坦桑尼亚每位母亲的基本指导（ECEM-TZ）：1型混合效果-实施随机对照试验方案

Essential Coaching for Every Mother Tanzania (ECEM-TZ): Protocol for a Type 1 Hybrid Effectiveness-Implementation Randomized Controlled Trial.

作者信息

Dol Justine, Mselle Lilian Teddy, Campbell-Yeo Marsha, Mbekenga Columba, Kohi Thecla, McMillan Douglas, Dennis Cindy-Lee, Tomblin Murphy Gail, Aston Megan

机构信息

Faculty of Health, Dalhousie University, Halifax, Canada.

IWK Health, Halifax, NS, Canada.

出版信息

JMIR Res Protoc. 2024 Dec 5;13:e63454. doi: 10.2196/63454.

DOI:10.2196/63454

PMID:39636672

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11659689/

Abstract

BACKGROUND

Despite global goals to improve maternal, newborn, and child health outcomes, mortality and morbidity continue to be a concern, particularly during the postnatal period in low- and middle-income countries. While mothers have the responsibility of providing ongoing care for newborns at home, they often receive insufficient newborn care education in Tanzania. Mobile health via text messaging is an ever-growing approach that may address this gap and provide timely education.

OBJECTIVE

We aim to evaluate a text message intervention called Essential Coaching for Every Mother Tanzania (ECEM-TZ) to improve maternal access to essential newborn care education during the immediate 6-week postnatal period.

METHODS

ECEM-TZ consists of standardized text messages from birth to 6 weeks post partum that provide evidence-based information on caring for their newborn and recognizing danger signs. Messages were developed and then reviewed by Tanzanian mothers and nurse midwives before implementation. A hybrid type 1 randomized controlled trial will compare ECEM-TZ to standard care among mothers (n=124) recruited from 2 hospitals in Dar es Salaam. The effectiveness outcomes include newborn care knowledge, maternal self-efficacy, breastfeeding self-efficacy, maternal mental health, attendance at the 6-week postnatal checkup, and newborn morbidity and mortality. The implementation outcomes include the reach and quality of implementation of the ECEM-TZ intervention.

RESULTS

Recruitment for this study occurred between June 13, 2024, and July 22, 2024. A total of 143 participants were recruited, 71 in the control and 72 in the intervention. The 6-week follow-up data collection began on July 30, 2024, and was completed on September 21, 2024.

CONCLUSIONS

This study will generate evidence about the effectiveness of implementing text messaging during the early postnatal period and the feasibility of doing so in 2 hospitals in Dar es Salaam. The intervention has been designed in collaboration with mothers and nurse midwives in Tanzania.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05362305; https://clinicaltrials.gov/study/NCT05362305.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63454.

摘要

背景

尽管全球致力于改善孕产妇、新生儿和儿童的健康状况，但死亡率和发病率仍然令人担忧，尤其是在低收入和中等收入国家的产后阶段。虽然母亲有责任在家中持续照顾新生儿，但在坦桑尼亚，她们往往接受的新生儿护理教育不足。通过短信进行的移动健康是一种不断发展的方法，可能会填补这一空白并提供及时的教育。

目的

我们旨在评估一种名为“坦桑尼亚每位母亲的基本指导”（ECEM-TZ）的短信干预措施，以改善母亲在产后立即的6周内获得基本新生儿护理教育的机会。

方法

ECEM-TZ包括从出生到产后6周的标准化短信，提供有关照顾新生儿和识别危险信号的循证信息。短信在实施前由坦桑尼亚母亲和助产护士进行了开发和审核。一项混合型1随机对照试验将在从达累斯萨拉姆的2家医院招募的母亲（n = 124）中比较ECEM-TZ与标准护理。有效性结果包括新生儿护理知识、母亲自我效能感、母乳喂养自我效能感、母亲心理健康、产后6周检查的出勤率以及新生儿发病率和死亡率。实施结果包括ECEM-TZ干预措施的覆盖范围和实施质量。