Translating new evidence into clinical practice: a quasi-experimental controlled before-after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding counselling in South Africa
| Autor: | Lyn Haskins, Max Kroon, Thorkild Tylleskär, Samuel O. M. Manda, Ute Dagmar Feucht, Tanya Doherty, David Sanders, Nigel Rollins, Ali Dhansay, Ingunn Marie S. Engebretsen, Ameena Ebrahim Goga, Tshifhiwa Nkwenika, Christiane Horwood, Shuaib Kauchali, Vaughn M. John |
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| Rok vydání: | 2020 |
| Předmět: |
Counseling
medicine.medical_specialty Health Knowledge Attitudes Practice Psychological intervention HIV & AIDS HIV Infections Global Health Likert scale South Africa Health facility Acquired immunodeficiency syndrome (AIDS) Intervention (counseling) medicine Humans business.industry Public health public health Infant Mentoring General Medicine medicine.disease Controlled Before-After Studies Family medicine Medicine Female business Breast feeding Quasi-experiment community child health |
| Zdroj: | BMJ Open e034770 BMJ Open, Vol 10, Iss 10 (2020) |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesWe report the effectiveness of a mentoring approach to improve health workers’ (HWs’) knowledge, attitudes and confidence with counselling on HIV and infant feeding.DesignQuasi-experimental controlled before–after study.SettingRandomly selected primary healthcare clinics (n=24 intervention, n=12 comparison); two districts, South Africa.ParticipantsAll HWs providing infant feeding counselling in selected facilities were invited.InterventionsThree 1–2 hours, on-site workshops over 3–6 weeks.Primary outcome measuresKnowledge (22 binary questions), attitude (21 questions—5-point Likert Scale) and confidence (19 questions—3-point Likert Scale). Individual item responses were added within each of the attitude and confidence domains. The respective sums were taken to be the domain composite index and used as a dependent variable to evaluate intervention effect. Linear regression models were used to estimate the mean score difference between intervention and comparison groups postintervention, adjusting for the mean score difference between them at baseline. Analyses were adjusted for participant baseline characteristics and clustering at health facility level.ResultsIn intervention and comparison sites, respectively: 289 and 131 baseline and 253 and 114 follow-up interviews were conducted (August–December 2017). At baseline there was no difference in mean number of correctly answered knowledge questions; this differed significantly at follow-up (15.2 in comparison; 17.2 in intervention sites (pConclusionA participatory, low-intensity on-site mentoring approach to disseminating updated infant feeding guidelines improved HWs’ knowledge, attitudes and confidence more than standard dissemination via a circular. Further research is required to evaluate the effectiveness, feasibility and sustainability of this approach at scale. |
| Databáze: | OpenAIRE |
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