Effect of male partner involvement on maternity waiting home utilization in Hadiya Zone, Southern Ethiopia: a cluster-randomized controlled trial protocol

BackgroundThe primary cause of adverse maternal health outcomes has been identified to be the delay in reaching care at health facility. This is often attributed to the long distances’ women need to travel to gain access to health facilities. Literature show that maternity waiting homes (MWHs) contribute significantly to the reduction of maternal death and stillbirth among users. Despite its importance in improving maternal & neonatal health outcomes, the utilization of MWHs is very low in Ethiopia. So, it is important to investigate what strategies could be effective in improving MWH utilization in Ethiopia. The aim of this study is to assess if male partner involvement could be used as a solution to improve MWH utilization in Ethiopia.Methods/designThis study will evaluate the effect of male partner involvement on MWH utilization in Hadiya Zone, Southern Ethiopia. A behavioral intervention will be performed using a cluster-randomized controlled trial design. The intervention will have two arms, i.e., experimental and control arms. The study participants will be pregnant women in their second trimesters with their male partners. The total trial sample size will be 388. That means 194 study participants in each arm. Randomization will be conducted at cluster level. Study participants and assessors will be masked. Data analysis will be performed by STATA version 14.0 using an Intention-To-Treat Approach.DiscussionThe content of the intervention will be group health education, home visits, and phone counseling. Health education will be delivered to "husband-expectant wife" pairs at the baseline. Then home visits will be conducted at the beginning of every month, and phone counseling will be conducted in the third week of every month for consecutive six months. The anticipated trial commencement time is November 2021.Trial RegistrationClinicalTrials.gov Identifier: NCT05015023. Registered August 20, 2021. https://clinicaltrials.gov/ct2/show/NCT05015023

A prenatal group based phone counseling intervention to improve breastfeeding rates and complementary feeding: a randomized, controlled pilot and feasibility trial

Background Despite numerous benefits for both mom and baby, few infants are exclusively breastfed for the recommended first six months. Additionally, infants are given solids too early. Prenatal education increases rates of breastfeeding initiation and we hypothesize it can also improve exclusive breastfeeding rates and prevent the early introduction of solids. We conducted a randomized controlled pilot and feasibility trial to understand the feasibility and maternal acceptance of a prenatal behavioral lifestyle intervention (PBLI) delivered via group based phone counseling (GBPC) and its effectiveness on rates of exclusive breastfeeding up to six months postpartum. Secondary aims included rates of any breastfeeding up to six months, rates of early introduction of solids, and infant feeding progression. Methods Forty-one pregnant women were recruited from a Kansas City Metropolitan Obstetrics and Gynecology office and randomly assigned to a usual care group or a PBLI. Women in the PBLI participated in six GBPC sessions where they learned about breastfeeding and introducing solids. Feeding questionnaires to assess breastfeeding and introduction of solids were sent at two weeks, two months, four months, and six months postpartum. Structured interviews were also conducted after the intervention and at six months postpartum to assess maternal acceptance and intervention feasibility. Results Participants overwhelmingly found the intervention acceptable and beneficial. Rates of exclusive breastfeeding and any breastfeeding did not differ between groups at any time point. No between group differences were found for early introduction of solids or infant feeding progression. Conclusions Mothers discontinue breastfeeding earlier than recommended despite high rates of initiation. A PBLI delivered via GBP is feasible, acceptable to participants, and showed positive impacts such as maternal empowerment for both breastfeeding and introducing solids. Future interventions should incorporate both prenatal and postpartum components. Trial registration Study protocols were approved by the University of Kansas Medical Center’s Human Subjects Committee (STUDY00140506) and registered at ClinicalTrials.gov on 02/22/2018 (NCT03442517, retrospectively registered). All participants gave written informed consent prior to data collection.

Design and Rationale for the Deep South Interactive Voice Response (IVR) System-Supported Active Lifestyle (DIAL) Study: Proposal for a Randomized Controlled Trial (Preprint)

BACKGROUND Physical inactivity and related cancer incidence and mortality rates are disproportionately high in the U.S. Deep South, a rural, medically underserved region with a large African American population compared to the rest of the nation. Given this region’s lower rates of literacy and Internet access, Interactive Voice Response (IVR)-automated telephone-based interventions have the potential to help overcome physical activity intervention barriers (literacy, internet access, costs transportation) but have yet to be extended to rural, underserved populations, such as the Deep South. Thus, extensive formative research was conducted to develop, and beta test the Deep South Interactive Voice Response System Supported Active Lifestyle (DIAL) intervention in preparation for dissemination in rural Alabama counties OBJECTIVE To describe the design and rationale of the ongoing efficacy trial of the DIAL intervention. METHODS The 2-arm randomized controlled trial will compare a 12-month physical activity intervention versus a wait-list control condition in 240 underactive adults from 6 rural Alabama counties. The DIAL intervention is based on the Social Cognitive Theory and includes IVR-automated physical activity phone counseling (daily in months 0-3, twice weekly in months 4-6 and weekly in months 7-12) and support from local rural county coordinators with the UAB O’Neal Comprehensive Cancer Center Community Outreach and Engagement Office. The primary outcome is weekly minutes of moderate-to-vigorous intensity physical activity (7-Day PAR, accelerometry) at baseline, 6 months, 12 months, and 18 months. Rural Active Living Assessments will be conducted in each rural county to assess walkability, recreational amenities, and inform future environment/policy efforts. RESULTS Start up activities (hiring/training staff, purchasing supplies) were completed in 2019. Study recruitment and assessments began in September 2020 and are ongoing. CONCLUSIONS IVR-supported phone counseling has great potential for addressing physical activity barriers (e.g., culture, literacy, cost, transportation) and reducing related rural health disparities in this region. CLINICALTRIAL ClinicalTrials.gov NCT03903874

Comparing the Effect of Face-to-Face with Phone Counselling Based on Cognitive-Behavioral Therapy on Vasomotor Symptoms in Postmenopausal Women: A Randomized Controlled Trial

Background: Hot flash and night sweat (HF/NS) are the most common complication in menopause that affects the quality of life of women. The present study was conducted with the aim of comparing the effectiveness of the phone with face-to-face counseling based on cognitive-behavioral therapy for vasomotor symptoms of postmenopausal women.Methods: The present study was a randomized clinical trial. In this study, 40 eligible postmenopausal women were randomly assigned to one of face-to-face or phone counseling methods using the block randomization. Six counseling sessions were weekly held for each person and women requested to record their hot flashes and night sweat in a diary. Data were analyzed using chi-square, ANCOVA, and independent t-test.Results: Thirty- six women completed the study. Women in two groups showed a significant improvement in the frequency, severity, and duration of hot flashes and the frequency and severity of night sweats after the intervention (P <0.001). Weekly means of hot flashes and night sweats, decreased after the intervention in both groups (face-to-face group: HF frequency from 31.92±7.98 to 18.83±7.35, HF severity from 2.24±0.28 to 1.21±0.23, HF duration from 4.22±1.17 min to 2.79±0.91min, NS frequency from 2.34±0.31 to 1.21±0.24 and NS severity from 1.70±0.34 to 1.03±0.29 and also in phone counseling group: HF frequency from 33.32±7.77 to 19.53±7.7, HF severity from 2.23±0.24 to 1.20±0.18, HF duration from 4.29±1.23 min to 2.68±0.95min, NS frequency from 2.33±0.31 to 1.14±0.16 and NS severity from 1.59±0.34 to 1.01±0.30). There was no significant difference between groups after the intervention in terms of HF frequency, severity, and duration, as well as NS frequency, and severity (p>0.05). Conclusion: Based on the results of this study, using of face-to-face and phone counseling methods based on cognitive-behavioral therapy had a similar effect on the reducing of frequency, severity and duration of hot flashes as well as the frequency and severity of night sweats. Using phone counseling in women who have difficulty to attend the clinic is recommended.Trial registration number: IRCT20180918041065N1 Website: https://www.irct.ir/login

No Mobile Phone Phobia dikalangan Mahasiswa Pascasarjana

This research was conducted with the aim to find out the symptoms of no mobile phone phobia (nomophobia) among graduate students UIN Sunan Kalijaga Yogyakarta as well as knowing how the process of mentoring for students nomophobia sufferers by counselors. This research uses qualitative research methods with the phenomenology of approach. Research data obtained from observations and interviews and then data analyzed by the reduction of data, display data and tethering conclusion. The subject of this research is the 16 graduate students UIN Sunan Kalijaga Yogyakarta. The research results obtained in this study show that graduate students using a smartphone or gedget ± 12 hours in a day so the use of a smartphone with a long duration will negatively affect for the body particularly the brain. Next mentoring can be done by a Counsellor for the client that is experiencing the symptoms of nomophobia is using telephone counselling. Phone counseling provides access and control to the client so that the client can request the assistance of a Counsellor anytime and anywhere and can disconnect a telephone in accordance with his wishes