ABSTRACT
Background: This study evaluated the effectiveness of Baby Friendly Spaces (BFS), a psychosocial support program for Rohingya refugee mothers of malnourished young children in Bangladesh. Because BFS was already being implemented, we examined the benefit of enhancing implementation supports. Methods: In matched pairs, 10 sites were randomized to provide BFS treatment as usual (BFS-TAU) or to receive enhanced implementation support (BFS-IE). 600 mothers were enrolled and reported on maternal distress, functional impairment, subjective well-being and coping at baseline and 8-week follow-up. Data were analyzed using multilevel linear regression models to account for clustering; sensitivity analyses adjusted for the small number of clusters. Results: Significant within-group improvements in BFSIE were observed for distres (-.48, p = .014), functional impairment (-.30, p = .002) and subjective well-being (.92, p = .011); improvements in BFS-TAU were smaller and not statistically significant. Between-group comparisons favored BFS-IE for distress (ß = -.30, p = .058) and well-being (ß = .58, p = .038). Sensitivity adjustments produced p-values above .05 for all between-group comparisons. Discussion: Feasible adjustments to implementation can improve program delivery to increase impact on maternal distress and well-being. Although results should be interpreted with caution, study design limitations are common in pragmatic, field-based research.
ABSTRACT
The purpose of this study was to identify the psychosocial factors of chlorinated water uptake and to design effective behavior change techniques applying the risk, attitude, norm, ability, and self-regulation (RANAS) behavior change model. This cross-sectional study was conducted in two Rohingya refugee camps in Cox's Bazar, Bangladesh. In total, 596 respondents were recruited through systematic random sampling. A structured interviewer-administered questionnaire was used to assess the psychosocial factors according to the RANAS model. We used correlation analysis and multivariable linear regression models to predict the psychosocial factors of the consumption of chlorinated water. The respondents in this study had a medium to high habit of drinking chlorinated water. For the overall sample, participants' habits were predicted by income, perceived vulnerability, like of chlorinated water, feelings of being healthy, action planning skills, and coping planning skills. In Camp 14, income, vulnerability, and coping planning were strongly influential in predicting habit; in Camp 16, liking chlorinated water and action planning were the most influential factors. Behavior change techniques against each factor with proper communication channels have been proposed for the overall sample and specific to each camp. The psychosocial factors identified and the behavior change strategies proposed in this study may help to promote chlorinated water consumption among the camp population. This study also recommends follow-up research that considers more contextual factors, uses larger sample sizes, and examines the effectiveness of the intervention.
ABSTRACT
BACKGROUND: To reduce morbidity and mortality, awareness regarding diabetes and its complications is necessary. This study aimed at assessing the level of knowledge, attitude, and practices (KAP) regarding complications of diabetes mellitus among patients with type 2 diabetes in Dhaka, Bangladesh. METHODS: A cross-sectional study was carried out recruiting patients with diabetes from the outpatient department of BIRDEM hospital in Dhaka. Overall, 425 patients with diabetes were enrolled in this study. A pretested questionnaire was filled by the interviewer with face to face interview. Levels of KAP were determined by calculating the scores. Multivarable linear regression was used to determine significant predictors for knowledge, attitude, and practices. RESULTS: On average, the level of knowledge, attitude, and practices were 9.2 (out of 14), 7.9 (out of 13), and 16.9 (out of 27), respectively. Age and gender were significant predictors of knowledge and attitude. Females had better level of knowledge and attitude compared to males (ßs = 0.55 and 1.24, respectively). Patients with graduate degrees and above compared to illiterates reported significantly greater knowledge and practice (ßs = 1.27 and 1.44, respectively), after adjustments for covariates. Educational program was the most important significant predictor of KAP. Higher duration of diabetes (ß = 0.07) and positive marital status (ß = 1.21) had influenced better practice. CONCLUSIONS: Lack of knowledge, poor attitude, and inadequate practice were found in this surveyed communinty. Level of education and educational program on diabetes were the most significant contributing factors. The current study suggests the need of structured educational programs on diabetes and its complications on a regular basis to assist patients in living a productive life.
