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.

项目概要背景：产前护理 (ANC) 是预防孕产妇和围产期发病率和死亡率的支柱但经测试，乌干达这些服务的利用率仍然很低。短信服务（SMS）和其他移动医疗（mHealth）位居世界前列。已提出干预措施，以促进积极的健康行为并加强知情决策此类干预措施无法改善围产期妇女的结局。知识转移和加强获得社会支持的机会然而，对移动医疗的评估很少。撒哈拉以南非洲地区开展了改善孕产妇护理的干预措施，那里的社会和推动成功干预措施的背景因素各不相同，此类干预措施对公共卫生的影响是不同的很少有研究还检验了基于理论的方法来制定干预措施。最大化最终用户的可接受性候选人：我是姆巴拉拉科技大学的讲师。受过流行病学、研究方法和数据分析方面的基本培训，发表了 12 篇出版物（其中 6 篇是第一我正在申请这个 K43 奖项，以确保在开发和采用低技术方面获得培训和指导。成本低、针对具体情况的新颖干预措施，以改善资源匮乏环境中的母婴健康。为了实现这一目标，我已经确定了一支具有生殖健康专业知识的强大指导团队（Drs. Matthews & Mugyenyi）、移动医疗、方法论和流行病学（Siedner 博士）、定性方法（Siedner 博士） Ware）、职业发展和项目实施（Obua 教授）。在确定的培训重点领域中的多学科导师和正式教学将使我能够获得必要的技能和实践经验来告知、设计、采用和测试新颖的干预策略改善资源匮乏环境中的母婴健康培训：我需要额外的经验和指导。以及以下方面的培训：1) 获取最终用户反馈以制定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度，以及 3) 实验性研究设计评估对孕妇的干预措施研究：我建议 1) 进行定性研究。研究旨在确定女性参与 ANC 的障碍和促进因素以及促进健康的决策设施，并描述他们对基于移动医疗的社会支持干预措施的偏好；2) 制定和实施根据这些定性结果迭代评估干预措施；3）对干预措施进行试点测试以评估提高 ANC 利用率和技术分娩的可行性、可接受性和初步效果。结果将使我能够在该奖项的第 5 年撰写 R01 申请，以评估与常规护理相比，基于移动医疗的社会支持干预措施可改善孕产妇和儿童健康我的最终目标是成为一名独立调查员，拥有以下方面的专业知识。制定和评估基于文化的解决方案，以降低孕产妇死亡率。