scholarly journals The Effectiveness of Free Face Mask Distribution on Use of Face Masks. A Cluster Randomised Trial in Stovner District of Oslo, Norway

Author(s):  
Atle Fretheim ◽  
Ingeborg Hess Elgersma ◽  
Fredrik Aaeng Kristiansen ◽  
Caroline Rømming Varmbo ◽  
Miriam Kristine Salame Olsbø ◽  
...  

Face masks are recommended as a means of reducing the spread of COVID-19, but there are practically no studies of interventions to increase face mask use. Over three weeks, nine grocery stores in the Stovner District of Oslo were randomly selected each day to have distribution of free face masks outside their entrance. Free face mask distribution increased the proportion of customers wearing a mask by 6.0 percentage points (adjusted, 95% CI 3.5–8.5). Mean mask usage was 91.7% in the control group and 97.1% in the treatment group (pooled SD 5.3%). Practically all those who wore masks had both nose and mouth covered. We conclude that free distribution of face masks increased their use. Similar trials can be conducted within a short period of time.

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016585 ◽  
Author(s):  
Kirsti Riiser ◽  
Sølvi Helseth ◽  
Hanna Ellingsen ◽  
Bjørg Fallang ◽  
Knut Løndal

IntroductionInterventions delivered in after-school programmes (ASPs) have the potential to become a means of ensuring adequate physical activity among schoolchildren. This requires a motivational climate, allowing for self-determined play. If trained, ASP staff may represent a valuable resource for supporting such play. Increasing knowledge and supportive skills among ASP staff may also potentially increase their motivation for work. The purpose of this article is to describe the development of the ‘Active Play in ASP’ intervention, which aims to promote physical activity among first graders attending ASP, and to present a protocol for a matched-pair cluster-randomised trial to evaluate the intervention.Methods and analysisInformed by experiences from practice, evidence-based knowledge and theory, the intervention was developed in a stepwise process including focus group meetings and a small-scale pilot test. The intervention contains a course programme for ASP staff to increase their skills in how to support physical activity through play. In a cluster randomised controlled trial, the ASPs will be matched and randomly allocated to receive the 7-month intervention or to a control group. Outcomes will be assessed at baseline, after 7 and 19 months. First graders attending the ASPs included are eligible. The primary outcome will be accelerometer-determined minutes in moderate to vigorous physical activity in the ASP. The study uses a mixed methods approach including observations and interviews to provide rich descriptions of the concept of children's physical activity in ASP. Moreover, the trial will assess whether the ASP staff benefits from participation in the intervention in terms of increased work motivation. Lastly, process evaluations of programme fidelity, satisfaction and suggestions on improvement will be performed.Ethics and disseminationThe study is approved by the Data Protection Official for Research (reference no 46008). Results will be presented in conferences and peer-reviewed journals.Trial registration numberClinical Trials (NCT02954614), pre-results.


Author(s):  
Allen Nsangi ◽  
Daniel Semakula ◽  
Andrew David Oxman ◽  
Astrid Austvoll- Dalghren ◽  
Matt Oxman ◽  
...  

Abstract Introduction We evaluated an intervention designed to teach 10 to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report here on outcomes measured one year after the intervention. Methods In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year-five children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books, and a teachers’ guide). The primary outcome, measured at the end of the school term and again after one year, was the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. Results We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n=60, 76 teachers and 6383 children) or control group (n=60, 67 teachers and 4430 children). After one year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared to 53.0% for the control schools (adjusted mean difference 16.7%, 95% CI 13.9 to 19.5; p<0·00001). In the intervention schools, 3160 (80.1%) of 3943 children that completed the test after one year achieved a predetermined passing score (≥13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference 39.5%, 95% CI 29.9 to 47.5). Conclusion Use of the learning-resources led to a large improvement in the ability of children to assess claims, which was sustained for at least one year.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Bernd Schulte ◽  
Amy O’Donnell ◽  
Harald Lahusen ◽  
Christina Lindemann ◽  
Mariya Prilutskaya ◽  
...  

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.


Author(s):  
Allen Nsangi ◽  
Daniel Semakula ◽  
Andrew David Oxman ◽  
Astrid Austvoll- Dalghren ◽  
Matt Oxman ◽  
...  

Abstract Introduction We evaluated an intervention designed to teach 10 to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report here on outcomes measured one year after the intervention. Methods In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year-five children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books, and a teachers’ guide). The primary outcome, measured at the end of the school term and again after one year, was the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. Results We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n=60, 76 teachers and 6383 children) or control group (n=60, 67 teachers and 4430 children). After one year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared to 53.0% for the control schools (adjusted mean difference 16.7%, 95% CI 13.9 to 19.5; p<0·00001). In the intervention schools, 3160 (80.1%) of 3943 children that completed the test after one year achieved a predetermined passing score (≥13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference 39.5%, 95% CI 29.9 to 47.5). Conclusion Use of the learning-resources led to a large improvement in the ability of children to assess claims, which was sustained for at least one year.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036416
Author(s):  
Laura Green ◽  
Jahnavi Daru ◽  
Julie Dodds ◽  
Francisco Jose Gonzalez Carreras ◽  
Doris Lanz ◽  
...  

IntroductionThe incidence of severe postpartum haemorrhage (PPH) that requires blood transfusion is on the increase. Fibrinogen levels have been shown to drop early and significantly during PPH, which is associated with worse outcomes. Early fibrinogen replacement could potentially improve outcomes. No studies have investigated the clinical impact of early cryoprecipitate transfusion in PPH. Prior to performing a full-scale trial, a pilot study is needed to determine feasibility of the intervention and recruitment.MethodsACROBAT is a cluster-randomised pilot study with a qualitative evaluation. Four large London maternity units are randomised to either the intervention or control group. The intervention group will adapt their major obstetric haemorrhage procedures to administer cryoprecipitate early for primary PPH. The control group will retain their standard of care.We include women at >24 weeks gestation who are actively bleeding within 24 hours of delivery and for whom transfusion of red blood cells (RBCs) has been started. We exclude women who decline blood transfusions in advance or have inherited Factor XIII or fibrinogen deficiency. Due to the emergency nature of the intervention, informed consent for administering the intervention is waived.The primary objective is to assess the feasibility of administering cryoprecipitate within 90 min of RBC request, as compared with standard treatment where cryoprecipitate is given later or not at all. Secondary objectives include the feasibility of recruitment and data collection, reasons for and barriers to consent, preliminary maternal clinical outcomes, identification of the optimal infrastructure pathways for study delivery, and acceptability of the intervention and outcomes.Ethics and disseminationThe trial has approvals from the London—Brighton & Sussex Research Ethics Committee (ref. 18/LO/2062), the Confidentiality Advisory Group (ref. 18/CAG/0199) and Health Research Authority (IRAS number 237959). Data analysis and publication of manuscripts will start in Q3 2020.Trial registration numberISRCTN12146519.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Leonie Sundmacher ◽  
Ronja Flemming ◽  
Verena Leve ◽  
Isabel Geiger ◽  
Sebastian Franke ◽  
...  

Abstract Background Patients in Germany are free to seek care from any office-based physician and can always ask for multiple opinions on a diagnosis or treatment. The high density of physicians and the freedom to choose among them without referrals have led to a need for better coordination between the multiple health professionals treating any given patient. The objectives of this study are to (1) identify informal networks of physicians who treat the same patient population, (2) provide these physicians with feedback on their network and patients, using routine data and (3) give the physicians the opportunity to meet one another in facilitated network meetings. Methods The Accountable Care Deutschland (ACD) study is a prospective, non-blinded, cluster-randomised trial comprising a process and economic evaluation of informal networks among 12,525 GPs and office-based specialists and their 1.9 million patients. The units of allocation are the informal networks, which will be randomised either to the intervention (feedback and facilitated meetings) or control group (usual care). The informal networks will be generated by identifying connections between office-based physicians using complete datasets from the Regional Associations of Statutory Health Insurance (SHI) Physicians in Hamburg, Schleswig Holstein, North Rhine and Westphalia Lip, as well as data from three large statutory health insurers in Germany. The physicians will (a) receive feedback on selected indicators of their own treatment activity and that of the colleagues in their network and (b) will be invited to voluntary, facilitated network meetings by their Regional Association of SHI physicians. The primary outcome will be ambulatory-care-sensitive hospitalisations at baseline, at the end of the 2-year intervention period, and at six months and at 12 months after the end of the intervention period. Data will be analysed using the intention-to-treat principle. A pilot study preceded the ACD study. Discussion Cochrane reviews show that feedback can improve everyday medical practice by shedding light on previously unknown relationships. Providing physicians with information on how they are connected with their colleagues and what the outcomes are of care delivered within their informal networks can help them make these improvements, as well as strengthen their awareness of possible discontinuities in the care they provide. Trial registration German Clinical Trials Register DRKS00020884. Registered on 25 March 2020—retrospectively registered.


2018 ◽  
Vol 120 (2) ◽  
pp. 176-187 ◽  
Author(s):  
Leila M. Larson ◽  
Melissa F. Young ◽  
Patricia J. Bauer ◽  
Rukshan Mehta ◽  
Amy Webb Girard ◽  
...  

AbstractResearch demonstrates the importance of nutrition for early brain development. Few studies have examined the effectiveness of multiple micronutrient powders (MNP) on child development. This study examined the impacts of home fortification with MNP on motor and mental development, executive function and memory of children living in Bihar. This two-arm cluster-randomised effectiveness trial selected seventy health sub-centres to receive either MNP and nutrition counselling (intervention) or nutrition counselling alone (control) for 12 months. Front-line health workers delivered the intervention to all households in study communities with a child aged 6–18 months. Data were collected using cross-sectional surveys at baseline and endline by selecting households from intervention (baseline,n2184; endline,n2170) and control (baseline,n2176; endline,n2122) communities using a two-stage cluster-randomised sampling strategy. Children in the intervention group had a significantly larger improvement from baseline to endline compared with those in the control group on scores for motor and mental development (Cohen’sd, motor=0·12; 95 % CI 0·03, 0·22; mental=0·15; 95 % CI 0·06, 0·25). Greater impacts of MNP on motor and mental development were observed in children from households with higher stimulation scores at baseline compared with those with lower stimulation (Cohen’sd, motor=0·20v. 0·09; mental=0·22v. 0·14;Pinteraction<0·05). No significant treatment differences were seen for executive function or memory. Home fortification with MNP through the existing health infrastructure in Bihar was effective in improving motor and mental development and should be considered in combination with other child development interventions such as stimulation.


2017 ◽  
Vol 20 (11) ◽  
pp. 2034-2041
Author(s):  
Tiago N Munhoz ◽  
Iná S Santos ◽  
Simone de M. Karam ◽  
Jose Martines ◽  
Gretel Pelto ◽  
...  

AbstractObjectiveThe present study aimed to assess the effects of an early childhood nutrition counselling intervention on intelligence (as measured by the intelligence quotient (IQ)) at age 15–16 years.DesignA single-blind, cluster-randomised trial.SettingIn 1998, in Southern Brazil, mothers of children aged 18 months or younger were enrolled in a nutrition counselling intervention (n 424). Counselling included encouragement and promotion of exclusive breast-feeding until 6 months of age and continued breast-feeding supplemented by protein-, lipid- and carbohydrate-rich foods after age 6 months up to age 2 years. The control group received routine feeding advice. In 2013, the fourth round of follow-up of these individuals, at the age of 15–16 years, was undertaken. IQ was assessed using the short form of the Wechsler Adult Intelligence Scale (WAIS-III). Mental disorders (evaluated using the Development and Well-Being Assessment (DAWBA)) and self-reported school failure, smoking and alcohol use were also investigated. Adjusted analyses were conducted using a multilevel model in accordance with the sampling process.SubjectsAdolescents, mean (sd) age of 15·4 (0·5) years (n 339).ResultsMean (sd) total IQ score was lower in the intervention group than the control group (93·4 (11·4) and 95·8 (11·2), respectively) but the association did not persist after adjustment. The prevalence of any mental disorders was similar between intervention and control groups (23·1 and 23·5 %, respectively). There were no differences between groups regarding school failure, smoking and alcohol use.ConclusionsNutrition counselling intervention in early childhood had no effect on intelligence measured during adolescence.


2021 ◽  
pp. oemed-2020-106794
Author(s):  
Luise Moelenberg Begtrup ◽  
Per Malmros ◽  
Charlotte Brauer ◽  
Sandra Soegaard Toettenborg ◽  
Esben Meulengracht Flachs ◽  
...  

ObjectiveThe aim was to test if targeting managers with an educational intervention reduces absence among pregnant employees.MethodsThe study was a non-blinded cluster randomised trial conducted in hospitals and daycare institutions from two administrative Danish Regions and two Danish municipalities. Clusters (work units) were assigned randomly and non-blinded to either (1) intervention, where all managers were invited to participate in a 3-hour seminar addressing needs and options for adjustment of work in pregnancy, or (2) control, with practice as usual. The primary outcome based on payroll data was long-term pregnancy-related absence, defined as ≥12.5% cumulated absence during pregnancy weeks 1–32. Intention-to-treat analysis was applied using mixed logistic regression.ResultsNinety work units were included (56 hospital departments and 34 daycare units) with 451 pregnant employees in the intervention group and 464 in the control group. Work units had on average 11 pregnant employees with no difference between the groups. 103 of the 216 invited managers (48%) participated in a the 3-hour seminar. In the intervention group, 154 (34%) had long-term pregnancy-related absence during pregnancy weeks 1–32 vs 166 (36%) in the control group. Relative odds of having long-term pregnancy-related absence, when being in the intervention group, was 1.06 (95% CI 0.71 to 1.58), with an interclass correlation coefficient of 0.07.ConclusionAn educational intervention targeting managers did not reduce pregnancy-related absence among pregnant employees.Trial registration numberNCT03002987.


Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Allen Nsangi ◽  
Daniel Semakula ◽  
Andrew D. Oxman ◽  
Astrid Austvoll-Dahlgren ◽  
Matt Oxman ◽  
...  

Abstract Introduction We evaluated an intervention designed to teach 10- to 12-year-old primary school children to assess claims about the effects of treatments (any action intended to maintain or improve health). We report outcomes measured 1 year after the intervention. Methods In this cluster-randomised trial, we included primary schools in the central region of Uganda that taught year 5 children (aged 10 to 12 years). We randomly allocated a representative sample of eligible schools to either an intervention or control group. Intervention schools received the Informed Health Choices primary school resources (textbooks, exercise books and a teachers’ guide). The primary outcomes, measured at the end of the school term and again after 1 year, were the mean score on a test with two multiple-choice questions for each of the 12 concepts and the proportion of children with passing scores. Results We assessed 2960 schools for eligibility; 2029 were eligible, and a random sample of 170 were invited to recruitment meetings. After recruitment meetings, 120 eligible schools consented and were randomly assigned to either the intervention group (n = 60 schools; 76 teachers and 6383 children) or the control group (n = 60 schools; 67 teachers and 4430 children). After 1 year, the mean score in the multiple-choice test for the intervention schools was 68.7% compared with 53.0% for the control schools (adjusted mean difference 16.7%; 95% CI, 13.9 to 19.5; P < 0.00001). In the intervention schools, 3160 (80.1%) of 3943 children who completed the test after 1 year achieved a predetermined passing score (≥ 13 of 24 correct answers) compared with 1464 (51.5%) of 2844 children in the control schools (adjusted difference, 39.5%; 95% CI, 29.9 to 47.5). Conclusion Use of the learning resources led to a large improvement in the ability of children to assess claims, which was sustained for at least 1 year. Trial registration Pan African Clinical Trial Registry (www.pactr.org), PACTR201606001679337. Registered on 13 June 2016.


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