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秘鲁新生儿复苏试验:一项整群随机试点试验,旨在评估偏远地区传统新生儿复苏与部分虚拟培训的效果对比。

RCPNEOPERU trial: a cluster randomized pilot trial to assess traditional neonatal resuscitation compared to partially virtual training in remote areas.

作者信息

Delgado Carlos A, Gómez Pomar Enrique, Velásquez Pablo, Sánchez Víctor, Shimabuku Roberto, Huicho Luis

机构信息

Universidad Nacional Mayor de San Marcos, Faculty of Medicine, Department of Pediatrics, Research Group in Neonatology (NEO), Lima, Peru; Instituto Nacional de Salud del Niño, Neonatal Unit, Lima, Peru; Universidad Peruana Cayetano Heredia, Centro de Investigación para el Desarrollo Integral y Sostenible (CIDIS) and Centro de Investigación en Salud Materna e Infantil (MAMAWAWA), Lima, Peru.

University of Kentucky, Department of Pediatrics, Lexington, KY, USA; St Bernards Regional Medical Center, Jonesboro, AR, USA.

出版信息

J Pediatr (Rio J). 2025 Jul-Aug;101(4):520-528. doi: 10.1016/j.jped.2025.04.008. Epub 2025 Jun 19.

Abstract

OBJECTIVE

To assess the effects of a neonatal resuscitation training program using traditional training and partial distance learning.

METHOD

Through an open cluster-randomized trial, the authors compared a traditional approach involving face-to-face theory and practice sessions using information and communication technology to offer theory and distance examination, followed by face-to-face practice. Twelve health facilities were allocated by blocked randomization. Comparisons were made adjusting for clustering in qualitative and quantitative data. The primary outcome was the percentage of infants with heart rates ≥100 per minute at the second minute after birth. The authors performed a cluster-level analysis for cluster randomized trials, simplifying the adjustment for individual- and cluster-level covariates.

RESULTS

The authors trained 403 health professionals in two arms in twelve facilities. After six months, the authors assessed 2180 birth deliveries, 966 newborns in the traditional training group (TT), and 1214 in the partial distance learning training group (pDL). The authors found no statistical evidence favoring any of the two trial arms (RR = 0.9859, CI 95 % = 0.9446; 1.0292, p = 0.4819).

CONCLUSIONS

The authors found no statistical evidence favoring traditional or distance learning methods for neonatal resuscitation training. Further research could assess improved online platforms to enable sustainable virtual reality instructor/provider interaction for theory, practice and testing, addressed to health cadres of rural and remote areas.

摘要

目的

评估采用传统培训和部分远程学习的新生儿复苏培训项目的效果。

方法

通过一项开放整群随机试验,作者比较了一种传统方法,该方法包括面对面的理论和实践课程,利用信息和通信技术提供理论和远程考试,随后进行面对面实践。通过整群随机化分配了12个卫生机构。在定性和定量数据中进行比较时对聚类进行了调整。主要结局是出生后第二分钟心率≥100次/分钟的婴儿百分比。作者对整群随机试验进行了整群水平分析,简化了对个体和整群水平协变量的调整。

结果

作者在12个机构的两组中培训了403名卫生专业人员。6个月后,作者评估了2180例分娩,传统培训组(TT)有966名新生儿,部分远程学习培训组(pDL)有1214名新生儿。作者没有发现统计学证据支持两个试验组中的任何一组(RR = 0.9859,95%CI = 0.9446;1.0292,p = 0.4819)。

结论

作者没有发现统计学证据支持传统或远程学习方法用于新生儿复苏培训。进一步的研究可以评估改进的在线平台,以实现农村和偏远地区卫生干部在理论、实践和测试方面可持续的虚拟现实指导教师/提供者互动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/87b9/12276612/ce2778e80293/gr1.jpg

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