Home-based Educational Intervention Research Articles

Process evaluation protocol plan for a home-based physical activity intervention versus educational intervention for persistent taxane-induced peripheral neuropathy (B-HAPI study): a randomized controlled trial

BackgroundEvaluation publications typically summarize the results of studies to demonstrate the effectiveness of an intervention, but little is shared concerning any changes implemented during the study. We present a process evaluation protocol of a home-based gait, balance, and resistance exercise intervention to ameliorate persistent taxane-induced neuropathy study according to 7 key elements of process evaluation.MethodsThe process evaluation is conducted parallel to the longitudinal, randomized control clinical trial examining the effects of the home-based gait, balance, and resistance exercise program for women with persistent peripheral neuropathy following treatment with taxanes for breast cancer (IRB approval: Pro00040035). The flowcharts clarify how the intervention should be implemented in comparable settings, fidelity procedures help to ensure the participants are comfortable and identify their individual needs, and the process evaluation allows for the individual attention tailoring and focus of the research to avoid protocol deviation.ConclusionsThe publication of the evaluation protocol plan adds transparency to the findings of clinical trials and favors process replication in future studies. The process evaluation enables the team to systematically register information and procedures applied during recruitment and factors that impact the implementation of the intervention, thereby allowing proactive approaches to prevent deviations from the protocol. When tracking an intervention continuously, positive or negative intervention effects are revealed early on in the study, giving valuable insight into inconsistent results. Furthermore, a process evaluation adds a participant-centered element to the research protocols, which allows a patient-centered approach to be applied to data collection.Trial registrationClinicalTrials.gov NCT04621721, November 9, 2020, registered prospectively. Protocol version: April 27, 2020, v2.

Implementing Home-Based Educational Interventions at Scale

Implementing Home-Based Educational Interventions at Scale

Role of Home Based Educational Intervention on Illness Perception and Health Services Utilization among Chronic Obstructive Pulmonary Disease Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) remains a significant public health challenge globally, particularly affecting middle-aged and older adults. Effective management of COPD requires not only clinical interventions but also patient-centric educational programs that enhance illness perception and encourage appropriate health services utilization. Objective: This study aimed to evaluate the effectiveness of a home-based educational intervention in improving illness perception and health services utilization among COPD patients. Methods: A quasi-experimental study was conducted at the Pulmonology Out-Patient Department of a public hospital in Lahore. From an initial screening of 200 participants, 130 met the inclusion criteria based on their illness perception scores. Following random sampling, 84 participants were enrolled and divided into control and intervention groups. The intervention group received a structured educational program on COPD management. Data on demographics, illness perception, and health services utilization were collected pre and post-intervention. Statistical analyses were performed using SPSS version 25, employing t-tests to compare the outcomes between the groups. Results: The study consisted predominantly of participants aged 30-60 years, with the majority (57.1%) in the 30-40 year age group. Post-intervention, the illness perception in the intervention group showed a significant improvement, with the mean score increasing from 54.24 ± 5.905 to 75.24 ± 7.564 (t = -14.183, p < 0.000). Health services utilization also saw a notable enhancement in the intervention group, with the mean score rising from 12.38 ± 1.396 to 20.07 ± 2.202 (t = -19.117, p < 0.000). Conclusion: The home-based educational intervention significantly improved both the illness perception and health services utilization among COPD patients. Such interventions can be pivotal in managing COPD effectively, reducing hospital readmissions, and promoting self-management.

A home-based educational intervention for cervical cancer screening services in rural Uganda

Background/Aims Despite the relative ease of prevention, the incidence of cervical cancer in Uganda is increasing and there is low uptake of screening services. One of the main contributing factors to low uptake is a lack of awareness. Targeting this barrier may help increase uptake and reduce the burden of cervical cancer. This study evaluated the effect of an educational intervention on knowledge, perception, intent to use and use of cervical cancer screening among women in rural southwestern Uganda. Methods This pre-test, post-test study was conducted with 150 women from a village in southwest Uganda, selected for its low uptake of cervical screening services. The home-based educational intervention consisted of a lecture and a discussion on cervical cancer and screening services. Data on women's knowledge, perceptions and use of screening services were captured at baseline and 7 weeks after the intervention, using a questionnaire. Chi-squared tests and paired sample t-tests were used to assess differences in participants' knowledge, perception and use of screening services. Results At baseline, participants had low scores for awareness, attitude and use of cervical screening. The intervention significantly improved knowledge (P<0.001), perception (P<0.001) and screening rate (P<0.001). Some participants' unwillingness to screen after the intervention was associated with marital status or religion. Conclusions The home-based health education intervention was effective in improving knowledge and perception of cervical cancer, and use of screening services. Use of this education intervention in rural regions of Uganda could be an effective strategy to increase use of screening services and thus improve early detection and prevention of cervical cancer.

Home-based educational interventions for family caregivers of older adults after stroke: a scoping review.

To map home-based educational interventions for family caregivers of older adults after stroke. Scoping review based on the JBI methodology, carried out on May 23, 2023. The Rayyan application and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews were used. Of the 1,705 studies, nine published from 2006 to 2020 were included: 44% of interventions were theoretical-practical educational; 77.7% were randomized clinical trials; and the "in-person" intervention (56%) was the most common, carried out by nurses in 88.9% of cases. Three to 15 42-minute sessions were carried out. The educational contents were organized into ten categories, divided into education aimed at caring for older adults and self-care for caregivers. Identified educational interventions strengthen participants' knowledge and skills in areas such as education, care, communication, self-management, rehabilitation and nutrition as well as self-care to safely assist older adults in their activities of daily living.

Examining the Remote Learning Experiences of Children Born Very Preterm During the COVID-19 Pandemic

This study examined the remote learning activities children born very preterm (VPT; gestational age ≤ 30 weeks) received, compared with children born full term (FT; gestational age ≥ 37 weeks), during the COVID-19 pandemic. Parents of 5- to 6-year-olds born VPT ( n = 33) and FT ( n = 33) reported on the provision, frequency, and duration of teacher-provided live instruction, educational materials, and homework; and parent-provided educational materials. More kindergarten children born VPT received small group instruction and fewer received large group instruction than FT children. Preschoolers born VPT engaged in parent-provided learning apps, educational videos, and reading activities less frequently or for shorter durations than FT children. Findings suggest that while teachers generally implemented remote learning similarly for children born VPT and FT, parents did not. Children born VPT are at higher risk for educational problems and may benefit from more intensive school- and home-based educational interventions to help offset the impact of school closures.

Effectiveness of Home-based Educational Intervention on Community Perception of Indoor Air Pollution

Effectiveness of Home-based Educational Intervention on Community Perception of Indoor Air Pollution

PRehabIlitatiOn with pReoperatIve exercise and educaTion for patients undergoing major abdominal cancer surgerY: protocol for a multicentre randomised controlled TRIAL (PRIORITY TRIAL)

BackgroundRadical surgery is the mainstream treatment for patients presenting with advanced primary or recurrent gastrointestinal cancers; however, the rate of postoperative complications is exceptionally high. The current evidence suggests that improving patients’ fitness during the preoperative period may enhance postoperative recovery. Thus, the primary aim of this study is to establish the effectiveness of prehabilitation with a progressive, individualised, preoperative exercise and education program compared to usual care alone in reducing the proportion of patients with postoperative in-hospital complications. The secondary aims are to investigate the effectiveness of the preoperative intervention on reducing the length of intensive care unit and hospital stay, improving quality of life and morbidity, and reducing costs.MethodsThis is a multi-centre, assessor-blinded, pragmatic, comparative, randomised controlled trial. A total of 172 patients undergoing pelvic exenteration, cytoreductive surgery, oesophagectomy, hepatectomy, gastrectomy or pancreatectomy will be recruited. Participants will be randomly allocated to prehabilitation with a preoperative exercise and education program (intervention group), delivered over 4 to 8 weeks before surgery by community physiotherapists/exercise physiologists, or usual care alone (control group). The intervention will comprise 12 to 24 individualised, progressive exercise sessions (including aerobic/anaerobic, resistance, and respiratory exercises), recommendations of home exercises (16 to 32 sessions), and daily incidental physical activity advice. Outcome measures will be collected at baseline, the week prior to surgery, during the hospital stay, and on the day of discharge from hospital, and 1 month and 1 months postoperatively. The primary outcome will be the development of in-hospital complications. Secondary outcomes include the length of intensive care unit and hospital stay, quality of life, postoperative morbidity and costs.DiscussionThe successful completion of this trial will provide robust and high-quality evidence on the efficacy of a preoperative community- and home-based exercise and education intervention on important postoperative outcomes of patients undergoing major gastrointestinal cancer surgery.Trial registrationThis trial was registered prospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12621000617864) on 24th May 2021.

Facilitators and barriers to living donor kidney transplantation

Facilitators and barriers to living donor kidney transplantation

Implementation of the kidney team at home intervention: Evaluating generalizability, implementation process, and effects.

SummaryResearch has shown that a home‐based educational intervention for patients with chronic kidney disease results in better knowledge and communication, and more living donor kidney transplantations (LDKT). Implementation research in the field of renal care is almost nonexistent. The aims of this study were (1) to demonstrate generalizability, (2) evaluate the implementation process, and (3) to assess the relationship of intervention effects on LDKT‐activity. Eight hospitals participated in the project. Patients eligible for all kidney replacement therapies (KRT) were invited to participate. Effect outcomes were KRT‐knowledge and KRT‐communication, and treatment choice. Feasibility, fidelity, and intervention costs were assessed as part of the process evaluation. Three hundred and thirty‐two patients completed the intervention. There was a significant increase in KRT‐knowledge and KRT‐communication among participants. One hundred and twenty‐nine out of 332 patients (39%) had LDKT‐activity, which was in line with the results of the clinical trials. Protocol adherence, knowledge, and age were correlated with LDKT‐activity. This unique implementation study shows that the results in practice are comparable to the previous trials, and show that the intervention can be implemented, while maintaining quality. Results from the project resulted in the uptake of the intervention in standard care. We urge other countries to investigate the uptake of the intervention.

‘Prime Time of Life’, A 12-Week Home-Based Online Multimodal Exercise Training and Health Education Programme for Middle-Aged and Older Adults in Laois

<strong>Introduction:</strong> Multimodal exercise training can ameliorate the physiological decline associated with ageing. This study aimed to investigate whether 12 weeks of a home-based online multimodal training and health education intervention could improve functional ability and perceptions of physical and mental health in middle-aged and older adults. <strong>Methods:</strong> Sixty-one male (N = 18, 59.1 ± 7.0 years) and female (N = 43, 60.9 ± 6.8 years) participants with various clinical conditions completed two 60-minute training sessions per week for 12 weeks delivered online via Zoom. All sessions included aerobic, resistance, balance, and flexibility exercises. One weekly session incorporated 15 minutes of health and fitness education. The pre/post testing sessions were conducted in a local community centre in line with COVID-19 public health guidelines. Paired samples t-tests and the Wilcoxon signed rank tests were utilised to compare scores pre and post intervention. <strong>Results:</strong> There were significant improvements in participants 6-minute walk (p &lt; 0.0001), sit-to-stand (p &lt; 0.0001), timed-up-and-go (p &lt; 0.0001), sit-and-reach (p &lt; 0.0001), squat jump (p &lt; 0.0001), core endurance (p &lt; 0.0001), grip strength (right hand p = 0.03, left hand p = 0.04) and balance (right leg p &lt; 0.0001, left leg p = 0.004) tests post intervention. Perceptions of physical (p &lt; 0.0001) and mental (p &lt; 0.0001) health also improved significantly. <strong>Discussion:</strong> Twelve weeks of online multimodal training and health education can significantly improve cardiovascular fitness, strength, power, balance, flexibility, and perceptions of physical health, mental health, and quality of life in middle-aged and older adults. While there are some limitations to online interventions, the benefits are numerous and equal to those reported for onsite interventions and should be considered for wider rollout in this population.

Improving Pregnant Mothers’ Intention toward HIV Testing through Home-based HIV Test and Education (HOPE) in Jember, Indonesia

The HIV testing program's implementation among pregnant mothers is still not going well due to their intention. Their intention is needed because it can affect pregnant mothers' behavior toward HIV testing. New interventions are needed to solve this problem, such as Home-based HIV Test and Education (HOPE). This study aimed to analyze the influence of HOPE to improve HIV testing intention among pregnant mothers. The pre-experimental design was used with one group pretest-posttest approach—thirty pregnant mothers in Jember following this study and involved by using a purposive sampling technique. The data were collected by using the intention questionnaire and analyzed with the Wilcoxon test. The result showed that pregnant mothers' intention of HIV testing numbers increased from 20 to 27. The results indicate that there is a significant influence of HOPE on the intention of HIV testing in pregnant women (p = 0.033). The Home-based HIV Test and Education (HOPE) intervention can improve pregnant mothers' intention toward HIV testing. The HOPE intervention can reach all pregnant mothers (and their husbands) to discover HIV testing information. Involving their husbands on HOPE intervention encouraged pregnant mothers' intention of HIV testing because their husbands were decision-makers in their family, and pregnant mothers will take HIV testing.

Community-based intervention for cervical cancer screening uptake in a semi-urban area of Pokhara Metropolitan, Nepal (COBIN-C): study protocol for a cluster-randomized controlled trial

BackgroundPrevious studies suggest that health intervention designed to increase cervical cancer screening has been effective to reduce cervical cancer incidence and mortality. The aim of this study is to determine the effect of a home-based health education intervention for increasing cervical cancer screening uptake delivered by trained female community health volunteers (FCHVs), a category of community health worker in Nepal.MethodsA community-based, open-label, two-armed, cluster-randomized trial [seven clusters (geographical wards) randomized for the intervention, and seven for the control arm]. The participants are recruited from a population-based survey with a sample size of 884. Based on population proportion size, 277 women will be recruited for the intervention group and 413 women recruited for the control group. A 12-month community-based health education intervention will be administered mobilizing the FCHVs, based on the Health Belief Model. The primary outcome measure of the study will be the difference in percentage of cervical cancer screening uptake between the two study arms. The primary outcomes will be modeled by using mixed-effect logistic regression analysis.DiscussionCOBIN-C is the first study investigating the effect of a community-based health education intervention by FCHVs on increasing cervical cancer screening uptake among women in Nepal. The purpose of this study is to develop and implement a home-based, culturally sensitive program to increase cervical cancer screening coverage at the community level.Trial registrationClinicalTrials.gov NCT03808064. Registered on January 14, 2019.

A Pilot Study to Evaluate a Computer-Based Intervention to Improve Self-care in Patients With Heart Failure

Cognitive dysfunction contributes to poor learning and impaired self-care (SC) for patients with heart failure. The aims of this study were to (1) evaluate the feasibility and acceptability of a nurse-led, virtual home-based cognitive training and SC education intervention to support SC and (2) evaluate the relationship between improvements in SC and cognitive change and examine 30-day readmission rates. In this 2-phase pilot study, we used a prospective, exploratory design. In phase 1, recruitment criteria and retention issues threatened feasibility and acceptance. Significant modifications were made and evaluated in phase 2. In phase 2, 12 participants were recruited (7 women and 5 men). Feasibility was supported. All participants and the study nurse positively evaluated acceptability of the intervention. Median SC scores improved over time. Thirty-day hospital readmission rates were 25%. Phase 1 indicates the intervention as originally designed was not feasible or acceptable. Phase 2 supports the feasibility and acceptability of the modified intervention. Further testing is warranted.

A Smartphone App for Patients With Acute Coronary Syndrome (MoTER-ACS): User-Centered Design Approach.

BackgroundPostdischarge interventions are limited for patients with acute coronary syndrome (ACS) due to few scheduled visits to outpatient clinics and the need to travel from remote areas. Smartphones have become viable lifestyle technology to deliver home-based educational and health interventions.ObjectiveThe aim of this study was to develop a smartphone-based intervention for providing postdischarge support to patients with ACS.MethodsThe content of Mobile Technology–Enabled Rehabilitation for Patients with ACS (MoTER-ACS) was derived from a series of small studies, termed prestudy surveys, conducted in 2017. The prestudy surveys were conducted in Prince Charles Hospital, Queensland, Australia, and consisted of questionnaires among a convenience sample of patients with ACS (n=30), a focus group discussion with health care professionals (n=10), and an online survey among cardiologists (n=15). Responses from the patient survey identified educational topics of MoTER-ACS. The focus group with health care professionals assisted with identifying educational materials, health monitoring, and self-management interventions. Based on the results of the cardiologists’ survey, monitoring of symptoms related to heart failure exacerbation was considered as a weekly diary.ResultsThe MoTER-ACS app covers multimedia educational materials to adopt a healthy lifestyle and includes user-friendly tools to monitor physiological and health parameters such as blood pressure, weight, and pain, assisting patients in self-managing their condition. A web portal that is linked to the data from the smartphone app is available to clinicians to regularly access patients’ data and provide support.ConclusionsThe MoTER-ACS platform extends the capabilities of previous mobile health platforms by providing a home-based educational and self-management intervention for patients with ACS following discharge from the hospital. The MoTER-ACS intervention narrows the gap between existing hospital-based programs and home-based interventions by complementing the postdischarge program for patients with ACS.

Enhancing Breastfeeding - Home-Based Education on Self-Efficacy: A Preventive Strategy.

Background:The aim of this study is to evaluate the effects of home-based education intervention on the exclusivity and promoting the rates of self-efficacy of breastfeeding.Materials and Methods:A randomized controlled trial was conducted Arak University of Medical Sciences in Takeghani Hospital in Iran between June 2015 and October 2015. A total of 130 eligible and voluntary women hospitalized in Arak University of Medical Sciences Hospital postpartum wards were randomized to receive usual care (n = 65) or education with CD and pamphlets (n = 65). Data regarding exclusive breastfeeding were collected using Denis and Fox's breastfeeding self-efficacy questionnaire. The primary outcome was collected by one assistant researcher during first postpartum visit. The secondary outcome was collected 4 weeks after birth of babies by telephone interviews. Data analysis was performed using descriptive (frequency, mean), independent samples t-test, Student's t-test, t2-test, and Chi-square test. All values of P < 0.05 were considered statistically significant.Results:There was no significant differences between the intervention and control groups with regard to age (P = 0.086) and gestational age (P = 0.741). The breastfeeding self-efficacy scores were higher in the intervention group (63.66 ± 6.11) than in the control group (57.04 ± 6.18) after 1 month of childbirth (P = 0.001). The exclusive breastfeeding rate in intervention group was 89.2 (n = 58) at 1st month after education compared with 55.4% (n = 36) in control group (P = 0.001).Conclusions:In a setting, a high breastfeeding rate and self-efficacy scores were found in education group. Therefore, nurses and midwives are thus required to adopt various health education strategies, such as home education, encourage breastfeeding.

Home-Based Exergaming on Preschoolers' Energy Expenditure, Cardiovascular Fitness, Body Mass Index and Cognitive Flexibility: A Randomized Controlled Trial.

Purpose: The effects of exergaming-based physical activity (PA) interventions on preschoolers’ health outcomes and cognition remain largely unexplored. Therefore, we conducted a randomized controlled trial to discern the effectiveness of a home-based educational exergaming intervention on preschoolers’ energy expenditure, fitness, body mass index, and cognition. Methods: Participants were 32 preschoolers (16 girls; 59.4% Asian; Mage = 4.72, SD = ±0.73) recruited from the Twin Cities area in Minnesota. During baseline testing, we measured preschooler’s daily energy expenditure (EE), cardiovascular fitness, body mass index, and cognitive flexibility using validated instruments. Participants were then randomly assigned to one of two conditions: (1) the exergaming intervention condition; or (2) control condition. The intervention program requested children participate in home-based educational exergaming using the LeapTV gaming console for at least 30 min/session 5 times/week. The control condition asked children to maintain regular PA patterns without any exergaming gameplay. Each condition lasted 12 weeks. We conducted identical outcome assessments for all children at baseline and post-intervention. Results: Analysis of covariance with repeated measures yielded significant time x group interaction effects for cognitive flexibility, Wilks’ Lambda = 0.81, F(1, 29) = 6.98, p = 0.01, η2 = 0.19, suggesting children in the exergaming group demonstrated significantly greater increases in cognitive flexibility as compared to those in the control group over time. There were no significant differences for time x group changes between the two groups for EE, Wilks’ Lambda = 0.92, F(1, 29) = 2.29, p = 0.14, η2 = 0.08; cardiovascular fitness, Wilks’ Lambda = 0.96, F(1, 29) = 1.07, p = 0.31, η2 = 0.04; and BMI, Wilks’ Lambda = 0.99, F(1, 29) = 0.05, p = 0.82, η2 = 0.01. However, our data did suggest a marginal effect of time for EE, Wilks’ Lambda = 0.89, F(1, 29) = 3.26, p = 0.08, η2 = 0.08, indicating that children’s daily EE increased from baseline to post-intervention. Conclusions: Home-based educational exergaming may positively impact cognitive flexibility in preschoolers. Studies with larger sample sizes in multiple geographic locations are needed, with our study suggesting a longer intervention period might also be warranted.

Effects of the home-based educational intervention on health outcomes among primarily Hispanic children with asthma: a quasi-experimental study

BackgroundChildhood asthma is a significant health issue with 8.3% prevalence in the U.S. Its prevalence is particularly higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. This study examines the impact of a home-based education led by Community Health Workers (CHWs) on health outcomes for asthmatic, predominantly Hispanic children in these communities.MethodsThe study was a quasi-experimental design to learn the effectiveness of the asthma home-based education by comparing changes of health outcomes between baseline and follow-up of intervention and control groups. This study enrolled 290 participants, consisting of 130 in the intervention group and 160 in the control group. The educational intervention led by the CHWs referenced the Asthma and Healthy Homes curriculum and contents of the Seven Principles of Healthy Homes. The multiple linear regression analysis was conducted to estimate the associations between the intervention and each health outcome.ResultsWhen comparing the intervention group with the control group, the intervention group showed a significantly greater decrease in asthma attacks than the control group (p = 0.049). Although all of the five Children’s Health Survey for Asthma (CHSA) scores showed significant improvements between baseline and follow-up in both groups, we found that increases of CHSA scores in the intervention group were higher than the control group except for emotional health of children (EC) score. The multiple linear regression models demonstrated that the mean changes in asthma attacks (p = 0.036) and emotional health of families (EF) score (p = 0.038) were significantly better in the intervention group than the control group, adjusting for children’s age of diagnosis, household income, use of steroids, family history of allergy, and type of insurance.ConclusionsThis study concluded that the home-based education by CHWs effectively improve health outcomes among children in communities lacking access to medical resources. The findings suggest the importance of the home-based education program in promoting emotional and medical care for children and their families in low-income communities like those in the Texas-Mexico border region.

Cost-effectiveness of a home-based group educational programme on renal replacement therapies: a study protocol

IntroductionLiving donor kidney transplantation (LDKT) is the optimal treatment for most patients with end-stage renal disease (ESRD). However, there are numerous patients who cannot find a living kidney donor. Randomised...

The Influence of a Home-Based Education Intervention on Family Caregivers’ Knowledge and Self-Efficacy for Cancer Pain Management in Adult Patients Within a Resource-Limited Setting

Cancer-related pain is prevalent and has debilitating effects on patients and their family. The effects of cancer pain can be curtailed if the family members caring for the patient receive essential support to enhance their capabilities for cancer pain management. Little has been done to study the available support to family caregivers (FCGs) towards pain management in adult cancer patients (ACPs) living in resource-limited countries where the burden of cancer is on the rise. This study evaluated the influence of an education intervention delivered in the home setting on FCGs' knowledge and self-efficacy (SE) for pain management in ACPs. One-group pre-/post-test design was used in a sample of 54 FCGs who had been caring for ACPs suffering from pain for at least 1month. Data were collected using the Family Pain Questionnaire and Caregiver Pain Management SE Scale. The FCGs' mean knowledge score post-intervention (26.69 ± 10) was higher than the baseline (45 ± 12.9), and the difference was statistically significant (t = 10.382, p = 0.000, CI = 17.12-25.43). Additionally, the FCGs' mean SE score post-intervention (1003.30 ± 191) was higher than the baseline (648.3 ± 273.4), and the difference was statistically significant (t = - 8.52, p = 0.000, CI = - 438.6-- 271.4). The home-based education intervention significantly and positively influenced the FCGs' knowledge and SE for pain management while at home. Cancer pain management educational interventions delivered at home should be considered as one of the strategies for enhancing cancer care in resource limited settings.