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Intervention Study to Improve Maternal Handwashing

22. september 2022 oppdatert av: 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.

Studieoversikt

Detaljert beskrivelse

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

Intervensjonell

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Ingen inngripen: 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.
Eksperimentell: Clinic
Handwashing promotion from healthcare workers at antenatal care 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.
Eksperimentell: Clinic + home
Handwashing promotion from healthcare workers at antenatal care clinic and from community health volunteers at home visits.
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.
Eksperimentell: 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.
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Frequency of washing hands with soap at potential pathogen transmission events by mothers of neonate
Tidsramme: 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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Frequency of washing hands with soap at potential pathogen transmission events by caregivers of neonate (other than mother)
Tidsramme: 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
Tidsramme: 1 week post-natal
Observed presence of soap and/or water at a handwashing station
1 week post-natal
Cost-effectiveness
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 2 weeks post-natal
Observed presence of soap and/or water at a handwashing station
2 weeks post-natal

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Forventet)

1. februar 2016

Primær fullføring (Forventet)

1. desember 2016

Studiet fullført (Forventet)

1. august 2018

Datoer for studieregistrering

Først innsendt

13. januar 2016

Først innsendt som oppfylte QC-kriteriene

3. mai 2016

Først lagt ut (Anslag)

6. mai 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

23. september 2022

Siste oppdatering sendt inn som oppfylte QC-kriteriene

22. september 2022

Sist bekreftet

1. oktober 2017

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Andre studie-ID-numre

  • 748140-1
  • ESRC P176/2015 (Annen identifikator: Amref)

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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