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Intervention Study to Improve Maternal Handwashing

22 september 2022 bijgewerkt door: State University of New York at Buffalo

Effects of Promoting Handwashing With Soap to Improve Maternal Handwashing Behavior During the Neonatal Period

The purpose of the handwashing intervention trial is to determine whether an interactive, storytelling approach to promoting handwashing with soap by health care workers can improve mothers' handwashing behavior during the first month of her child's life.

Studie Overzicht

Toestand

Ingetrokken

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Infectious diseases, such as umbilical cord infection, pneumonia, and sepsis, are responsible for about a quarter of neonatal deaths. Contaminated hands likely play a role in transmitting pathogens to a neonate, therefore handwashing with soap has the potential to interrupt transmission and improve neonatal health. The primary objective of this study is to develop and evaluate a scalable, cost-effective handwashing promotion program to improve handwashing behavior among mothers and caregivers of neonates. The investigators will first conduct a qualitative study to assess the feasibility and acceptability of a set of interventions. The investigators propose to evaluate the impact of the intervention components, designed as three progressively intense interventions, using a randomized controlled trial with elements of a stepped wedge design. The study will be conducted in Meru County, Kenya, enrolling a total of 800 pregnant women who seek non-emergency antenatal care at a government health facility during a 1 year period. Clinic based health care workers and community health volunteers will disseminate the intervention using an interactive storytelling approach. The focus of the interactions between the health care workers and volunteers and the participant will be on addressing barriers to handwashing through interactive question and answer sessions, rather than a didactic, educational session. The investigators will assess the impact of interventions on observed maternal and caregiver handwashing behavior and estimate the cost effectiveness for each intervention.

Studietype

Ingrijpend

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Kenia
    • Meru County
      • Igembe North And Igembe South Subcounties, Meru County, Kenia
        • Government funded antenatal care clinics

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind
  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Vrouw

Beschrijving

Inclusion Criteria:

  • Pregnant women
  • Seeking routine (non-emergency) care at a participating antenatal care clinic during the study period
  • Between 30 and 36 weeks pregnant (calculated based on last known menstrual period) when they seek antenatal care
  • Live within 30 minutes or 1-2 km one-way travel from the clinic
  • Plan to remain in the study area for at least one month post-partum
  • Willing to allow the field worker to visit her home following the antenatal care visit on the day of enrollment to conduct baseline assessments at the household
  • Sought antenatal care from a qualified medical provider for the first time at or after 28 weeks gestation

Exclusion Criteria:

  • Excluded if another member of their household or compound/homestead enrolled in this study
  • Excluded if enrolled in the formative research for this study

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Geen tussenkomst: Control
Women will receive standard antenatal care but will not receive any additional handwashing promotion, soap, or handwashing device during their enrollment. At the end of data collection, handwashing with soap will be recommended to participants in the control arm and their families.
Experimenteel: Clinic
Handwashing promotion from healthcare workers at antenatal care clinic.
Gedragsmatig: Clinic
Pregnant women will receive handwashing promotion from a trained facility-based health care worker during her regular antenatal visit at a healthcare clinic. To the extent feasible, everyone accompanying the pregnant woman will be invited to take part in the behavior change communication session. The participant will be provided with several bars of soap to take home and she will be encouraged to maintain a designated place for washing hands (with soap and water) at the home. A poster indicating the key events for handwashing with soap will be posted at the clinic and smaller posters will be given to the participant to post in her home. A system will be established to send regular SMS messages to the participant promote handwashing with soap during the neonatal period.
Experimenteel: Clinic + home
Handwashing promotion from healthcare workers at antenatal care clinic and from community health volunteers at home visits.
Gedragsmatig: Clinic + home
Women will receive all components of the clinic-based handwashing promotion in addition to handwashing promotion during 3-4 home visits before their expected delivery date and during the neonatal period from a community health volunteer. All household members present will be invited to join in the session, with emphasis on including all caregivers of the neonate.
Experimenteel: Clinic + home + handwashing device
Handwashing promotion from healthcare workers at antenatal care clinic and from community health volunteers at home visits with provision of one handwashing device.
Gedragsmatig: Clinic + home + handwashing device
Women will receive all components of the clinic + home-based handwashing promotion intervention in addition to one handwashing device (i.e. tap and basin to use as a handwashing station) during the first home visit by the community health volunteer. The community health volunteer will work with the woman and her family to identify the location where the neonate will be most of the time in order to position the handwashing station as close to the neonate as possible.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Frequency of washing hands with soap at potential pathogen transmission events by mothers of neonate
Tijdsspanne: 1 week post-natal
Direct observation of handwashing behavior of mothers at times when pathogens may be transmitted from the mother to the neonate
1 week post-natal
Frequency of washing hands with soap at potential pathogen transmission events by mothers of neonate
Tijdsspanne: 2 weeks post-natal
Direct observation of handwashing behavior of mothers at times when pathogens may be transmitted from the mother to the neonate
2 weeks post-natal

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Frequency of washing hands with soap at potential pathogen transmission events by caregivers of neonate (other than mother)
Tijdsspanne: 1 week post-natal
Direct observation of handwashing behavior of caregivers (other than mother) at times when pathogens may be transmitted from the caregiver to the neonate
1 week post-natal
Number of participants with soap and water present at a handwashing station
Tijdsspanne: 1 week post-natal
Observed presence of soap and/or water at a handwashing station
1 week post-natal
Cost-effectiveness
Tijdsspanne: 1 month post-partum
Approximate cost of the intervention per participant
1 month post-partum
Frequency of washing hands with soap at potential pathogen transmission events by caregivers of neonate (other than mother)
Tijdsspanne: 2 weeks post-natal
Direct observation of handwashing behavior of caregivers (other than mother) at times when pathogens may be transmitted from the caregiver to the neonate
2 weeks post-natal
Number of participants with soap and water present at a handwashing station
Tijdsspanne: 2 weeks post-natal
Observed presence of soap and/or water at a handwashing station
2 weeks post-natal

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

State University of New York at Buffalo

Medewerkers

United States Agency for International Development (USAID)
Save the Children
Unilever R&D

Onderzoekers

  • Hoofdonderzoeker: Pavani K. Ram, M.D., State University of New York at Buffalo

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Verwacht)

1 februari 2016

Primaire voltooiing (Verwacht)

1 december 2016

Studie voltooiing (Verwacht)

1 augustus 2018

Studieregistratiedata

Eerst ingediend

13 januari 2016

Eerst ingediend dat voldeed aan de QC-criteria

3 mei 2016

Eerst geplaatst (Schatting)

6 mei 2016

Updates van studierecords

Laatste update geplaatst (Werkelijk)

23 september 2022

Laatste update ingediend die voldeed aan QC-criteria

22 september 2022

Laatst geverifieerd

1 oktober 2017

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • 748140-1
  • ESRC P176/2015 (Andere identificatie: Amref)

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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