High Blood Lead Levels, Lead Exposure
Conditions
Keywords
lead, pediatric, Sub-Saharan Africa, lead risk reduction
Brief summary
The goal of this clinical trial is to learn if BLL (blood lead level) screening and "healthy home" lead prevention program created in the US is adaptable to a Sub-Saharan African context. It will also work to address child lead exposure in Nairobi, Kenya. The main questions it aims to answer is: * Can materials and protocols developed for a US audience be effective in a Sub-Saharan African one? * Is there a difference in learning and action between groups that receive different degrees of intervention? Researchers will compare the outcomes of a group that received lead risk reduction information only in the clinical setting to a group that also received a home visit and tailored risk reduction messages. Participants will: * Have their child's blood lead levels measured at several timepoints * Take part in a questionnaire about lead risk * Receive lead risk reduction messaging either only in the clinic setting or also in their homes * Have their knowledge and risk reduction behaviors measured
Interventions
BEHAVIORALHome visit with tailored messages
The home visit will be conducted within 2 weeks of initial screening. During the home visit, the lead exposure risk survey will be re-administered, for comparison to in-clinic self-report survey responses. In addition, an observational checklist of potential lead exposure risk factors will be conducted to identify and discuss residential features and items in the home environment that may be influencing their BLL. Tailored messages on lead exposure risk reduction will be provided. A random sample of caregivers will complete an in-depth interview to gather barriers, understandability, and acceptability of the lead risk reduction messages received.
BEHAVIORALIn-clinic lead risk reduction intervention
For children with BLL \< 5 ug/dL, the result will be provided to the caregiver, together with standard post-test messaging on reducing lead exposure. A job-aid, such as a poster, showing common sources of lead exposure in children, and important sources of iron rich foods will be used to guide messaging. For BLLs ≥ 5, tailored messaging on potential sources identified on the risk factor survey will be provided. A random sample of caregivers will complete an in-depth interview to gather barriers, understandability, and acceptability of the lead risk reduction messages received.
Sponsors
University of Washington
National Institutes of Health (NIH)
National Institute of Environmental Health Sciences (NIEHS)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Months to 72 Months
Healthy volunteers
Yes
Inclusion criteria
* Caregivers with children ages 12-72 months attending routine care/vaccination visit at Nairobi clinical site.
Exclusion criteria
Children outside of age range, caregivers younger than 18; plan to leave study catchment within 9 months. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recall of survey risk factors | 3 and 9 months post clinic visit | Lead risk surveys will be completed by participants during the clinic visit and at 3 and 9 months post home visit. Qualitative analysis of the lead risk survey will summarize themes on understandability and acceptability of survey items and messages. The rapid analysis will also explore facilitators and barriers to uptake of recommended exposure reduction measures, and individual level determinants associated with uptake (e.g., empowerment, self-efficacy). |
| Self report of risk-reduction behavior | 3 and 9 months post clinic visit | Assess the proportion of caregivers self-reporting uptake of at least one of their risk reduction recommendations within arms and by BLL. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Differences in outcomes between arms | 3 and 9 months post clinic visit | Using risk survey responses and self-reported changes in risk reduction behavior, we will compare the participants of both arms to assess for differences. |
Countries
Kenya
Contacts
CONTACTKaren Jansen
PRINCIPAL_INVESTIGATORSarah Benki-Nugent
University of Washington
Outcome results
None listed