A Cluster Randomised Trial of Effectiveness of Educational Intervention in Primary Health Care on Early Childhood Caries

2009 ◽  
Vol 43 (2) ◽  
pp. 110-118 ◽  
Author(s):  
S.Z. Mohebbi ◽  
J.I. Virtanen ◽  
M. Vahid-Golpayegani ◽  
M.M. Vehkalahti
Keyword(s):  
Health Care ◽  
Early Childhood ◽  
Primary Health Care ◽  
Educational Intervention ◽  
Early Childhood Caries ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Primary Health ◽  
Cluster Randomised ◽  
Childhood Caries

scholarly journals Feasibility of alcohol screening and brief intervention in primary health care in Kazakhstan: study protocol of a pilot cluster randomised trial

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Bernd Schulte ◽  
Amy O’Donnell ◽  
Harald Lahusen ◽  
Christina Lindemann ◽  
Mariya Prilutskaya ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Brief Intervention ◽  
Randomised Trial ◽  
Alcohol Screening ◽  
Cluster Randomised Trial ◽  
Control Group ◽  
Screening And Brief Intervention ◽  
Primary Health ◽  
Cluster Randomised

Abstract Background Identifying and addressing heavy drinking represents a major public health priority worldwide. Whilst the majority of alcohol screening and brief intervention (ASBI) research has been conducted in western, high-income countries, evidence is growing that ASBI can also impact positively on heavy drinkers in low- and middle-income country populations. This mixed methods study aims to assess the feasibility of conducting a fully randomised controlled trial of the effectiveness of ASBI in primary care in Kazakhstan and explore the feasibility and acceptability of implementing ASBI in this setting from patients’ and physicians’ perspectives. Methods Six primary health care units in the region of Pavlodar will be cluster randomised to either an intervention (WHO manualised 5 min alcohol brief intervention plus alcohol leaflet) or control group (simple feedback plus alcohol leaflet). Primary feasibility measures will be rates of participation at baseline and retention of eligible patients at the 3-month follow-up point. Patient/physician questionnaires and physician focus groups will assess additional dimensions of feasibility, as well as acceptability, according to the RE-AIM framework: Reach (rates of eligible patients screened/received advice); Effectiveness (change in AUDIT-C score); Adoption (rate/representativeness of participating physicians); Implementation (quality of ASBI/barriers and facilitators to delivery); and Maintenance (potential sustainability of intervention). Discussion This is the first trial of the feasibility and acceptability of ASBI in Kazakhstan. As the planning and assessment of implementation determinants is based on the RE-AIM framework, the project outcomes will be relevant for the future development, tailoring and implementation of ASBI in Kazakhstan. Trial registration DRKS, DRKS00015882, Registered 17 December 2018.

Secondary prevention of stroke by a primary health care approach: An open-label cluster randomised trial

2021 ◽  
Vol 84 ◽  
pp. 53-59
Author(s):  
P.N. Sylaja ◽  
Gurpreet Singh ◽  
S. Sivasambath ◽  
K. Arun ◽  
Panniyammakal Jeemon ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Secondary Prevention ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Open Label ◽  
Primary Health ◽  
Cluster Randomised ◽  
Care Approach

scholarly journals A community-based service enhancement model of training and employing Ear Health Facilitators to address the crisis in ear and hearing health of Aboriginal children in the Northern Territory, the Hearing for Learning Initiative (the HfLI): study protocol for a stepped-wedge cluster randomised trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelvin Kong ◽  
Alan Cass ◽  
Amanda Jane Leach ◽  
Peter Stanley Morris ◽  
Amy Kimber ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Service ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Stepped Wedge ◽  
Primary Health ◽  
Cluster Randomised ◽  
Hearing Health ◽  
Aboriginal Children

Abstract Background Almost all Aboriginal children in remote communities have persistent bilateral otitis media affecting hearing and learning throughout early childhood and school years, with consequences for social and educational outcomes, and later employment opportunities. Current primary health care and specialist services do not have the resources to meet the complex needs of these children. Method/design This stepped-wedge cluster randomised trial will allocate 18 communities to one of five 6-monthly intervention start dates. Stratification will be by region and population size. The intervention (Hearing for Learning Initiative, HfLI) consists of six 20-h weeks of training (delivered over 3 months) that includes Certificate II in Aboriginal Primary Health Care (3 modules) and competencies in ear and hearing data collection (otoscopy, tympanometry and hearScreen), plus 3 weeks of assisted integration into the health service, then part-time employment as Ear Health Facilitators to the end of the trial. Unblinding will occur 6 months prior to each allocated start date, to allow Community Reference Groups to be involved in co-design of the HfLI implementation in their community. Relevant health service data will be extracted 6-monthly from all 18 communities. The primary outcome is the difference in proportion of children (0 to 16 years of age) who have at least one ear assessment (diagnosis) documented in their medical record within each 6-month period, compared to control periods (no HfLI). Secondary outcomes include data on sustainability, adherence to evidence-based clinical guidelines for otitis media, including follow-up and specialist referrals, and school attendance. Structured interviews with staff working in health and education services, Ear Health Trainees, Ear Health Facilitators and families will assess process outcomes and the HfLI broader impact. Discussion The impact of training and employment of Ear Health Facilitators on service enhancement will inform the health, education and employment sectors about effectiveness of skills and job creation that empowers community members to contribute to addressing issues of local importance, in this instance ear and hearing health of children. Trial registration ClinicalTrials.gov NCT03916029. Registered on 16 April 2019.

Promotion of Oral Health Care in Infants - A Preventive Strategy to Reduce the Burden of Early Childhood Caries

2020 ◽  
Vol 4 (5) ◽  
pp. 18-22
Author(s):  
Subhathira Rajasekaran ◽  
Sham S Bhat ◽  
Vidya Bhat ◽  
Sundeep Hegde K ◽  
Neha Thilak ◽  
...  
Keyword(s):  
Health Care ◽  
Early Childhood ◽  
Oral Health ◽  
Early Childhood Caries ◽  
Oral Health Care ◽  
Preventive Strategy ◽  
Childhood Caries

scholarly journals An ecological study on the association between universal health service coverage index, health expenditures, and early childhood caries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morenike Oluwatoyin Folayan ◽  
◽  
Maha El Tantawi ◽  
Jorma I. Virtanen ◽  
Carlos Alberto Feldens ◽  
...  
Keyword(s):  
Health Care ◽  
Early Childhood ◽  
Linear Regression ◽  
Health Expenditure ◽  
Early Childhood Caries ◽  
Global Prevalence ◽  
Independent Variable ◽  
Service Coverage ◽  
Universal Health ◽  
Childhood Caries

Abstract Background Universal health care (UHC) may assist families whose children are most prone to early childhood caries (ECC) in accessing dental treatment and prevention. The purpose of this study was to determine the association between UHC, health expenditure and the global prevalence of ECC. Methods Health expenditure as percentage of gross domestic product, UHC service coverage index, and the percentage of 3–5-year-old children with ECC were compared among countries with various income levels using one-way analysis of variance (ANOVA). Three linear regression models were developed, and each was adjusted for the country income level with the prevalence of ECC in 3–5-year-old children being the dependent variable. In model 1, UHC service coverage index was the independent variable whereas in model 2, the independent variable was the health expenditure as percentage of GDP. Model 3 included both independent variables together. Regression coefficients (B), 95% confidence intervals (CIs), P values, and partial eta squared (ƞ2) as measure of effect size were calculated. Results Linear regression including both independent factors revealed that health expenditure as percentage of GDP (P < 0.0001) was significantly associated with the percentage of ECC in 3–5-year-old children while UHC service coverage index was not significantly associated with the prevalence of ECC (P = 0.05). Every 1% increase in GDP allocated to health expenditure was associated with a 3.7% lower percentage of children with ECC (B = − 3.71, 95% CI: − 5.51, − 1.91). UHC service coverage index was not associated with the percentage of children with ECC (B = 0.61, 95% CI: − 0.01, 1.23). The impact of health expenditure on the prevalence of ECC was stronger than that of UHC coverage on the prevalence of ECC (ƞ2 = 0.18 vs. 0.05). Conclusions Higher expenditure on health care may be associated with lower prevalence of ECC and may be a more viable approach to reducing early childhood oral health disparities than UHC alone. The findings suggest that currently, UHC is weakly associated with lower global prevalence of ECC.

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