Use Of Community Volunteers Research Articles

Knowledge of malaria control and attitudes towards community involvement among female community volunteers: effect of capacity building in a rural community, southeast Nigeria

Introductioncommunity volunteers have limited skills but are an important link between the community and health facilities. We determined the effect of a capacity building intervention on knowledge of malaria control and attitudes towards community involvement among female community volunteers as part of a larger community-based intervention study on pregnant women and children under five.Methodswe conducted a before and after intervention study (no randomization or controls) among female community volunteers in Amagu community in Abakaliki Local Government Area. The intervention consisted of training sessions on knowledge of malaria and its control. The training took the form of lectures, role plays and practical demonstrations. Supportive supervision by trained community health extension workers was also provided during their field work. We compared pre-training test and post-training test scores after six months interval and analysed the data using paired t test at 5% level of significance with EPI INFO software version 7.2.3.Resultsthe mean age of the participants was 28.5(± 6.0) years. All had a minimum level of secondary education. There was significant improvement in the mean scores of their knowledge of malaria signs and symptoms (p < 0.001), preventive measures (p < 0.001) and appropriate drug treatment (p < 0.001) in the post-training test when compared with the pre-training test. The overall mean knowledge scores pre and posttest were 147.8 and 169.8 respectively (p < 0.001) out of a maximum achievable score of 195. Also there was significant improvement in the perception of the participants on community involvement in promoting referral of pregnant women with fever (p = 0.001), the use of intermittent preventive therapy with sulphadoxine-pyrimethamine (p = 0.048) and funding initiatives to sustain activities (p = 0.037).Conclusioncapacity building of female community volunteers coupled with supportive supervision by trained community health workers improved the female community volunteers´ knowledge of malaria, its control and their perception of community involvement in control activities. It is recommended that the use of community volunteers as a low cost health resource can be explored further for incorporation into existing policies on malaria control in resource constrained environments.

Implementing a community vector collection strategy for monitoring vector-borne diseases in Ghana

Background: Monitoring vector-borne diseases requires sampling of very large numbers of disease vectors in order to corroborate infections in the human population. This can be challenging, as current vector collection tools are either inefficient, or expensive to implement from a public health perspective. To circumvent this challenge, this study compared a community vector collection strategy using a double-netted mosquito collection method (a tent trap (TT)) to the traditional human landing collection (HLC) method in three communities in lymphatic filariasis-endemic districts in Ghana. Methods: Following community entry and sensitization, community volunteers appointed by the community leaders were trained in the mosquito collection and storage methods and provided with supplies for mosquito collection over a 7-month period. They were visited occasionally by the study team to retrieve the mosquito samples for identification. The collectors were also assessed to evaluate their perspectives on using community vector collectors for monitoring vector-borne diseases. Results: The results of the study indicated that the TT method collected significantly more mosquitoes (63%) over the collection period than HLC (37%). Thus, the TTs were observed to be performing relatively better than the HLC (P&lt;0.001). The collectors knew the importance of mosquitoes in transmitting diseases, could identify the main diseases that were locally transmitted within their communities. They appreciated the involvement of the community in the collection as this enhanced community ownership of the programme as well as providing some financial incentives to those directly involved in the collection. Conclusions: The study revealed that use of community volunteers for the collection of mosquitoes for xenomonitoring purposes can be a viable strategy in the monitoring of vector-borne diseases. However, further development of the strategies and assessments of the costs involved will be required to make this a sustainable approach to monitoring vector-borne disease interventions and enhance community ownership of the programmes.

An Authentic Poverty Simulation for Health Care Profession Students Using Community Volunteers Experiencing Poverty.

Poverty is a harsh reality for more than 40 million Americans, which can lead to detrimental health outcomes. Considering health professionals encounter clients of low-income status, increasing awareness and empathy toward this population is essential. This article describes a novel approach to conducting poverty simulations by using community volunteers that are currently living or have recently lived in poverty, lending to a more authentic experience for students. The community volunteers acted as resource workers during the simulation. Five lessons were learned as part of this authentic approach including the importance of orientation, consistent volunteer recruitment, volunteer appreciation, simulation role ownership, and importance of incentives. This approach is an effective initial step in increasing awareness and empathy among health care profession students toward individuals living in poverty. Use of community volunteers with personal experience with poverty enhances the realism of this experience for students.

Evaluating the implementation fidelity of a community-based intervention to promote hearing conservation among farm and rural youth.

Noise-induced hearing loss is common among farm and rural youth. There is a lack of programs preparing this high-risk population to use hearing conservation strategies. Safety Days are 1-day workshops that teach 100,000 rural children safe farm practices in 400 sites across the USA annually. As part of a larger study for fourth graders, a hearing conservation lesson was delivered at 25 sites nationwide. However, the fidelity to the study-designed curriculum and quality of instruction was unknown. We examined whether community volunteers are capable of delivering, with adequate fidelity and quality, a planned intervention designed to increase use of hearing conservation strategies among farm and rural youth. We invited instructors (n = 22) to deliver a health lesson to fourth graders and provide lesson recordings. We developed instruments rating (i) fidelity of the teaching to the curriculum and (ii) quality of instruction. Initial instruments were modified based on the review for clarity, relevance, and conceptual fit; inter-rater reliabilities were .90 (content fidelity) and 1.00 (quality of instruction). Of seven recordings reviewed, mean fidelity to the planned curriculum was 1.51 (max score = 2), with nearly four fifths of lesson items fully addressed. Overall mean of rating of quality of instruction was 1.97 (out of 2). Fidelity to both content and quality of instruction was high. Results provide a model and support for use of community volunteers (with no special educational or experiential background) and fidelity testing as cost-effective strategies to provide sustainable programming for hearing conservation among farm and rural youth.

Implementing a community vector collection strategy for monitoring vector-borne diseases in Ghana

Background: Monitoring vector-borne diseases requires sampling of very large numbers of disease vectors in order to corroborate infections in the human population. This can be challenging, as current vector collection tools are either inefficient, or expensive to implement from a public health perspective. To circumvent this challenge, this study compared a community vector collection strategy using a double-netted mosquito collection method (a tent trap (TT)) to the traditional human landing collection (HLC) method in three communities in lymphatic filariasis-endemic districts in Ghana. Methods: Following community entry and sensitization, community volunteers appointed by the community leaders were trained in the mosquito collection and storage methods and provided with supplies for mosquito collection over a 7-month period. They were visited occasionally by the study team to retrieve the mosquito samples for identification. The collectors were also assessed to evaluate their perspectives on using community vector collectors for monitoring vector-borne diseases. Results: The results of the study indicated that the TT method collected significantly more mosquitoes (63%) over the collection period than HLC (37%). Thus, the TTs were observed to be performing relatively better than the HLC (P&lt;0.001). The collectors knew the importance of mosquitoes in transmitting diseases, could identify the main diseases that were locally transmitted within their communities. They appreciated the involvement of the community in the collection as this enhanced community ownership of the programme as well as providing some financial incentives to those directly involved in the collection. Conclusions: The study revealed that use of community volunteers for the collection of mosquitoes for xenomonitoring purposes can be a viable strategy in the monitoring of vector-borne diseases. However, further development of the strategies and assessments of the costs involved will be required to make this a sustainable approach to monitoring vector-borne disease interventions and enhance community ownership of the programmes.

Community Volunteer Support for Families With Young Children: Protocol for the Volunteer Family Connect Randomized Controlled Trial.

BackgroundUse of community volunteers to support vulnerable families is a widely employed strategy with a long history. However, there has been minimal formal scientific investigation into the effectiveness of volunteer home visiting programs for families. There is also a need for research examining whether volunteer home visiting leads to improved outcomes for volunteers.ObjectiveThe objective of this paper is to describe the research protocol for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home visiting program designed to support families of young children who experience social isolation or a lack of parenting confidence and skills. The project is being conducted in partnership with 3 leading not-for-profit organizations, designed to contribute to the body of evidence that informs decisions about appropriate family support services according to the level of need. It is the first study to examine outcomes for both the families and the volunteers who deliver the service.MethodsThe RCT is being conducted in 7 sites across Australia. We aim to recruit 300 families to the study: 150 control (services as usual) and 150 intervention (services as usual + volunteer home visiting) families. Intervention families will receive the service for 3-12 months according to their needs, and all participants will complete 6 data collection points over 15 months. A minimum of 80 volunteers will also be recruited, along with a matched community comparison group. The volunteers will complete 3 data collection points over 12 months. Primary outcomes include community connectedness and parenting competence. Secondary outcomes include parent physical and mental health; general parent well-being; parent empowerment; the child-parent relationship; sustainability of family routines; child immunization; child nutrition or breastfeeding; number of accidental injury reports; and volunteer health, well-being, and community connectedness.ResultsThis effectiveness trial was funded in 2016, and we aim to complete data collection by the end of 2018. The first results are expected to be submitted early in 2019.ConclusionsThere is a need to rigorously assess volunteer home visiting and whether it has a unique and important role on the service landscape, complementary to professional services. This research is the first trial of a volunteer home visiting program to be conducted in Australia and one of the largest of its kind worldwide.Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12616000396426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370304 (Archived by WebCite athttp://www.webcitation.org/70q42fU7V)Registered Report IdentifierRR1-10.2196/1000

\u201cWe don\u2019t want our clothes to smell smoke\u201d: changing malaria control practices and opportunities for integrated community-based management in Baringo, Kenya

BackgroundThe decline in global malaria cases is attributed to intensified utilization of primary vector control interventions and artemisinin-based combination therapies (ACTs). These strategies are inadequate in many rural areas, thus adopting locally appropriate integrated malaria control strategies is imperative in these heterogeneous settings. This study aimed at investigating trends and local knowledge on malaria and to develop a framework for malaria control for communities in Baringo, Kenya.MethodsClinical malaria cases obtained from four health facilities in the riverine and lowland zones were used to analyse malaria trends for the 2005–2014 period. A mixed method approach integrating eight focus group discussions, 12 key informant interviews, 300 survey questionnaires and two stakeholders’ consultative forums were used to assess local knowledge on malaria risk and develop a framework for malaria reduction.ResultsMalaria cases increased significantly during the 2005–2014 period (tau = 0.352; p < 0.001) in the riverine zone. March, April, May, June and October showed significant increases compared to other months. Misconceptions about the cause and mode of malaria transmission existed. Gender-segregated outdoor occupation such as social drinking, farm activities, herding, and circumcision events increased the risk of mosquito bites. A positive relationship occurred between education level and opinion on exposure to malaria risk after dusk (χ2 = 2.70, p < 0.05). There was over-reliance on bed nets, yet only 68% (204/300) of respondents owned at least one net. Complementary malaria control measures were under-utilized, with 90% of respondents denying having used either sprays, repellents or burnt cow dung or plant leaves over the last one year before the study was conducted. Baraza, radios, and mobile phone messages were identified as effective media for malaria information exchange. Supplementary strategies identified included unblocking canals, clearing Prosopis bushes, and use of community volunteers and school clubs to promote social behaviour change.ConclusionsThe knowledge gap on malaria transmission should be addressed to minimize the impacts and enhance uptake of appropriate malaria management mechanisms. Implementing community-based framework can support significant reductions in malaria prevalence by minimizing both indoor and outdoor malaria transmissions.

Student Attitudes Toward Using Community Volunteers Enhance Clinical Reasoning Skills as Part of Laboratory Coursework

Abstract Date Presented 4/1/2017 Student attitudes toward the use of community volunteers with clients with chronic neurological conditions were assessed, especially when embedded in core master of occupational therapy coursework and in preparation for Level II fieldwork rotations. Primary Author and Speaker: Bryan Gee Additional Authors and Speakers: Kimberly Lloyd

Diabetes prevention and care in the universal health coverage context: The example of Thailand

Universal health coverage (UHC) is a key policy issue in countries of the World Health Organization (WHO) South-East Asia Region. However, despite projections of significant increases in burden, there is little protection against the financial risks associated with noncommunicable diseases (NCDs), including diabetes. Thailand achieved UHC of all 67 million of the population in 2002, under three public health insurance schemes. The country therefore provides a case-study on diabetes prevention and care in the context of UHC. Although the budget for the Thai Universal Coverage (UC) scheme, which covers nearly 80% of the population, increased significantly during 2003-2013, the proportion allocated to clinical prevention and health promotion declined from 15% to 11%. The financial case for investment in diabetes prevention is made, particularly with respect to a focus on primary care and the use of community volunteers. The UC scheme can expand to nearly 100% population coverage, with a comprehensive benefit package and financial risk protection. Although the rates of complications and fatalities in patients with diabetes have improved over the last few years, achievement of well-controlled fasting blood glucose for all patients is still the main challenge for further improvement. It is recommended that, in order to improve coverage of diabetes care and prevention, it is essential for countries in the WHO South-East Asia Region to include major NCD services, in particular primary prevention, in their UHC strategies. Since a resilient health system is key to UHC delivery, strengthening of the health workforce and infrastructure should be part of any action plan to prevent and control diabetes.

A randomized controlled trial to evaluate an educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure: Rationale, design and methodology.

BackgroundChronic heart failure (CHF) is an increasingly important health problem worldwide. Effective self-care can improve the outcomes and quality of life in patients with CHF. Acknowledging the important role of educational interventions for improving self-care, we sought to assess a new educational strategy involving community health volunteers (CHVs) that could reduce the cost and, hypothetically, increase the effectiveness of self-care education in patients with CHF.Methods/DesignIn this ongoing three-arm controlled trial, approved by two human research ethics committees in Australia and Iran, 231 patients with CHF registered at a referral cardiovascular hospital in Iran were randomly allocated into three groups -trained by community health volunteers at patients’ homes, rained by formal health professionals at hospital; and a control group with no formal educational exposure. Data obtained through interviewing participants and using the Persian self-care of CHF index (pSCHFI) before and two months after interventions will be analysed using SAS and SPSS.DiscussionThe results of this study may help health service systems, especially in countries with limited resources, make use of community volunteers to teach patients with CHF to develop self-care behaviors and skills, reducing the cost of care and improving CHF outcomes. Also, this home-based educational strategy using face-to-face training, if successful, may provide psychosocial supports for patients suffering from chronic illnesses.Trial registration numberACTRN12614000788673 (Australian New Zealand Clinical Trials Registry)

Use of community volunteers to improve knowledge and uptake of tuberculosis and human immunodeficiency virus screening services among community members in Qu′an Pan Local Government Area, Plateau State

Background: The global impact of the converging dual epidemics of tuberculosis (TB) and human immunodeficiency virus (HIV)/AIDS is one of the major public health challenges of our time. Ignorance, fear, stigma and poverty have promoted the course of TB and HIV infections, particularly among people residing in the rural areas despite the availability of free diagnostic and treatment services. Community volunteers (CV) have been used successfully to promote and sustain knowledge and utilization of health services in various parts of the world. This study sought to determine the impact of the use of CV on knowledge and uptake of TB/HIV screening services in the study population. Methodology: The study design was a community-based quasi-experimental study. A multistage sampling technique was used to select the study participants. The Primary Health Care (PHC centres offering TB and HIV screening services were the primary sampling units while the communities close to the PHCs were the secondary sampling units. The intervention involved a CV in each community providing education and services on TB and HIV/AIDS infections to the community members. Knowledge and uptake of TB and HIV screening services among the community members were assessed before and after the intervention. Results: A total of 1305 people were recruited into the study and five communities each were selected per PHC. Postintervention, there was an increase in the knowledge of the cause, mode of transmission, symptoms and treatment of TB among community members from a mean score of 2.23 ± 2.31 to 5.37 ± 2.64 (P < 0.0001). There was also an increase in the knowledge of the modes of transmission, symptoms and prevention of HIV/AIDS among community members from a mean score of 6.66 ± 2.92 to 8.36 ± 3.35 (P < 0.0001). Uptake of TB screening rose from 59.4% to 75.0% (P = 0.0161) among community members with a history of chronic cough and uptake of HIV counselling and testing (HCT) also rose from 53.8% to 64.1% (P = 0.0215) among the community members.Conclusion: Community Volunteers were found to improve the people's knowledge of TB and HIV/AIDS infections as well as uptake of HCT and TB screening services. Their use will help improve TB and HIV collaborative activities and also contribute to the reduction of morbidity and mortality associated with TB and HIV infections.

Changes in complementary feeding practices and nutrition status in returnee children aged 6-23 months in northern Uganda

Objectives: Evaluate changes in underweight and wasting, feeding patterns, water use, sanitation, immunisation, disease episodes, deworming and vitamin A supplementation in children aged 6-23 months in returnee villages benefiting from a community-based supplementary feeding programme in northern Uganda. Community perceptions on the causes and effects of childhood malnutrition, the use of community volunteers, the involvement of the men in the promotion of child nutrition and changes in childhood nutrition and feeding practices were also assessed.Design: Programme impact evaluation.Setting: The study was carried out in the districts of Pader and Agago in northern Uganda.Subjects: Children aged 6-23 months (207), and adult men and women.Outcome measures: Weight and mid-upper-arm circumference were used to determine underweight and wasting, respectively. Immunisation, deworming and vitamin A supplementation status was assessed. Oedema and morbidity or disease episodes were also determined. Community perceptions on the quality, utilisation and types of supplementary feeding services offered, understanding of malnutrition and the involvement of the men were also assessed. Finally, the impact of mother care groups and village health teams, as well as changes in child nutrition status and feeding, were assessed.Results: The prevalence of wasting (11.1%) and underweight (22.7%) is higher than the baseline of 11% and 17.8%, respectively. Eighty-six per cent of the children were still breastfeeding. A high percentage (79.2%) of children were exclusively breastfed. The largest proportion of children (42.3%) ate two times a day, and 55.6% of them consumed food from their own plates. Over three quarters (75.8%) and 93.7% of the children had received measles and diphtheria, pertussis and tuberculosis vaccines (DPT3), respectively. Ninety-five per cent and 66.7% had received vitamin A supplements and deworming tablets, respectively. The water usage rate was 19.2 l/person/day. Sixty per cent of the households had their own pit latrines. The programme was perceived to have improved the nutritional knowledge and feeding practices of the community. The use of volunteer mothers for nutrition education encouraged other community members to take childhood nutrition seriously.Conclusion: Childhood wasting and underweight rates have remained high in the two districts, despite an improvement in nutrition-related knowledge and practices. Advances in complementary feeding and related sanitation practices were recorded. An increase in vitamin A supplementation, with reductions in DPT3 immunisation and deworming were observed at the end of this community-based supplementary feeding programme. Community volunteers, through the provision of education and the identification of malnourished children, were pivotal in changing nutrition knowledge and the attitudes of community members. The support of volunteers with savings, loans and seeds were important incentives when promoting nutrition. Given the reliance of the volunteers on incentives from the project, we are sceptical as to whether nutrition education and the screening of acutely malnourished children will continue in these communities post the project.

Effects of malaria volunteer training on coverage and timeliness of diagnosis: a cluster randomized controlled trial in Myanmar

BackgroundThe use of community volunteers is expected to improve access to accurate diagnosis and timely treatment of malaria, using rapid diagnostic test (RDT) and artemisinin-based combination therapy (ACT). However, empirical data from the field are still limited. The aim of this study was to assess whether training village volunteers on the use of Paracheck-Pf® RDT and ACT (artemether-lumefantrine (AL)) for Plasmodium falciparum and presumptive treatment with chloroquine for Plasmodium vivax had an effect on the coverage of timely diagnosis and treatment and on mortality in malaria-endemic villages without health staff in Myanmar.MethodsThe study was designed as a cluster randomized controlled trial with a cross-sectional survey at baseline, a monthly visit for six months following the intervention (village volunteers trained and equipped with Paracheck-Pf®) and an endline survey at six months follow-up. Survey data were supplemented by the analysis of logbooks and field-based verbal autopsies. Villages with midwives (MW) in post were used as a third comparison group in the endline survey. Intention-to-treat analysis was used.ResultsOf 38 villages selected, 21 were randomly assigned to the intervention (two villages failed to participate) and 17 to the comparison group. The two groups had comparable baseline statistics. The blood tests provided by volunteers every month declined over time from 279 tests to 41 but not in MW group in 18 villages (from 326 to 180). In the endline survey, among interviewed subjects (268 intervention, 287 in comparison, 313 in MW), the coverage of RDT was low in all groups (14.9%, SE 2.4% in intervention; 5.7%, SE 1.7% in comparison; 21.4%, SE 2.6% in MW) although the intervention (OR 3.2, 95% CI 1.5-6.7) and MW (OR 5.4, 95% CI 2.6-11.0) were more likely to receive a blood test. Mean (SE) of blood tests after onset of fever in days was delayed (intervention 3.6 (0.3); comparison 4.8 (1.3); MW 3.2 (0.4)). Malaria mortality rates per 100,000 populations in a year were not significantly different (intervention 130 SE 37; comparison 119 SE 34; MW 50 SE 18). None of the dead cases had consulted volunteers.ConclusionsThe results show that implementing volunteer programmes to improve the coverage of accurate and timely diagnosis with RDT and early treatment may be beneficial but the timeliness of detection and sustainability must be improved.

Pilot study of the use of community volunteers to distribute azithromycin for trachoma control in Ghana.

To assess the skills of community health volunteers in diagnosing active trachoma and distributing azithromycin in the Northern Region of Ghana. Six community health volunteers from Daboya were trained to diagnose trachoma and to treat the disease using azithromycin. They were also informed of the drug's possible side-effects. Under supervision, each volunteer then examined, and if necessary treated, 15 households. The dose of azithromycin was determined by weight; height was also measured. Tablets were given in preference to suspension when possible. The volunteers' diagnostic sensitivity for active trachoma was 63%; their specificity was 96%. At the household level, their "decision to treat" was correct in 83% of households. In 344 treatment episodes, volunteers planned a dose of azithromycin outside the range 15-30 mg/kg on only seven occasions (2.0% of all planned treatments). The volunteers' drug management skills were good, the response of the community was excellent, and adverse reactions were infrequent. Diagnosis of active trachoma, record-keeping skills, and knowledge of side-effects were found to need greater emphasis in any future education programme. Most people aged four years or older were able to swallow tablets. For those taking tablets, the correlation between the data gathered for height and weight shows that calculating azithromycin doses by height is a valid alternative to calculating it by weight. Trained community health volunteers have a potential role in identifying active trachoma and distributing azithromycin. To simplify training and logistics, it may be better to base dosage schedules on height rather than weight for those taking tablets, which included most people aged four years or more in the population studied.

Recruitment, Retention, and Activity of Volunteers Promoting Mammography Use in Rural Communitites

As of a community mammography promotion, the authors recruited volunteers in rural communities to conduct intervention activities. Volunteers were trained to promote mammography use among the women in their community using a variety of community activities and/or barrier-specific telephone counseling (BSTC). As prior research on BSTC has suggested that it is a particularly effective means of screening promotion, the authors were interested in determining whether volunteers could be recruited and trained to be effective counselors. The results of this analysis suggest that recruiting volunteers for BSTC is not more difficult than recruitment of volunteers for more traditional community activities, but that special efforts may be required to retain volunteers doing BSTC and to encourage their activity. Overall, the use of community volunteers for mammography promotion in rural areas is possible, and volunteers using either intervention strategy may be able to increase screening use.

Study of Strategies for the Recuitment of Elders Including the Use of Community Volunteers

The primary objective was to compare study participation when first contact was made by telephone versus an unscheduled visit to the household. The secondary objective was to compare study participation when three differing modes of questionnaire presentation were used. The residents of 300 randomly selected households were contacted by community volunteers and asked to participate in a study of the etiology of cancer and other chronic diseases. Two methods of first contact were used, a telephone call to schedule a home visit and an unscheduled visit to the household. Three modes of questionnaire presentation were used. Residents of a retirement community in Arizona who were aged 50 or over. Agreement to participate, defined as acceptance of and agreement to complete the study questionnaires. Participation in the study, defined as acceptance and completion of the study questionnaires. No difference was observed in participation when first contact was made by telephone (46%) as compared with an unscheduled visit to the household (45%) (P = 0.83). Similarly, no difference in the participation was observed between three modes of presentation of the questionnaire to the householders (P = 0.13). Agreement to participate was, however, significantly higher when first contact was made by visiting the home (81% vs 55%) (P less than 0.001). Neither the strategy used for first contact nor mode of questionnaire presentation affected participation.

An Affordable High-Tech Solution to School Management Problems

Effective use of community volunteers to increase automation of high school administrative tasks can result in better finan cial management in our schools. Better financial manage ment can result in better resource management, and better resource management should result in better schools.