Bhuiya Nudar A, Liu Scott, Muyodi David, Bucher Sherri L
Scholarly Concentration in Public Health Certificate Program, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Indiana University-Indianapolis, Indianapolis, Indiana, United States of America.
Moi Teaching and Referral Hospital, Eldoret, Kenya.
PLOS Glob Public Health. 2024 Apr 16;4(4):e0001708. doi: 10.1371/journal.pgph.0001708. eCollection 2024.
Hypothermia is a leading newborn complication, especially among premature and/or low birth weight infants. Within low/middle-income countries where incubators and radiant warmers are often in short supply, leading to gaps in the thermal care chain, neonatal hypothermia underlies high rates of newborn morbidity and mortality. Kangaroo Mother Care/Skin-to-skin care is an effective method for prevention of hypothermia in premature and low birthweight babies but can be very burdensome for families and healthcare providers. Our international multidisciplinary team has developed a prototype for a wearable biomedical device ("NeoWarm") to provide continuous thermal care and augment kangaroo mother care practices in low-resource settings. The objective of this study was to assess the feasibility and acceptability of NeoWarm and to obtain user design feedback for an early prototype from among adult end-users in Western Kenya. We performed key informant interviews (n = 17) among healthcare providers and 5 focus group discussions (FGDs) among 3 groups of adult stakeholders of premature babies, including: (1) parents/family members of premature babies aged 6 weeks or less (3 FGDs); (2) healthcare providers of newborns (e.g., nurses; physicians; 1 FGD); (3) community opinion leaders and stakeholders (e.g., traditional birth attendants; pastors; village elders; 1 FGD). Content and thematic analyses of transcripts indicate that NeoWarm is acceptable and feasible in promoting facility-based kangaroo mother care in the Kenyan setting. Novel findings derived from respondents include (1) the ability of the device to potentially overcome several barriers to traditional kangaroo mother care methods and (2) user-driven encouragement to expand the use case of the device to potentially include community-based kangaroo mother care and neonatal transport. User design feedback obtained during the interviews informed several key design iterations for subsequent prototypes of the device.
体温过低是一种主要的新生儿并发症，在早产儿和/或低体重儿中尤为常见。在中低收入国家，保温箱和辐射保暖器往往供应短缺，导致热护理链出现缺口，新生儿体温过低是新生儿发病率和死亡率高的根本原因。袋鼠式护理/肌肤接触护理是预防早产儿和低体重儿体温过低的有效方法，但对家庭和医疗服务提供者来说可能非常繁重。我们的国际多学科团队开发了一种可穿戴生物医学设备原型（“NeoWarm”），以在资源匮乏的环境中提供持续的热护理并加强袋鼠式护理实践。本研究的目的是评估NeoWarm的可行性和可接受性，并从肯尼亚西部的成年最终用户那里获得对早期原型的用户设计反馈。我们对医疗服务提供者进行了关键信息访谈（n = 17），并对三组早产婴儿的成年利益相关者进行了5次焦点小组讨论（FGD），包括：（1）6周及以下早产婴儿的父母/家庭成员（3次FGD）；（2）新生儿医疗服务提供者（如护士；医生；1次FGD）；（3）社区意见领袖和利益相关者（如传统助产士；牧师；村长；1次FGD）。对访谈记录的内容和主题分析表明，NeoWarm在肯尼亚环境中促进基于机构的袋鼠式护理是可接受且可行的。受访者得出的新发现包括：（1）该设备有能力潜在地克服传统袋鼠式护理方法的几个障碍；（2）用户推动鼓励扩大该设备的用例，可能包括基于社区的袋鼠式护理和新生儿转运。访谈期间获得的用户设计反馈为该设备后续原型的几个关键设计迭代提供了信息。
