评价强化计划生育教育对乌干达维多利亚湖渔业社区计划生育知识和使用的效果：一项随机对照试验。

Evaluating the effectiveness of enhanced family planning education on knowledge and use of family planning in fishing communities of Lake Victoria in Uganda: a randomized controlled trial.

机构信息

UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.

Global Health Institute, University of Antwerp, Antwerp, Belgium.

出版信息

BMC Health Serv Res. 2022 Apr 14;22(1):506. doi: 10.1186/s12913-022-07898-3.

DOI:10.1186/s12913-022-07898-3

PMID:35421987

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9012015/

Abstract

INTRODUCTION

Family planning knowledge is poor and use is low in Ugandan fishing communities. We compared the effectiveness of enhanced family planning (FP) education with routine counselling on FP knowledge and use.

METHODS

Individuals aged 15-49 years were randomly assigned to intervention or control arm. The intervention constituted enhanced FP education based on a simplified handout extracted from the WHO FP guidance tool called, "Family planning: A global handbook for FP providers" which participants took home for additional reading. The control arm constituted FP counselling following Uganda Ministry of Health guidelines. FP knowledge score and contraceptive prevalence rate (CPR) were compared between trial arms at baseline and at 12 months. Negative binomial regression models were used to estimate the effect of the intervention on FP knowledge and use.

RESULTS

Overall, 1410 participants were screened to enrol 1004 (502 per study arm, 48.5% women). Subsequently, 384 (76.5%) and 383 (76.3%) completed the 12 months' follow-up in the intervention and control arms respectively. At baseline, a median FP knowledge score of 8 and a < 70% FP knowledge score was observed for all participants with a CPR of 36.8%. At month-12, the median FP knowledge score improved in both arms, higher in the intervention arm than the control arm (46 vs 30; p < 0.001). In the intervention arm, 304 (79.2%) had a score of ≥70 compared with 21 (5.5%) in the control arm (p < 0.001). In the negative binomial regression model, the change in FP knowledge score was 47% higher in the intervention arm than in the control arm (score ratio: 1.47, 95%CI: 1. 43-1.51, p < 0.001). The change in CPR was 16% higher in the intervention arm than in the control arm (Prevalence ratio: 1.16, 95%CI: 1.01-1.34, p < 0.040).

INTERPRETATION

Enhanced FP education using a simplified FP education handout was more effective in increasing FP knowledge and use compared to routine FP counselling for people living in fishing communities. Innovative FP education interventions are recommended for improving FP knowledge and optimizing uptake in remote-rural settings where literacy levels are low.

TRIAL REGISTRATION

The study was registered by the Pan African Clinical Trial Registry on 03 July 2021 with a Trial Registration Number PACTR202107891858045 . "Retrospectively registered".

摘要

引言

乌干达渔业社区的计划生育知识匮乏，使用率低。我们比较了强化计划生育（FP）教育与常规咨询对 FP 知识和使用的效果。

方法

年龄在 15-49 岁的个体被随机分配到干预组或对照组。干预组采用简化的 FP 教育，该教育基于从世界卫生组织 FP 指导工具中提取的简化手册，称为“计划生育：全球 FP 提供者手册”，参与者将手册带回家供额外阅读。对照组采用乌干达卫生部指南规定的 FP 咨询。在基线和 12 个月时，比较试验臂之间的 FP 知识得分和避孕普及率（CPR）。使用负二项回归模型估计干预对 FP 知识和使用的影响。

结果

共有 1410 名参与者接受了筛查，纳入了 1004 名（每组 502 名，48.5%为女性）。随后，分别有 384 名（76.5%）和 383 名（76.3%）参与者完成了干预组和对照组的 12 个月随访。在基线时，所有参与者的 FP 知识得分中位数为 8，FP 知识得分 <70%的比例为 46%，CPR 为 36.8%。在第 12 个月时，两组的 FP 知识得分均有所提高，干预组的得分高于对照组（46 对 30；p<0.001）。在干预组中，有 304 名（79.2%）的得分≥70%，而对照组只有 21 名（5.5%）（p<0.001）。在负二项回归模型中，干预组的 FP 知识得分变化比对照组高 47%（得分比：1.47，95%CI：1.43-1.51，p<0.001）。干预组的 CPR 变化比对照组高 16%（流行率比：1.16，95%CI：1.01-1.34，p<0.040）。