Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to impove neonatal survival in Quang Ninh province, Vietnam

Autor: Lars Åke Persson, Lars Wallin, Nguyen Thu Nga, Katarina Ekholm Selling, Tran Quang Huy, Duong M. Duc, Leif A. Eriksson, Dinh Thi Phuong Hoa, Nguyen Thanh Thuy
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Gerontology
Program evaluation
Health Knowledge
Attitudes
Practice
medicine.medical_specialty
knowledge translation
neonatal mortality
Psychological intervention
Medicine (miscellaneous)
law.invention
Odds
facilitation
Translational Research
Biomedical
Social Facilitation
03 medical and health sciences
0302 clinical medicine
community health workers
Randomized controlled trial
law
Knowledge translation
Infant Mortality
Health Sciences
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Cluster randomised controlled trial
neonatal health
process evaluation
Vietnam
business.industry
Research
030503 health policy & services
Infant
Newborn
Attendance
Infant
Public Health
Global Health
Social Medicine and Epidemiology
Continuity of Patient Care
Hälsovetenskaper
Perinatal Care
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
Family medicine
Facilitator
Female
0305 other medical science
business
Program Evaluation
Zdroj: Trials
ISSN: 1745-6215
Popis: Background Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health – Knowledge Into Practice trial evaluated facilitation of community groups (2008–2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30–0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention. Methods Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models. Results To ensure eight active facilitators over 3 years, 11 Women’s Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19–0.73) than control communes (n = 46). Conclusions This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups’ work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts. Trial registration ISRCTNISRCTN44599712. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-1141-z) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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