Health Behavior, Infant Nutrition Disorders
Conditions
Keywords
sharing histories, autobiographical memory, health behavior, narrative communication, community health workers, global health, maternal and child health, stunting
Brief summary
The purpose of this study is to determine the effectiveness of an innovative methodology for training Community Health Workers that will improve their effectiveness in educating mothers to adopt best practice health behaviors in the home.
Detailed description
Objective: Training of community health workers (CHW) is a growing priority to close the gap between health services and mothers/families in resource poor communities. To address research needs on how to improve effectiveness of CHW training, the investigators tested an innovative CHW teaching methodology called Sharing Histories hypothesizing that this would empower and enable CHW to better teach mothers to improve health knowledge and behaviors that contribute to improved child growth. Method: The study was a cluster-randomized controlled trial: 22 health facility jurisdictions were matched and randomly assigned as experimental or control. Health personnel Tutors and female CHW were trained using either the Sharing Histories methodology (experimental) or a standard but still participatory teaching method (control). Training content, materials, and other interventions were held constant between study groups. Impact on maternal knowledge and practices, and child growth and morbidity were measured in representative household surveys at baseline, midterm, and final evaluation, with 600 mothers interviewed - 300 in each study group - at each point in time.
Interventions
BEHAVIORALSharing Histories training method for CHW
Female Community Health Worker training participants were led through a guided process of recalling and sharing their autobiographical memories of their personal experiences in the first 1000 days of each of their children (pregnancy, childbirth, postpartum, newborn, breastfeeding, complementary feeding, infant diarrhea and hygiene, pneumonia). On the basis of memories, cultural beliefs and practices are identified and training content is built.
BEHAVIORALStandard training method for CHW
Female Community Health Workers were trained with standard participatory teaching method with three phases: identify knowledge, provide new knowledge, evaluate learning.
Sponsors
United States Agency for International Development (USAID)
Instituto de Investigacion Nutricional, Peru
Future Generations Graduate School
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
No minimum to 23 Months
Healthy volunteers
Yes
Inclusion criteria
* Adult interviewed must be mother or guardian of a child under two years of age. * Child from birth (0.1 months-old) to under two years of age (23.9 months-old).
Exclusion criteria
* If a mother selected for interview had more than one child under age two years, only the younger child was considered for the interview and anthropometry measurements.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in rate of stunting in children under two years of age (birth to 23.9 months of age) | Chidren born up to 24 months prior to the baseline survey in 2010. Children born up to 24 months prior to the final survey in 2014 | Stunting is defined as low height-for-age less than -2 z-scores from the median on the World Health Organization growth standard, 2006. |
Outcome results
None listed