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

基本信息

批准号：
10563193
负责人：
Keshet Ronen
金额：
$ 54.56万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
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/10563193
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 Cluster randomized trial Communication Communities Community Health Consultations County County Government Data Data Reporting Deterioration 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 Recommendation Resource-limited setting Risk Role Services Social support Standardization Time Triage Visit Woman arm care seeking 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

项目摘要

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.

项目概要/摘要 2017 年，有 250 万名儿童在出生后第一个月内死亡，其中估计有 200 万人是因儿童死亡而死亡。通过在家中提供基本的新生儿护理以及快速识别疾病和寻求护理来预防社区卫生志愿者 (CHV) 是一大批非专业卫生工作者，其职责是：在肯尼亚，CHV 每月开展一次活动，促进资源有限地区获得预防性护理和治疗。对孕妇和产后妇女进行家访，以提供教育和筛查并发症。肯尼亚各县采用了数字社区健康工具包 (dCHT)，通过以下方式支持 CHV 工作流程：跟踪客户、管理任务和指导家访标准化 CHV 家访扩大了母亲的工作范围。获得信息和支持，但是新生儿疾病的风险集中在出生后的头几周生活及其迅速恶化的可能性意味着，即使每月一次的家访也会让母亲和需要按需支持的新生儿。我们的团队开发了一种交互式短信干预措施 Mobile WACh Neo (NEO)，它可以连接在产后高危期，有医护人员远程陪伴的母亲可以改善产妇状况 NEO 发送自动化的、基于理论的、可操作的日常信息，系统地指导。母亲评估新生儿危险迹象，并促进与医护人员的实时对话以进行分类医疗问题和增强的产妇社会支持。该提案的总体目标是将 NEO 交互式短信集成到现有的数字化支持肯尼亚西部 CHV 工作流程的基础设施 (dCHT)，通过以下方式实现远程通信我们提出以下具体目标：雇用一名人力。在dCHT中开发NEO交互式短信模块的中心设计方法，命名为CHV-NEO Aim 2：评估 CHV-NEO 对新生儿死亡率、门诊就诊率和护理人员提供基本必需品的影响一项实用的整群随机试验中的新生儿护理（脐带护理、热护理和开始母乳喂养）。目标 3：确定 CHV-NEO 对 CHV 和主管工作流程的影响，并评估 CHV-NEO 的决定因素 NEO 的可接受性、采用度和使用保真度我们相信这一创新策略将会成功。在现有 CHV 基础设施内实施，将改善家庭预防性护理的提供，增加及时将新生儿疾病转诊至机构，降低新生儿死亡率。 CHV-NEO 有潜力弥补资源有限环境中改善新生儿健康的关键差距。完成这些目标将产生可随时规模化的干预措施以及关于其两个方面的严格数据。有效性及其成功实施的推动因素。