健康细胞方法在提高与 COVID-19 相关的知识、态度和实践方面的成功：基于社区的准实验试验的双重差分分析。

Success of health cell approach in improving knowledge, attitude and practice related to COVID-19: difference-in-differences analyses of a community-based quasi-experimental trial.

机构信息

Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh

Liggins Institute, University of Auckland, Auckland, New Zealand.

出版信息

BMJ Open. 2023 Aug 21;13(8):e067096. doi: 10.1136/bmjopen-2022-067096.

DOI:10.1136/bmjopen-2022-067096

PMID:37604628

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10445378/

Abstract

OBJECTIVES

There remain hesitations and miscommunication regarding appropriate public health behaviours and conceptions related to COVID-19. We tested the effectiveness of the community-based health cell approach in improving knowledge, attitude and practice (KAP) related to COVID-19.

SETTING

Households of the Bauniabadh slum area in Mirpur, Dhaka, Bangladesh.

PARTICIPANTS

Household heads (HHs) and homemakers (HMs) of intervention (n=211) and comparison households (n=209).

INTERVENTIONS

Behaviour change communication delivered at the community level in a quasi-experimental manner through small-scale community meetings and home visits.

OUTCOME VARIABLES AND METHODS

The outcomes of interest were before-after mean and per cent changes in KAP scores. Data were collected from HHs and HMs before and after the intervention and difference-in-differences (DID) analysis technique was applied.

RESULTS

We found statistically significant (p<0.05) before-after differences in the responses to the KAP questions made by the intervention groups. The DID models estimated the improvements in COVID-19-related KAP of HHs by 16.58 (95% CI: 14.05, 19.12), 20.92 (95% CI: 18.17, 23.67) and 28.45 (95% CI: 23.84, 33.07) per cent points, respectively. The DID estimates of KAP in HMs were 17.8 (95% CI: 15.09, 20.51), 22.33 (95% CI: 19.47, 25.19) and 28.06 (95% CI: 23.18, 32.93) per cent points, respectively. Overall, 20.91 (95% CI: 18.87, 22.94) and 21.81 (95% CI: 19.68, 23.94) per cent points of improvement were observed among HHs and HMs, respectively. The DID estimates of before-after mean changes in different KAP domains ranged from 2.24 to 2.68 units and the overall changes in KAP scores among HHs and HMs were 7.11 (95% CI: 6.42, 7.8) and 7.42 (95% CI: 6.69, 8.14) units.

CONCLUSION

Scientifically valid information disseminated at the community level using the health cell approach could bring positive changes in KAP related to COVID-19.

摘要

目的

对于与 COVID-19 相关的公共卫生行为和概念，仍存在疑虑和沟通不畅的问题。我们检验了以社区为基础的卫生小组方法在提高与 COVID-19 相关的知识、态度和实践（KAP）方面的有效性。

地点

孟加拉国达卡米尔普尔的巴努亚巴德贫民窟地区的家庭。

参与者

干预组（n=211）和对照组家庭的户主（HH）和家庭主妇（HM）。

干预措施

以准实验的方式在社区层面进行行为改变传播，通过小型社区会议和家访进行。

结果变量和方法

感兴趣的结果是 KAP 得分的前后均值和百分比变化。在干预前后从 HH 和 HM 收集数据，并应用差值（DID）分析技术。

我们发现，干预组对 KAP 问题的回答存在统计学上显著（p<0.05）的前后差异。DID 模型估计 HH 中与 COVID-19 相关的 KAP 分别提高了 16.58（95%CI：14.05，19.12）、20.92（95%CI：18.17，23.67）和 28.45（95%CI：23.84，33.07）个百分点。HM 中 KAP 的 DID 估计值分别为 17.8（95%CI：15.09，20.51）、22.33（95%CI：19.47，25.19）和 28.06（95%CI：23.18，32.93）个百分点。总体而言，HH 和 HM 中分别观察到 20.91（95%CI：18.87，22.94）和 21.81（95%CI：19.68，23.94）个百分点的改善。不同 KAP 领域的 DID 估计前后均值变化范围为 2.24 至 2.68 个单位，HH 和 HM 的 KAP 评分总体变化为 7.11（95%CI：6.42，7.8）和 7.42（95%CI：6.69，8.14）个单位。