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Sharing Histories: Test of a Teaching Method for Community Health Workers

Not Applicable
Completed
Conditions
Infant Nutrition Disorders
Health Behavior
Interventions
Behavioral: Sharing Histories training method for CHW
Behavioral: Standard training method for CHW
Registration Number
NCT02903602
Lead Sponsor
Future Generations Graduate School
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
600
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CHW training method-Sharing HistoriesSharing Histories training method for CHWExperimental clusters of primary health care facilities provided training to Community Health Workers (CHW) from their communities utilizing the experimental teaching methodology, "Sharing Histories". CHW in both study groups made home visits to pregnant women and mothers of children under two years of age to teach mothers, monitor behaviors and danger signs in pregnant women, newborns, and children, and refer cases when needed for preventive and curative care.
CHW training method-StandardStandard training method for CHWControl clusters of primary health care facilities provided training to Community Health Workers (CHW) from their communities utilizing a standard CHW teaching methodology. CHW in both study groups made home visits to pregnant women and mothers of children under two years of age to teach mothers, monitor behaviors and danger signs in pregnant women, newborns, and children, and refer cases when needed for preventive and curative care.
Primary Outcome Measures
NameTimeMethod
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.

Secondary Outcome Measures
NameTimeMethod
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