ABSTRACT
@#Introduction: Although the mass media are increasingly becoming a platform for disseminating health messages to promote attitude and behavioural changes, little is known about how radio programmes influence safe child feeding practices among mothers of infants and children. Consequently, this study examined the knowledge, attitude and behaviour towards food and nutrition radio programmes in mothers of children under five years with severe acute malnutrition in Northern Nigeria. Methods: This study employed a survey research design using data derived from a structured questionnaire undertaken with mothers (N=402) of children suffering from severe acute malnutrition (SAM) and who have been listening to radio programmes on tackling malnutrition within six months to the time of the fieldwork. Results: Findings revealed that while mothers appeared to have a higher comprehension of child feeding programmes on the radio, their attitude and actual uptake of the messages were not encouraging. Furthermore, being young, having few children, having a primary education, and frequent listening to SAM-related messages on the radio were associated with mothers’ positive knowledge, attitude and actual uptake of the messages disseminated. Conclusion: The findings provided a link between demographic characteristics of mothers and how they comprehend, believe and act on the messages they received from these radio programmes. It is therefore argued that the understanding of this link might inform the focus of future intervention aimed at promoting best child feeding practices in Northern Nigeria.
ABSTRACT
Background@#Chronic obstructive pulmonary disease (COPD) is one of the contributors to the burden of non-communicable disease. Health education is a key component in COPD management. Effective health education interventions directed to patient, family and community are necessary to prevent exacerbations, emergency room visits, hospitalizations and improve quality of life for patients with COPD. The general objective of the study was to determine effectiveness of health education interventions directed to patient, family and community. Specifically, to determine the effect on the number of acute exacerbations, COPD related emergency room visits and hospitalizations, improvement in the quality of life and patient satisfaction.@*Methods@#This study only included comparative clinical trials randomized or non- randomized, parallel or cross-over clinical trial design, cohort study involving humans as the participants. It also includes published studies in peer reviewed journals of PubMed, clinical trials registered Cochrane Central Register of Controlled Trials, and the grey literature. There were no foreign language studies included relevant to this review. The non-comparative clinical trials, outcomes research or real-world data, animal experiments, reviews and case reports were excluded. The study population of reviewed literature has an established diagnosis of Chronic Obstructive Pulmonary Disease based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for diagnosis of COPD. Studies involving COPD patients who have other co morbidities were also included. The patients with COPD in the study were similar to patients consulting in family and community medicine practice clinics in the Philippines. Data synthesis was done separately for each type of intervention, i.e., patient directed, family directed, community directed health education intervention on Chronic Obstructive Pulmonary Disease. Quantitative analysis was only possible for studies reporting similar outcomes and units of measures such as number of COPD-related hospitalizations and emergency room visits for health education intervention directed to patient and improvement in the quality-of-life scores for health education intervention directed to family and community. Narrative synthesis was done when it was not feasible to include studies to do pooled analysis due to any of the following reasons such as different outcomes and when outcomes not reported as means with standard deviation. The Review Manager 5 software was used in the analysis of the data. Sensitivity analysis was done by restricting the analysis to published studies and with low risk of bias.@*Results@#A total of ten studies were included. Health education interventions directed to patient has no benefit in decreasing the number of COPD related emergency room visits (1.84, 95% CI 0.94,2.74) and insufficient evidence to decrease the number of COPD related hospitalizations (4.33,95%CI-4.69,13.34). Health education intervention directed to family have insufficient evidence to improve the quality of life among patients with COPD (0.35,95% CI -0.49,1.19). Community directed health education intervention have significantly improved the quality of life among patients with COPD (-1.95,95% CI -3.37, -0.53).The studies had low risk for bias in terms of random sequence generation, allocation concealment and blinding of outcome assessment except for one study that was a non-randomized trial (Tabari et al, 2018). The highest risk for bias across the studies was the non-blinding of the participants. The withdrawals or dropouts in one study exceeded 20%. Three studies reported non possibility of blinding the assessor (Marques et al 2015, Nguyen et al 2019, Tabari et al 2018). Furthermore, five studies (Gallefos, 2004, Hernandez et al 2015, Tabari et al 2018, Van Wetering et al 2010, Marques et al, 2015) did not report the use of intention to treat analysis@*Discussion@#Effective health education interventions directed to patient, family and community in conjunction with standard of care may decrease exacerbations, hospitalizations, emergency visits, better quality of life and patient satisfaction. The studies included for this review were heath education interventions solely directed to patient, to family and to community and not a combination of the interventions directed to patient and family, or patient and community, or patient and family and community. Overall, health education interventions are integrated in a patient centered family focused community-oriented care for COPD. Health education is just one of the components of the integrated care on COPD. Better control of COPD is likely due to the combined effects of the different care components. Hence, there is a need for more randomized controlled trials on health education interventions directed to patient and family. Inclusion of COPD related hospitalizations, emergency room visits, acute exacerbations as outcome measures in health education interventions directed to patient, family and community is useful to provide evidence in effectiveness of the intervention. The authors declare no financial or funding involvement in the development and implementation of this study. This protocol was registered with Research Grants Administration Office (RGAO) with Registration No. RGAO-2020-1276, Research Implementation Development Office (RIDO) and to the Research Committee of the Philippine Academy of Family Physicians. The study was given Certification of Exemption from Ethical Review by the University of the Philippines Research Ethics Board (UPMREB CODE: UPMREB 2020-783-EX
Subject(s)
Pulmonary Disease, Chronic ObstructiveABSTRACT
@#health problem throughout the world. The effects of theexisting intervention in ensuring compliance to thesubscribed regimen and the impact of nutrition education inenhancing dietary modification during pregnancy inMalaysia have been minimal. This study aims to develop,implement and evaluate the effects of the Health BeliefModel educational intervention on haemoglobin level amonganaemic pregnant women.Methods: This is a quasi-experimental research with pre-post test design with control group involving 81 participantsper group from two health clinics in Sepang. The primaryoutcome was a change in the haemoglobin levels followingeducational intervention. Secondary outcomes includeknowledge on anaemia, Health Belief Model (HBM)constructs, dietary iron intake and compliance towards ironsupplementation. The intervention group received a HBM-based education intervention programme. Results: The response rate in the intervention and controlgroup were 83.9% and 82.7% respectively. Generalisedestimating equations analysis showed that the interventionwas effective in improving the mean haemoglobin level(β=0.75, 95%CI=0.52, 0.99, p<0.001), the knowledge score(β=1.42, 95%CI=0.36, 2.49, p=0.009), perceived severityscore (β=2.2, 95%CI= 1.02, 3.39, p<0.001) and increasedproportion of high compliance level (AOR=4.59, 95%CI=1.58,13.35, p=0.005).Conclusion: HBM-based health education programme hasproven to be effective in improving the haemoglobin levels,knowledge scores, perceived severity scores andcompliance level of participants. The study resultsemphasized on the effectiveness of such an approach,therefore it is recommended that future educationalinterventions which aim at increasing preventive healthybehaviours in pregnant women may benefit from theapplication of this model in primary health care settings.
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Background: There is a paucity of evidence on improvement in malnutrition status after follow-up intervention among malnourished under-five children. Objective: The objective of the study is to assess the effect of community-based follow-up health education intervention on the awareness level of mothers, calorie intake, protein intake, and weight gain of malnourished children. Methods: This intervention study was conducted from December 2012 to October 2014 in three phases at rural Puducherry, coastal South India. The intervention group (57 mothers of 64 children) and control group (60 mothers of 64 children) included moderate and severely malnourished children aged 13� months. Children in the control group were taken from different areas and matched for age (�months) and sex. Health education intervention and follow-up supervision for 15 months were given to the mothers. Results: Awareness level in all domains increased significantly in the intervention group. In the intervention group, 81% (52) of malnourished children turned out to normal, whereas in the control group, 64% (41) of them became normal. There was a statistically significant difference between the mean changes in the protein intake among boys (15.34 g to 19.91 g in the intervention group against 13.6 g to 16.24 g in the control group) and girls (15.09 g to 19.57 g in the intervention group against 13.36 g to 16.51 g in the control group) and calorie intake among girls (993.86 kcal to 1116.55 kcal in the intervention group against 992.65 kcal to 1078.75 kcal in the control group) between the two groups. Conclusion: There was comparatively marginal increase in protein intake, calories' intake, and weight gain in the intervention group.
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Primary health care as stated in the Alma Ata declaration underscores the importance of health education as one of the key methods of preventing and controlling prevailing health problems. This study seeks to test the effect of health education on perception and treatment seeking behaviour among care givers of under fives in a rural setting in Ogun State, Nigeria. The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples for this study and a semi- structured questionnaire was used to collect relevant information. The intervention consisted of a structured educational programme based on a course content adapted from the national malaria control programme. A total of 400 respondents were recruited into the study with 200 each in both the experimental and control groups and were followed up for a period of 3 months when the knowledge and treatment seeking behaviour was reassessed. There was no statistically significant differences observed between the experimental and control groups in terms of socio-dermographic characteristics such as age [p=0.99], marital status [p=0.48], religion [p=0.1], and income [p=0.51]. The highest proportion of mothers reported malaria [45% & 47%] in experimental and control groups respectively, followed by Upper respiratory tract infection [22% & 25%], diarrhoea and vomiting [14% & 17%], measles [12% & 15%], convulsion [8% & 11%] and others [3% & 5%]. Only 52.1% (experimental) and 48% (control) groups of mothers believed that fever can kill a child. Furthermore, about 40% (experimental) and 44% (control) groups believed fever was not fatal while 8.0% of both groups were not sure. Post intervention, these differences were not statistically significant. The proportion of those who got their source of information about prevention of fever from health worker increased from 60.0% (preintervention) to 95.0% (post-intervention) (p<0.001) compared to the control group which increased from 62.0% (pre-intervention) to 62.5% (post-intervention) (p>0.001). Furthermore, 72.9% & 50.8% of respondents in the experimental and control group respectively commenced treatment at the right time (first day of fever). There was a significant increase of 24.6% [p=0.001] post intervention in the experimental group with no significant change in the control [p=0.64]. The study concludes that a systematic health education programme to caregivers should be a component of Roll back Malaria programme in Africa. Early diagnosis and prompt treatment is essential to control of infection and this can only be effectively carried out by those at the frontline of care at home.