论信息的方法，以开发干预措施最大化最终用户可接受性。候选人：我是姆巴拉拉科学技术大学的讲师通过流行病学，研究方法和数据分析的基础培训，有12个出版物（6个首先撰写）。我正在申请这一K43奖，以确保发展和采用较低的培训和精神训练成本，特定于上下文的新干预措施，以改善低资源环境中的母子健康。指导：为了实现这一目标，我已经确定了一个具有复制健康专业知识的强大心态（Drs。 Matthews＆Mugyenyi），MHealth，方法论和流行病学（Siedner博士），定性方法（博士 Ware），职业发展和项目实施（OBUA教授）。利用这支强大的团队在确定的培训重点领域中的多学科导师和形式教学法将使我能够获得必要的技能和动手经验，以告知，设计，采用和测试新颖的干预策略在低资源环境中改善产妇健康。培训：我需要额外的经验，精神训练和培训：1）引起最终用户反馈以开发干预措施的定性方法，2）以患者为中心的干预开发和评估的技术接受，以及3）实验研究设计以评估孕妇的干预措施。研究：我建议1）进行定性研究以识别妇女参与ANC的障碍和促进者的障碍和促进者设施，并描述他们对基于MHealth的社会支持干预措施的偏好； 2）发展和迭代根据这些定性结果评估干预措施； 3）试点测试干预措施以评估可行性，可接受性和初步效率，以提高ANC利用率和熟练的出生。这个培训和结果将使我在本奖项的第五年撰写R01申请，以评估与常规护理相比，基于MHealth的社会支持干预措施以改善产妇和儿童健康乌干达的成果。我的最终目标是成为一名独立调查员，并具有专业知识对文化知识的解决方案的开发和评估，以降低产妇死亡率。