Maternal, Neonatal and Child Health Research Network (MNCHRN), Pakistan.
NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, the University of Edinburgh, Edinburgh, UK.
J Glob Health. 2020 Dec;10(2):020438. doi: 10.7189/jogh.10.020438. Epub 2020 Dec 19.
Children in lower middle-income countries (LMICs) are more at risk of dying, than those in High Income Countries (HICs), due to highly prevalent deadly yet preventable childhood infections. Alongside concerns about the incidence of these infections, there has been a renewed interest in involving community health workers (CHWs) in various public health programs. However, as CHWs are increasingly asked to take on different tasks there is a risk that their workload may become unmanageable. One solution to help reduce this burden is the use of mobile health (mHealth) technology in the community through behaviour change. Considering there are various CHWs based mHealth approaches on illness management and education, therefore, we aimed to appraise the available literature on effectiveness of these mHealth approaches for caregivers to improve knowledge and management about common under-five childhood infections with respect to behaviour change.
We searched six databases between October to December 2019 using subject heading (Mesh) and free text terms in title or abstract in US English. We included multiple study types of children under-five or their caregivers who have been counselled, educated, or provided any health care service by CHWs for any common paediatric infectious diseases using mHealth. We excluded articles published prior to 1990 and those including mHealth technology not coming under the WHO definition. A data extraction sheet was developed and titles, abstracts, and selected full text were reviewed by two reviewers. Quality assessment was done using JBI tools.
We included 23 articles involving around 300 000 individuals with eight types of study designs. 20 studies were conducted in Africa, two in Asia, and one in Latin America mainly on pneumonia or respiratory tract infections followed by malaria and diarrhoea in children. The most common types of Health approaches were mobile applications for decision support, text message reminders and use of electronic health record systems. None of the studies employed the use of any behaviour change model or any theoretical framework for selection of models in their studies.
Coupling mhealth with CHWs has the potential to benefit communities in improving management of illnesses in children under-five. High quality evidence on impact of such interventions on behaviour is relatively sparse and further studies should be conducted using theoretically informed behaviour change frameworks/models.
PROPSERO Registration number: CRD42018117679.
相较于高收入国家（HICs）的儿童，中低收入国家（LMICs）的儿童面临着更高的死亡率，这主要是因为他们更容易感染那些高致命性但可预防的儿童传染病。除了对这些传染病发病率的担忧之外，人们对让社区卫生工作者（CHWs）参与各种公共卫生项目的兴趣也有所恢复。然而，随着 CHWs 被要求承担越来越多的不同任务，他们的工作量可能会变得难以管理。帮助减轻这种负担的一种方法是在社区中使用移动健康（mHealth）技术来进行行为改变。鉴于已经有各种基于 CHWs 的 mHealth 方法可用于疾病管理和教育，因此，我们旨在评估关于这些 mHealth 方法的现有文献，以了解它们对提高照顾者关于常见五岁以下儿童传染病的知识和管理能力，从而改善行为变化的效果。
我们在 2019 年 10 月至 12 月期间，使用美国英语的主题词（Mesh）和标题或摘要中的自由文本术语，在六个数据库中进行了搜索。我们纳入了多项研究，这些研究涉及五岁以下儿童或其照顾者，他们通过 CHWs 接受了针对任何常见儿科传染病的咨询、教育或提供了任何医疗服务，且使用了 mHealth。我们排除了 1990 年以前发表的文章和不属于世卫组织定义的 mHealth 技术的文章。我们制定了一个数据提取表，并由两位审阅者对标题、摘要和选定的全文进行了审阅。使用 JBI 工具进行了质量评估。
我们纳入了 23 篇文章，这些文章涉及约 30 万人，其中包括 8 种研究设计。20 项研究在非洲进行，两项在亚洲进行，一项在拉丁美洲进行，主要涉及肺炎或呼吸道感染，其次是儿童疟疾和腹泻。最常见的健康方法类型是用于决策支持的移动应用程序、短信提醒和使用电子健康记录系统。这些研究中没有任何一项使用任何行为改变模型或任何理论框架来选择模型。
将 mHealth 与 CHWs 结合使用，有可能使社区受益，改善五岁以下儿童的疾病管理。关于这种干预措施对行为影响的高质量证据相对较少，应该使用基于理论的行为改变框架/模型进一步开展研究。
PROPSERO 注册号：CRD42018117679。
