Community-based Education Intervention Research Articles

Empowering Pregnant Women: A Community-Based Health Education Intervention to Promote Healthy Behaviors

Pregnant women in rural areas like Lubuk Alung often face barriers to accessing quality health information and care, leading to suboptimal health behaviors during pregnancy. This study aimed to evaluate the impact of a community-based health education intervention on pregnant women's knowledge, attitudes, and practices regarding healthy behaviors in Lubuk Alung. A quasi-experimental study was conducted with 150 pregnant women (75 intervention, 75 control) in Lubuk Alung. The intervention group received a 12-week program of structured health education sessions delivered by trained community health workers. Sessions covered topics such as nutrition, exercise, antenatal care, childbirth preparation, and breastfeeding. The control group received standard antenatal care. Pre- and post-intervention surveys assessed knowledge, attitudes, and self-reported practices related to healthy behaviors. The intervention group demonstrated significant improvements in knowledge about healthy behaviors (p<0.001), more positive attitudes towards these behaviors (p<0.01), and increased adoption of practices like consuming a balanced diet, engaging in regular physical activity, attending antenatal care visits, and exclusive breastfeeding (p<0.05). The control group showed minimal changes. In conclusion, community-based health education interventions are effective in empowering pregnant women in rural settings. They increase knowledge, shift attitudes, and promote the adoption of healthy behaviors during pregnancy. Such programs should be integrated into routine antenatal care services in areas like Lubuk Alung.

Statistical analysis plan for cluster randomised trial to evaluate a community-level complementary food safety and hygiene and nutrition intervention in Mali: the MaaCiwara study

BackgroundDiarrheal disease is a significant cause of morbidity and mortality in under-fives in many low- and middle-income countries. Changes in food safety, hygiene practices, and nutrition around the weaning period may reduce the risk of disease and improve infant development. The MaaCiwara study aims to evaluate the effectiveness of a community-based educational intervention designed to improve food safety and hygiene behaviours, as well as child nutrition. This update article describes the statistical analysis plan for the MaaCiwara study in detail.Methods and designThe MaaCiwara study is a parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures, involving 120 clusters of rural and urban communities. These clusters are randomised to either receive the community-based behaviour change intervention or to the control group. The study participants will be mother–child pairs, with children aged between 6 and 36 months. Data collection involves a day of observation and interviews with each participating mother–child pair, conducted at baseline, 4 months, and 15 months post-intervention.The primary analysis aims to estimate the effectiveness of the intervention on changes to complementary food safety and preparation behaviours, food and water contamination, and diarrhoea. The primary outcomes will be analysed generalised linear mixed models, at individual level, accounting for clusters and rural/urban status to estimate the difference in outcomes between the intervention and control groups. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. In addition, structural equation analysis will be conducted to examine the causal relationships between the different outcomes.Trial registrationInternational Standard Randomised Controlled Trial Number (ISRCTN) register: ISRCTN14390796. Registered on 13 December 2021.

Effectiveness of multimethod, community-based educational interventions on the knowledge and attitude to birth preparedness and complications readiness among women in southwest Nigeria

BackgroundBirth preparedness and complications readiness (BP/CR) is an effective strategy to reduce maternal and newborn morbidity and mortality.AimTo assess the effect of educational interventions on women’s knowledge and attitude regarding...

Implementing Community-Based Strategies for Improved Pneumonia Care in Children: Insights From a Pilot Study.

Respiratory ailments, encompassing a spectrum of disorders, are a leading cause of mortality and morbidity in children, with pneumonia being particularly significant, accounting for 16% of child mortality. To ensure timely engagement with healthcare services, it is imperative to instill awareness through Information, Education, and Communication (IEC) initiatives targeting mothers of children under five. The primary objective of this pilot study is to assess the feasibility of a community-based intervention on health-seeking behaviour, knowledge, and practice measures concerning the management and prevention of pneumonia in children. The pilot study mirrored the main study's procedures in two villages, Bhuvanahalli and Gavanahalli, each randomly assigned as either an experimental or a control group. We selected 12 mothers with children under the age of five who had community-acquired pneumonia, employing a straightforward random technique, with six mothers from each group. These mothers were interviewed using a structured questionnaire focusing on health-seeking behaviour, knowledge, and practices related to the management and prevention of pneumonia. Mothers in the experimental group received a community-based intervention, specifically an educational set focusing on health-seeking behaviour, knowledge, and practice measures concerning the management and prevention of pneumonia in children, while those in the control group continued with their routine practices. We collected post-test data from the mothers in both groups at the 2nd, 4th, and 6th months of the intervention. The data analysis was conducted using the IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York) software. The Mann-Whitney test and Kruskal-Wallis analyses indicated a notable and statistically significant shift in health-seeking behaviour, knowledge, and practices pertaining to the management and prevention of pneumonia in children as a result of the community-based educational intervention implemented in the experimental group (P<0.05). Community-based intervention is crucial to preventing mortality and morbidity in children. The findings of the pilot study affirm its feasibility and lay a strong foundation for further investigation and implementation.

Effects of community-based educational video interventions on nutrition, health, and use of health services in low- and middle-income countries: systematic review and meta-analysis

Abstract Context Health education using videos has been promoted for its potential to enhance community health by improving social and behavior change communication. Objective To provide stakeholders in maternal and child health with evidence that can inform policies and strategies integrating video education to improve maternal, newborn, and child health. Data sources Five databases (MEDLINE, Embase, Scopus, Web of Science, and CENTRAL) were searched on January 28, 2022, and November 10, 2022 (updated search). Quantitative and qualitative studies conducted in low- and middle-income countries on the effects of video-based interventions on nutrition, health, and health service use were eligible. There was no restriction on time or language. Study selection was done in 2 stages and in duplicate. Data extraction A total of 13 710 records were imported to EndNote. Of these, 8226 records were screened by title and abstract using Rayyan, and 76 records were included for full-text evaluation. Results Twenty-nine articles (n = 12 084 participants) were included in this systematic review, and 7 were included in the meta-analysis. Video interventions improved knowledge about newborn care (n = 234; odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40), colostrum feeding (n = 990; OR, 60.38; 95%CI, 18.25–199.78), continued breastfeeding (BF; n = 1914; OR, 3.79; 95%CI, 1.14–12.64), intention to use family planning (FP) (n = 814; OR, 1.57; 95%CI, 1.10–2.23), and use of FP (n = 864; OR, 6.55; 95%CI, 2.30–18.70). Video interventions did not result in reduced prelacteal feeding or improvement in early initiation of BF. The qualitative studies showed that video interventions were acceptable and feasible, with perceived impacts on communities. Conclusion This systematic review and meta-analysis indicated that video interventions improved knowledge of newborn care, colostrum feeding, and continuing BF, and the intention to use FP. Given the high levels of heterogeneity and inconsistency in reporting, more research with stronger designs is recommended. Systematic review registration PROSPERO registration no. CRD42022292190.

Community-based intervention for managing hypertension and diabetes in rural Bangladesh

BackgroundApproximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area.MethodsSix villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the “strong” educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a “weak” intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention.ResultsOverall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6–9.9) in the first intervention group, 1.9 mm Hg (95% CI − 0.5–4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4–7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis.ConclusionsCommunity-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries.Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.

Effect of nursing intervention on women’s knowledge about pregnancy problems and utilization of obstetrics care services in Edu, Kwara State, Nigeria

PurposeThis study assesses the effect of nursing intervention on the knowledge of women about pregnancy-related problems and utilization of obstetrics care services in Edu, Nigeria. MethodsPre-test post-test control of quasi-experimental design was adopted for the study. Researchers-designed questionnaire was used for data collection and a split-half test was used to determine the reliability of the instrument. One hundred and twenty women were exposed to ten weeks of community-based nursing education intervention sessions, (sixty experimental groups and sixty control groups). Pre-tests administered to sampled women before nursing health education intervention sessions and followed by Post-test. The results were analyzed using mean and standard deviation while the t-test was used to test the hypothesis at an Alpha level of 0.05. ResultsThe findings showed the positive effect of a nursing health education intervention on the knowledge of women about pregnancy problems with pre-intervention on experimental group mean of 63.33, and post-intervention mean of 72.22 with t-value of 1.26 less than the table value of 1.96. The study further showed a mean score of 35.97 experimental group and 28.33 for the control group with a t-value of 1.64, which shows little effect of intervention on the willingness of women to utilize obstetrics care services in Edu, Nigeria. ConclusionThe study concluded that the nursing health education intervention programme in this study on pregnancy-related problems programmes had a positive effect on the knowledge of women but had no effect on the utilization of OCS by women in Edu Local Government Areas. We recommended that health education programmes should be intensified to improve the knowledge level of women and encourage the use of obstetric care services in the community.

Effectiveness of a community-based health education intervention on prostate cancer fatalism: a quasi-experimental study

Effectiveness of a community-based health education intervention on prostate cancer fatalism: a quasi-experimental study

Community-Based Child Labor Trafficking Prevention in Ghana: A Rights-Based Approach

ABSTRACT There are 152 million children in the world who are victims of child laborers are found in Africa; 73 million are involved in hazardous labor. Almost half of child labor (72.1 million) is found in Africa. One in five children in Africa (19.6%) is a child laborer, whilst prevalence in other regions such as Arab States, Asia, and Europe is between three percent and seven percent (International Labor Organization). This study evaluates a community-based child rights education intervention implemented in Ghana, West Africa, to address the problem. The project contributed to an eight percent increase in school enrollment (which has been associated with a decrease in child labor trafficking in other studies), an equivalence of 706 students in one and half years after implementation. The study contributes to United Nations Sustainable Development Goals five and 16 (promoting gender equality, facilitating human rights advancement and strengthening accountable institutions). It also provides project implementation strategies to support the efforts of anti-trafficking institutions. In addition, it fosters awareness on the traumatic impact of child labor trafficking and a call to action for social workers to develop clinical interventions to support victims. It also discusses various limitations, implications, and future directions for the study.

An educational intervention study to enhance breast cancer awareness among women and primary healthcare providers of an urban health center area, Visakhapatnam.

Breast cancer is the most common malignancy in women worldwide posing greater health challenge. The poor survival rate from breast cancer in India may be attributed to lack of awareness, low rate of screening uptake and presentation of cases in advanced stage. To assess the baseline knowledge and effectiveness of educational intervention in improving the knowledge regarding breast cancer. A quasi-experimental community-based health educational intervention study was performed among 100 women and 18 female primary healthcare providers residing in urban field practice area. Face-to-face interviews were performed using a questionnaire adapted from the Breast Cancer Awareness Measure (Breast-CAM) Version 2. Data were analyzed using SPSS version 25. To assess the difference between pre- and postintervention scores, Mc-Nemar's test and paired sample t tests were applied. Association between socio-demographic variables and difference in mean scores was assessed by using ANOVA and independent t test. P value less than 0.05 was taken as statistically significant. The mean pre-intervention score of knowledge items (21 including warning signs, risk factors of breast cancer) among 100 women participants was 7.19 ± 3.45 and postintervention mean score was 18.18 ± 2.42. The mean pre-intervention score among 18 primary healthcare providers was 10.89 ± 4.59 and postintervention score was 19.89 ± 1.28. There was significant improvement in mean scores. The increase in percentage of scores in all 21 items postintervention was significant (Mc-Nemar's test). There was significant association between socio-demographic profile and increase in mean scores. The study identified various barriers for seeking medical care among women. The community-based educational intervention was effective in enhancing the knowledge regarding breast cancer among women.

Addressing racial inequality and its effects on vaccination rate: A trial comparing a pharmacist and peer educational program (MOTIVATE) in diverse older adults.

BACKGROUND: The mortality, morbidity, health care utilization, and cost attributable to vaccine-preventable diseases are substantial for those aged 50 years and older. Although vaccination is the most cost-effective strategy to prevent common infectious diseases in older adults, vaccination rates remain below US Centers for Disease Control and Prevention benchmarks, especially among racial minorities. Historical mistrust, structural racism within the US medical system, and misinformation contributed to lower immunization rates among minorities, especially Black Americans. To address the critical need to increase knowledge and trust in vaccination, 2 community-based educational interventions were tested: a pharmacist-led didactic session (PHARM) and a peer-led educational workshop (PEER). OBJECTIVE: To determine and compare the effectiveness and costs of PEER and PHARM community-based education models in improving knowledge and trust in vaccinations. METHODS: The Motivating Older adults to Trust Information about Vaccines And Their Effects (MOTIVATE) study was a cluster-randomized trial conducted in the greater Delaware Valley Region sites from 2017 to 2020. The included sites (7 senior centers, 3 housing units, 1 church, and 1 neighborhood family center) predominantly served Black communities. Participants were randomized to either PHARM or PEER sessions covering influenza, pneumococcal disease, herpes zoster, and beliefs related to vaccines. Peer leaders facilitated smaller workshops (5-10 participants), whereas pharmacists conducted larger didactic lectures with 15-43 participants. Outcomes were captured through a self-administered survey at baseline, postprogram, and 1 month after the program. Intervention costs were measured in 2017 US dollars. RESULTS: 287 participants were included. Their mean age was 74.5 years (SD = 8.94), 80.5% were women, 64.2% were Black, and 48.1% completed some college. Knowledge scores within groups for all 3 diseases significantly increased postprogram for both PEER and PHARM and were sustained at 1 month. Between-group knowledge differences were significant only for influenza (PEER participants had significantly larger improvement vs PHARM). Vaccination trust significantly increased in both groups. Total program costs were $11,411 for PEER and $5,104 for PHARM. CONCLUSIONS: Both interventions significantly improved knowledge and trust toward vaccination and retained their effect 1 month after the program. The 2 effective community-based education models should be expanded to ensure timely and trusted information is available to educate older adults about vaccine-preventable diseases. Further research is encouraged to assess the long-term cost-effectiveness of these models' utilization on a larger scale. DISCLOSURES: Dr Schafer is an employee of Merck; however, at the time of the project, he was a professor at Thomas Jefferson University. The other authors have no conflicts of interest to disclose. This study was supported in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this article are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. The sponsor played no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the article. Study Registration Number: NCT03239665.

Effect of Community-based Nurse-led Education Intervention on Youth Knowledge of preventive practices towards HIV/AIDS in Igbotako in Okitipupa Local Government Area, Ondo State, Nigeria

Background: Health education according to World Health Organization is the most effective weapon against the transmission and spread of HIV/AIDS worldwide. This study examines the effect of community-level health education on the knowledge and attitude of youths in the Igbotako community towards HIV/AIDS prevention practices. Objectives: This is intending to assess the effect of health education counseling on the knowledge, prevention practices and attitude towards prevention practices among youths aged 15 to 29 years. Methods: Multi-stage sampling method was employed for the study. In the first stage, Okitipupa was selected at random. The second stage involved the purposeful sampling of the Igbotako community and in the third stage, 200 youths between the age of 15 and 29 were randomly selected, with consideration of education and professional background to avoid bias. Confidentiality was assured and respondents were administered with anonymous questionnaires before and after the health education seminars and the resulting data was analyzed with SPSS version 20. Results: Results showed that community health education significantly improves the awareness and knowledge of respondents about HIV/AIDS (χ2 = 398.63, p-value = 0.0043). The awareness about prevention practices of respondents statistically significantly improves after the health education seminars (χ2 = 208.22 p-value = 0.0219). Also, the attitude towards prevention practices statistically significantly improved as respondents became aware of the various risky behaviours and practices they do (χ2 = 318.71, p-value = 0.0182). Regression analysis showed that marital status i.e. being single (Z= 189.45, p-value= 0.048), gender i.e. being female (Z= 193.78, p-value= 0.021) and profession, being a student (Z= 123.93, p-value= 0.001). Conclusion: The study concludes that continuous community education through health talks, seminars and shows will positively reduce the transmission of HIV/AIDS in the community.

A Community-Based Educational Intervention: Increasing Medication Adherence in Rural Older Adults

ABSTRACT Purpose This study evaluated the effectiveness of a community-based, interdisciplinary, medication education intervention for rural older adults. Methods The research design was a quasi-experimental pretest/posttest design. Self-efficacy, adherence to refills and medication, and knowledge were examined. An educational intervention was conducted with each participant on their prescribed medications. Findings Mean scores for the adherence to refills and medication subscale decreased from 9.9 to 8.5 (p = .003) indicating improved adherence. Mean scores for the knowledge subscale increased from 21.8 to 22.4 (p = .192). Conclusions Results suggest a community-based, interdisciplinary, individualized medication education intervention could increase medication adherence in rural older adults.

Community-based alcohol education intervention (THEATRE) study to reduce harmful effects of alcohol in rural Sri Lanka: design and adaptation of a mixed-methods stepped wedge cluster randomised control trial

IntroductionAlcohol consumption is a leading cause of mortality, morbidity and adverse social sequelae in Sri Lanka. Effective community-based, culturally adapted or context-specific interventions are required to minimise these harms. We...

The effectiveness of different educational interventions in reducing the prehospital delay of patients with coronary artery disease: a systematic review

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Recognizing symptoms of coronary artery disease (CAD) is important and challenging for CAD patients. Failure in detecting the related symptoms may lead to prehospital delay and decelerate the golden time of ischemic reperfusion. Purpose The purpose of the systematic review aims to evaluate types of education programs (through randomized control trial) of their effectiveness on reducing prehospital delay regarding CAD. Method The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted to proceed this review. We searched from Pubmed, Cochrane Library, Scopus, CINAHL and EMBASE using a combination of free text words and Medical Subject Headings guided by the PICO framework. The abstracts and full-text screening were peer-reviewed by two reviewers. Results A total of 722 records were identified through database searching of which 11 randomized controlled trials were finally included into this review (n = 38773). The Cochrane Risk of Bias assessment tool 2.0 was utilized to examine the methodological quality of the included studies. Eight out of 11 studies conducted one by one individualized-educational intervention program (n = 11007); two studies used mass media campaign for the general public education program (n = 24753), and one study used the community-based educational intervention model (n = 3031). Of the three types of education models, the one to one individualized-educational intervention was found to be the most effective model to have reduce prehospital delay time shorter ranged from 30-60 minutes in the experimental groups while comparing to the control groups. Conclusion Individualized-educational program is found to be the most effective intervention to reduce prehospital delay for CAD patients. Health care providers are encouraged to apply one to one educational program in term of reducing prehospital delay for CAD patients both in clinical and community setting. Moreover, family members of high-risk patients are suggested to be included in a step-by-step action plan that eliminates the wait and see approach to reach medical support.

Education Intervention Has the Potential to Improve Short-Term Dietary Pattern among Older Adults with Undernutrition.

Low-cost educational interventions to improve dietary pattern is a pragmatic solution to prevent undernutrition in low- and middle-income countries. A prospective nutritional education intervention was conducted among older adults aged 60 years or above with undernutrition with 60 people in each intervention and control group. The objective was to develop and evaluate the efficacy of a community-based nutrition education intervention to improve the dietary pattern of older adults with undernutrition in Sri Lanka. The intervention consisted of two modules to improve the diversity, the variety of diet, and the serving sizes of food consumed. The primary outcome was the improvement of the Dietary Diversity Score (DDS) and the secondary outcomes were the Food Variety Score and Dietary Serving Score, which was assessed using the 24 h dietary recall. The mean difference in scores between the two groups was compared using the independent sample t-test at baseline, two weeks and three months post-intervention. Baseline characteristics were comparable. After two weeks, only the difference in DDS between the two groups was statistically significant (p = 0.002). However, this was not sustained at three months (p = 0.08). This study concludes that nutrition education interventions have the potential for short-term improvement in dietary patterns in older adults in a Sri Lanka setting.

A theory-driven, culture-tailored educational intervention for cervical cancer screening among rural Chinese females: A feasibility and pilot study

ObjectiveThis study aimed to evaluate the feasibility and preliminarily estimate the effects of a theory-driven, culture-tailored, community-based educational intervention promoting cervical cancer screening among rural females. MethodsAn experimental study with the two-arm parallel, nonrandomized control trial design was implemented, followed by individual semi-structured interviews. Thirty rural females between 26 and 64 were recruited, with 15 in each group. Both groups were exposed to the usual care about cervical cancer screening promotion from the local clinics, while participants in the intervention group additionally received five educational sessions in 5 weeks. Data were collected at baseline and immediately postintervention. ResultsAll participants completed the study, and the retention rate was 100%. Participants in the intervention group had more significant increments in cervical cancer screening-related self-efficacy (P ​< ​0.001), knowledge (P ​< ​0.001), and intention levels (P ​= ​0.003) than those in the control group. Most participants showed acceptance and satisfaction with this educational intervention. ConclusionsThis study revealed that the theory-driven, culture-tailored, community-based educational intervention was feasible among the rural populations to promote cervical cancer screening. A large-scale interventional study with a prolonged follow-up duration is warranted to explore this educational intervention's effectiveness further.

Protocol for a parallel group, two-arm, superiority cluster randomised trial to evaluate a community-level complementary-food safety and hygiene and nutrition intervention in Mali: the MaaCiwara study (version 1.3; 10 November 2022)

BackgroundDiarrhoeal disease remains a significant cause of morbidity and mortality among the under-fives in many low- and middle-income countries. Changes to food safety practices and feeding methods around the weaning period, alongside improved nutrition, may significantly reduce the risk of disease and improve development for infants. We describe a protocol for a cluster randomised trial to evaluate the effectiveness of a multi-faceted community-based educational intervention that aims to improve food safety and hygiene behaviours and enhance child nutrition.MethodsWe describe a mixed-methods, parallel group, two-arm, superiority cluster randomised controlled trial with baseline measures. One hundred twenty clusters comprising small urban and rural communities will be recruited in equal numbers and randomly allocated in a 1:1 ratio to either treatment or control arms. The community intervention will be focussed around an ideal mother concept involving all community members during campaign days with dramatic arts and pledging, and follow-up home visits. Participants will be mother–child dyads (27 per cluster period) with children aged 6 to 36 months. Data collection will comprise a day of observation and interviews with each participating mother–child pair and will take place at baseline and 4 and 15 months post-intervention. The primary analysis will estimate the effectiveness of the intervention on changes to complementary-food safety and preparation behaviours, food and water contamination, and diarrhoea. Secondary outcomes include maternal autonomy, enteric infection, nutrition, child anthropometry, and development scores. A additional structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Qualitative and health economic analyses including process evaluation will be done.ConclusionsThe trial will provide evidence on the effectiveness of community-based behavioural change interventions designed to reduce the burden of diarrhoeal disease in the under-fives and how effectiveness varies across different contexts.Trial registrationISRCTN14390796. Registration date December 13, 2021

Involving men and boys in family planning: A systematic review of the effective components and characteristics of complex interventions in low- and middle-income countries.

Involving men and boys as both users and supporters of Family Planning (FP) is now considered essential for optimising maternal and child health outcomes. Evidence on how to engage men and boys to meet FP needs is therefore important. The main objective of this review was to assess the strength of evidence in the area and uncover the effective components and critical process- and system-level characteristics of successful interventions. We searched nine electronic databases, seven grey literature databases, organisational websites, and the reference lists of systematic reviews relating to FP. To identify process evaluations and qualitative papers associated with the included experimental studies, we used Connected Papers and hand searches of reference lists. Experimental and quasi-experimental studies of behavioural and service-level interventions involving males aged 10 years or over in low- and middle-income countries to increase uptake of FP methods were included in this review. Methodology was a causal chain analysis involving the development and testing of a logic model of intervention components based on stakeholder consultation and prior research. Qualitative and quantitative data relating to the evaluation studies and interventions were extracted based on the principles of 'effectiveness-plus' reviews. Quantitative analysis was undertaken using r with robust variance estimation (RVE), meta-analysis and meta-regression. Qualitative analysis involved 'best fit' framework synthesis. We identified 8885 potentially relevant records and included 127 in the review. Fifty-nine (46%) of these were randomised trials, the remainder were quasi-experimental studies with a comparison group. Fifty-four percent of the included studies were assessed as having a high risk of bias. A meta-analysis of 72 studies (k = 265) showed that the included group of interventions had statistically significantly higher odds of improving contraceptive use when compared to comparison groups (odds ratio = 1.38, confidence interval = 1.21 to 1.57, prediction interval = 0.36 to 5.31, p < 0.0001), but there were substantial variations in the effect sizes of the studies (Q = 40,647, df = 264, p < 0.0001; I 2 = 98%) and 73% was within cluster/study. Multi-variate meta-regression revealed several significant intervention delivery characteristics that moderate contraceptive use. These included community-based educational FP interventions, interventions delivered to women as well as men and interventions delivered by trained facilitators, professionals, or peers in community, home and community, or school settings. None of the eight identified intervention components or 33 combinations of components were significant moderators of effects on contraceptive use. Qualitative analysis highlighted some of the barriers and facilitators of effective models of FP that should be considered in future practice and research. FP interventions that involve men and boys alongside women and girls are effective in improving uptake and use of contraceptives. The evidence suggests that policy should continue to promote the involvement of men and boys in FP in ways that also promote gender equality. Recommendations for research include the need for evaluations during conflict and disease outbreaks, and evaluation of gender transformative interventions which engage men and boys as contraceptive users and supporters in helping to achieve desired family size, fertility promotion, safe conception, as well as promoting equitable family planning decision-making for women and girls.

Nutritional practices of the preschool-aged children and associated factors: A cross-sectional study in Rupandehi district of Nepal

Undernutrition is a common problem among Nepali preschool-aged children. Every parent’s feeding practice should be focused on preventing unhealthy eating behaviors of preschool-aged children as it is very difficult to change it in their later life. This study was carried out to assess the key nutritional practices and associated factors among the 3-5-year-old preschool-aged children from their primary caregivers/mothers by employing a quantitative research method. Data were collected through scheduled interviews and observations from mothers/primary caregivers of 394 preschool-aged children who were selected through a multi-stage random sampling procedure in Rupandehi District of Nepal. Binary logistic regression was done to determine the predictors of nutritional practices of preschool-aged children. A p-value less than 0.05 is considered statistical significance. Economic statuses including caste/ethnicity were the main socio-economic and demographic variables to determine the nutritional practices of the preschool-aged children. Findings of the study indicated that majority of preschool-aged children were found in low-level nutritional practices. The preschoolaged children from marginal economic status, including disadvantage-cohorts of the Terai and Dalit, were the victims of the poor nutritional practices. Hence, community-based nutrition education intervention and mothers/caregivers’ awareness programs on feeding practices may be an incredible effort to improve the nutritional status of preschool-aged children if the program is intervened by targeting the background characteristics of the community group.