面对面与远程 (mHealth) 交付在肯尼亚农村的响应式育儿干预:一个集群随机对照试验
Italo Lopez Garcia1, Jill Luoto2, Frances Aboud3
1Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA. italolop@usc.edu.
BMC public health
|September 5, 2024
概括
这项研究比较了面对面的早期儿童发展 (ECD) 育儿干预措施与使用mHealth.com的混合模型. 目标是找到具有成本效益的,可扩展的解决方案,以改善贫困环境中的儿童发展.
科学领域:
- 全球健康 全球健康
- 发展心理学 发展心理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 贫困,营养不良和缺乏刺激会影响低,中,小,中等收入国家43%的5岁以下儿童的发育.
- 现有的幼儿发展 (ECD) 育儿干预措施往往过于昂贵,并且在资源不足的环境中无法扩大.
- 目前的ECD干预措施的短期影响往往会消失,需要新的方法来实现持续的变化.
研究的目的:
- 实验性地比较传统的亲自ECD育儿干预与混合模型,包括mHealth (基于智能手机的视听内容和WhatsApp).
- 评估混合交付模式在两年内相对有效性,成本和长期可持续性.
- 确定最佳的交付模式,以最大限度地影响和持续影响在资源有限的环境中对育儿行为和儿童发展结果的持续影响.
主要方法:
- 一个集群随机对照试验 (cRCT),涉及肯尼亚90个村庄和大约1200个家庭.
- 干预交付模式包括传统的面对面小组会议和混合模式,越来越多地用mHealth组件取代面对面会议.
- 通过中线 (12个月) 和终线 (24个月) 调查收集数据,通过调解分析评估治疗意向对主要结果和调解途径的影响.
主要成果:
- 该研究假设混合模型的成本较低,但与面对面访问相比,远程互动的有效性可能较差.
- 评估将确定持续两年对育儿行为和儿童发展结果的影响.
- 调解分析将探索干预影响结果的途径.
结论:
- 这项研究旨在确定提供最具成本效益和可扩展的ECD育儿干预方案的模型.
- 将干预措施纳入现有医疗保健系统 (例如,社区健康促进者) 和利用低成本技术是可持续性的关键.
- 研究结果将有助于制定可扩展的,可持续的解决方案,以改善资源有限的环境中的早期儿童发展.
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