HRB open research最新文献

{"title":"The role of general practitioners in the management of patients with acne using isotretinoin: Protocol for a scoping review of clinical practice guidelines","authors":"Diarmuid Quinlan, Laura J Sahm, Linda O'Keeffe, Miriam Santer, Tony Foley","doi":"10.12688/hrbopenres.13914.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13914.1","url":null,"abstract":"Background Acne is the most common inflammatory skin disease, affecting most teenagers and many adults. Acne imposes physical, psychological, social and fiscal burdens, with additional concerns around antimicrobial stewardship. Isotretinoin is the most effective treatment for severe acne. However, there are well-documented serious adverse effects with teratogenicity, impact on mental health and blood abnormalities of particular concern. The prescribing practice of isotretinoin varies substantially internationally. Some countries restrict isotretinoin prescribing solely to dermatologists, while other countries have guidance supporting GPs to prescribe isotretinoin as well. The existing literature lacks clarity around the important issue of who should prescribe isotretinoin and fails to describe the specific role of GPs in managing patients with acne using isotretinoin. This scoping review will address this evidence gap by examining the role of the GP in prescribing isotretinoin in acne clinical practice guidelines. Methods This scoping review adopts the Joanna Briggs Institute scoping review methodology with PRISMA extension for scoping reviews. The search strategy will interrogate medical databases and grey literature, and will also directly contact key stakeholders internationally, to identify clinical practice guidelines on the use of isotretinoin in acne from 2013 to May 2024. Two reviewers will independently review all citations, and full text of selected sources, against relevant inclusion-exclusion criteria. Appropriate data extraction tool(s) will be designed, piloted and refined, whereupon full data extraction will be undertaken. Results This scoping review will interrogate diverse evidence sources and distil the evidence base informing the role of GPs in prescribing isotretinoin for people with acne. Conclusion The strategic objective of this scoping review is to explore and illuminate the evidence around the role of GPs in prescribing isotretinoin when managing patients with acne.","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graduate and Undergraduate Medical Curricula That Address the Needs of People Who Experience Homelessness: A Scoping Review Protocol","authors":"Matthew Linvill, Logan Verlaque, Caitríona O’Sullivan, Felicia Manocchio, Matthew King, Connor Mabbott, Aisling Walsh, Gráinne Cousins","doi":"10.12688/hrbopenres.13902.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13902.1","url":null,"abstract":"Background The impact that increased homelessness has on the healthcare system should be of great concern to medical providers and the institutions that train them. While the demand for medical providers who understand the healthcare needs of homeless individuals is high, traditional medical curricula do not adequately address this. Objectives This scoping review aims to examine published undergraduate and graduate medical curricula that address the healthcare needs of homeless individuals to support the development and evaluation of homeless healthcare curricula globally. Methods This paper will utilise Arksey & O’Malley’s framework for scoping reviews to ensure a systematic scoping review. Research will be conducted in accordance with the Joanna Briggs Institute's (JBI) Updated Methodological Guidance for the Conduct of Scoping Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Review (PRISMA-ScR). Due to financial and time constraints, only articles published after 2000 and written in English will be reviewed. A comprehensive search strategy will be developed that includes searches in PubMed, Scopus, Embase and CINAHL with additional hand-searching of key articles. Each article will be screened independently by two reviewers. A third reviewer will resolve any disagreements. Data extraction will begin with a pre-defined extraction form (Extended Data File 3) and will be subsequently analysed with JBI’s current guidelines on inductive approaches to qualitative content analysis. Conclusion Research findings will be distributed to individuals who oversee the university’s medical curricula at the Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences. Discussions will be held to assess opportunities for the implementation/integration of homeless healthcare curricula. Furthermore, these findings will be disseminated globally to healthcare providers and administrators at conferences, hospitals and clinics.","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":" 92","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preschool children’s ideas about peer-mediated intervention for autistic children who use minimal speech: a qualitative study protocol","authors":"M. O'Donoghue, N. Kennedy, Carol-Anne Murphy","doi":"10.12688/hrbopenres.13907.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13907.1","url":null,"abstract":"Background Without intervention and support, autistic children may have limited interactions with their peers in inclusive preschool settings, thus restricting the potential of this environment to support children’s learning and social development. Peer-mediated interventions (PMIs) include a variety of approaches which aim to support non-autistic and autistic children to interact with each other. Children have contributed little to the design and development of PMIs. This study aims to provide a qualitative, child-centred, description of the implementation of PMI, according to non-autistic preschool children. Methods Focus groups will be conducted with a convenient sample of preschool children recruited from a local preschool. Talk- and art-based activities will be used to generate discussion around a series of vignettes. Focus groups will be video, and audio recorded and transcribed and analysed using a reflexive approach to thematic analysis. Ethics and Dissemination Ethical approval has been granted by the Faculty of Education and Health Sciences University of Limerick, Research Ethics Committee (2024_04_05_EHS). Findings will be disseminated through journal publication and through distribution of lay summaries and an infographic.","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"15 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behaviour change interventions addressing antibiotic treatment seeking behaviour for respiratory tract infections in primary care settings: A scoping review protocol","authors":"Anthony Maher, Kevin Roche, Eimear C Morrissey, Andrew W Murphy, Greg Sheaf, Cristin Ryan, Gerry Molloy","doi":"10.12688/hrbopenres.13831.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13831.1","url":null,"abstract":"Objective This scoping review aims to synthesise the extent and type of evidence on behaviour change interventions which address antibiotic treatment seeking behaviour for respiratory tract infections in the primary care/community setting. Introduction Antimicrobial Resistance is recognised as a global health and economic threat by the World Health Organization and World Bank. Several lines of evidence point to patient and public demand as a key driver of inappropriate antibiotic use. Current policy initiatives acknowledge the need to prepare for the future by managing public expectations regarding antibiotics, especially for influenza-like illness and other respiratory tract infections. These initiatives emphasise the importance of designing and evaluating effective interventions that generate actionable knowledge for policy and practices related to the appropriate use of antibiotics. Behaviour change interventions, in this context, can aim to modify patients' attitudes, beliefs, and behaviours regarding antibiotics. Inclusion criteria Identified studies will describe behaviour change interventions aimed at potential patients/participants within the primary care/community setting that address patient expectations of antibiotic use for respiratory tract infections. Diagnoses for respiratory tract infections will be classified by ICD-10 criterion. Methods This scoping review will search the literature in Medline, Embase, CINAHL, PsycINFO, Web of Science Core Collection, Scopus, and Google Scholar to explore behaviour change interventions used to reduce expectations of antibiotics for respiratory tract infections in primary care. This review will follow the Joanna Briggs Institute guidelines for scoping reviews. It will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"115 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An EDucation and eXercise intervention for gluteal tendinopathy in an Irish setting: a protocol for a feasibility randomised clinical trial (LEAP-Ireland RCT).","authors":"Sania Almousa, Bill Vicenzino, Rebecca Mellor, Alison Grimaldi, Kathleen Bennett, Frank Doyle, Geraldine M McCarthy, Suzanne M McDonough, Jennifer M Ryan, Karen Lynch, Jan Sorensen, Helen P French","doi":"10.12688/hrbopenres.13796.2","DOIUrl":"10.12688/hrbopenres.13796.2","url":null,"abstract":"<p><strong>Background: </strong>Gluteal tendinopathy (GT) is a degenerative tendon condition characterised by pain over the greater trochanter of the hip. A randomised controlled trial (RCT) in Australia found that 14 sessions of EDucation on load management plus eXercise (EDX) delivered over 8 weeks resulted in greater improvements in global rating of change and pain outcomes at 8 and 52 weeks, compared with corticosteroid injection or 'wait and see'. Typically, 5-6 physiotherapy sessions are provided in public and private physiotherapy settings in Ireland, therefore, the aim of this study is to examine the feasibility of conducting a future definitive RCT to investigate effectiveness of 6 sessions of the EDX programme compared to usual care.</p><p><strong>Methods: </strong>We will randomly allocate 64 participants with GT to physiotherapist-administered EDX or usual care. The EDX intervention (EDX-Ireland) will be delivered in 6 sessions over 8 weeks.To determine feasibility of an RCT, we will assess recruitment and retention and outcome measure completion. The health status outcomes to be assessed at baseline, 8 weeks and 3 months include: Global Rating of Change, pain severity, the Victorian Institute of Sport Assessment-Gluteal Questionnaire (VISA-G), the Patient-Specific Functional Scale, the Pain Catastrophizing Scale, Patient Health Questionnaire (PHQ), Pain Self-Efficacy Questionnaire, the EQ-5D-5L, the Central Sensitisation Inventory and hip abductor muscle strength. We will explore acceptability of the EDX-Ireland intervention from the perspective of patients and treatment providers, and the perspective of referrers to the trial. A Study Within A Trial will be also applied to compare recording of exercise adherence using app-based technology to paper diaries.</p><p><strong>Discussion: </strong>There is a need to establish effective treatments for GT that potentially can be implemented into existing health systems. The findings of this feasibility trial will inform development of a future definitive RCT.</p><p><strong>Registration: </strong>The trial is registered prospectively on ClinicalTrials.gov ( NCT05516563, 27/10/2022).</p>","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"6 ","pages":"76"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practitioners' and women's experiences of perimenopause consultations: A qualitative evidence synthesis protocol.","authors":"Laura-Jane McCarthy, Aoife O'Mahony, Aisling Jennings, Sheena M McHugh","doi":"10.12688/hrbopenres.13908.1","DOIUrl":"https://doi.org/10.12688/hrbopenres.13908.1","url":null,"abstract":"<p><strong>Background: </strong>Perimenopause precedes menopause and can cause a myriad of symptoms for women. General practitioners (GPs) are frequently the first contact for perimenopausal women with symptoms. However, women express feeling dissatisfied with the consultations they have with their GPs for perimenopausal symptoms. Moreover, diagnostic difficulties can make these consultations challenging for GPs. Despite these challenges, research to date has focused on menopause, not the transition to menopause. To date, no evidence synthesis has examined how women experience perimenopause consultations, nor how GPs experience providing care to these women.</p><p><strong>Objective: </strong>To systematically search, collate, and appraise the qualitative literature to understand general practitioners' and women's experiences of perimenopause consultations and examine how treatment decisions are made during consultations.</p><p><strong>Methods: </strong>A meta-ethnography will be conducted following Sattar <i>et al.</i> (2021) guidelines for conducting a meta-ethnography as developed by Noblit and Hare (1988). Seven databases will be systematically searched. To be included, studies must report on the experiences of either general practitioners and/or perimenopausal women and published since 2014 to capture the most up-to-date evidence. Quality assessment will be conducted using CASP (Critical Appraisal Skills Programme) tools. A GRADE-CERqual (Confidence in the Evidence from Reviews of Qualitative research) will be conducted to assess the confidence of the findings. PROSPERO registration number CRD42024520537.</p><p><strong>Discussion: </strong>Findings will provide new and useful insight into how GPs and women experience consultations for perimenopause and how decisions are made during these consultations.</p>","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"7 ","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort profile: Improved Pregnancy Outcomes via Early Detection (IMPROvED), an International Multicentre Prospective Cohort.","authors":"Gillian M Maher, Louise C Kenny, Kate Navaratnam, Zarko Alfirevic, Darina Sheehan, Philip N Baker, Christian Gluud, Robin Tuytten, Marius Kublickas, Boel Niklasson, Johannes J Duvekot, Caroline B van den Berg, Pensee Wu, Karolina Kublickiene, Fergus P McCarthy, Ali S Khashan","doi":"10.12688/hrbopenres.13812.2","DOIUrl":"10.12688/hrbopenres.13812.2","url":null,"abstract":"<p><strong>Background: </strong>Improved Pregnancy Outcomes via Early Detection (IMPROvED) is a multi-centre, European phase IIa clinical study. The primary aim of IMPROvED is to enable the assessment and refinement of innovative prototype preeclampsia risk assessment tests based on emerging biomarker technologies. Here we describe IMPROvED's profile and invite researchers to collaborate.</p><p><strong>Methods: </strong>A total of 4,038 low-risk nulliparous singleton pregnancies were recruited from maternity units in Ireland (N=1,501), United Kingdom (N=1,108), The Netherlands (N=810), and Sweden (N=619) between November 2013 to August 2017. Participants were interviewed by a research midwife at ~11 weeks (optional visit), ~15 weeks, ~20 weeks, ~34 weeks' gestation (optional visit), and postpartum (within 72-hours following delivery).</p><p><strong>Findings to date: </strong>Clinical data included information on maternal sociodemographic, medical history, and lifestyle factors collected at ~15 weeks' gestation, and maternal measurements, collected at each study visit. Biobank samples included blood, urine, and hair collected at each study visit throughout pregnancy in all units plus umbilical cord/blood samples collected at birth in Ireland and Sweden. A total of 74.0% (N=2,922) had an uncomplicated pregnancy, 3.1% (N=122) developed preeclampsia, 3.6% (N=143) had a spontaneous preterm birth, and 10.5% (N=416) had a small for gestational age baby. We evaluated a panel of metabolite biomarkers and a panel of protein biomarkers at 15 weeks and 20 weeks' gestation for preeclampsia risk assessment. Their translation into tests with clinical application, as conducted by commercial entities, was hampered by technical issues and changes in test requirements. Work on the panel of proteins was abandoned, while work on the use of metabolite biomarkers for preeclampsia risk assessment is ongoing.</p><p><strong>Future plans: </strong>In accordance with the original goals of the IMPROvED study, the data and biobank are now available for international collaboration to conduct high quality research into the cause and prevention of adverse pregnancy outcomes.</p>","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"6 ","pages":"65"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11190647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care bundles for women during pregnancy, labour/birth, and postpartum: a scoping review.","authors":"Theo Ryan, Tess McGrinder, Valerie Smith","doi":"10.12688/hrbopenres.13905.1","DOIUrl":"10.12688/hrbopenres.13905.1","url":null,"abstract":"<p><strong>Background: </strong>Care bundles, introduced in 2001, are described as a set of at least three evidence-based healthcare interventions delivered together in a clinical care episode by all healthcare providers. Although widely implemented in some healthcare areas, care bundle use in maternity care appears relatively recent. To identify the types of care bundles that have been developed, evaluated, or implemented for women during the perinatal period, we undertook a scoping review.</p><p><strong>Methods: </strong>Joanna Briggs Institute methodological guidance for scoping reviews was used. MEDLINE, CINAHL, Embase, Maternity and Infant Care, and Epistemonikos were searched from January 2000 to October 2023. Records that reported on women during pregnancy and up to six-weeks postpartum as the intended or actual recipients of a care bundle, were included. The concept of interest was development, evaluation, or implementation of a care bundle. The context was maternity care provision, in any setting or geographical location.</p><p><strong>Results: </strong>The search yielded 147 eligible records of which 69 originated in the USA. Most records were concerned with care bundle evaluation (n=74), and most were published in the last five-years (n=95). Eleven categories of clinical conditions were identified. These were surgical site infection, obstetric haemorrhage, perineal trauma, sepsis, stillbirth, hypertension, safe reduction of caesarean section, enhanced recovery after caesarean, placenta accrete, perinatal anxiety/depression, and 'other' which contained 21 records reporting on care bundles for one clinical condition. Few clinical conditions had good overlap of care bundle elements. Systematic reviews based on data from non-randomised studies may be feasible for some clinical conditions.</p><p><strong>Conclusions: </strong>This scoping review provides comprehensive insight on care bundles in maternity care. Few studies were found that evaluated the effectiveness of these bundles, and many bundles for similar clinical conditions contained diverse elements. A more global approach to care bundle development, evaluation, and implementation in maternity care is recommended.</p>","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"7 ","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building public trust and confidence in secondary use of health data for healthcare improvement and research: a qualitative study pre-protocol.","authors":"Tina Bedenik, Caitriona Cahir, K Bennett","doi":"10.12688/hrbopenres.13711.2","DOIUrl":"10.12688/hrbopenres.13711.2","url":null,"abstract":"<p><p><b>Background</b>  Secondary use of health data provides opportunities to drive improvements in healthcare provision, personalised medicine, comparative effectiveness research, health services innovation, and policy and practice. However, secondary data use requires compliance with relevant legislation, implementation of technical safeguards, ethical data management, and respect for data sharers. Existing evidence suggests widespread support for secondary use of health data among the public, which co-exists with concerns about privacy, confidentiality and misuse of data. Balancing the protection of individuals' rights against the use of their health data for societal benefits is of vital importance, and trust underpins this process. The study protocol explores how to build public trust and confidence in the secondary use of health data through all key stakeholder groups in Ireland, towards developing a culture that promotes a safe and trustworthy use of data. <b>Methods</b>  This study will adopt a qualitative cross-sectional approach conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research COREQ guidelines. Participants in the study will include academics and researchers; healthcare professionals, data protection, ethics and privacy experts and data controllers; pharmaceutical industry and patients and public. Purposive and convenience sampling techniques will be utilised to recruit the participants, and data will be collected utilizing focus groups that may be supplemented with semi-structured interviews. Data will be coded by themes using reflexive thematic analysis (TA) and collective intelligence (CI) will be convened post-analysis to explore the preliminary findings with the participants. <b>Ethics and Dissemination</b>  Ethical approval was obtained from the Royal College of Surgeons in Ireland Research Ethics Committee (REC202208013). Final data analysis and dissemination is expected by Q1 2024. Findings will be disseminated through peer-reviewed journal publications, presentations at relevant conferences, and other academic, public and policy channels. Lay summaries will be designed for Public and Patient Involvement (PPI) contributors and general public.</p>","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"6 ","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the role that Care Groups play in providing breastfeeding and infant feeding support at community level: a qualitative study in Dedza district in Malawi.","authors":"Pieternella Pieterse, Aisling Walsh, Ellen Chirwa, Maria Chikalipo, Chimwemwe Msowoya, Janet Mambulasa, Anne Matthews","doi":"10.12688/hrbopenres.13736.2","DOIUrl":"10.12688/hrbopenres.13736.2","url":null,"abstract":"<p><strong>Background: </strong>Promoting exclusive breastfeeding is a key nutrition policy objective in Malawi. This study assesses the role that Care Group Volunteers (CGVs) play in providing breastfeeding and infant feeding support at community level. Care Groups are a peer-to-peer learning approach, which has been part of Malawi's nutrition policy since 2012, its role within community-level nutrition support remains under-researched.</p><p><strong>Methods: </strong>In July 2021, we conducted 60 qualitative semi structured interviews in Dedza District with village leaders, Health Surveillance Assistants (HSAs), CGVs and district health officials, mothers with at least one child under two (n=36) who were purposively selected. All interviews were recorded, transcribed and translated into English and then analysed using qualitative data analysis software. Thematic analysis was used to elicit key themes.</p><p><strong>Results: </strong>Only eight out of 36 women reported receiving breastfeeding support from care groups. All mothers reported receiving breastfeeding support at the health facility where they delivered their baby(ies) and some (n=24) also at ante-natal care clinics. In total, 18 interviewees reported interacting with the Care Groups, mostly during cooking demonstrations or receiving home visits. Little interaction was observed by interviewees between HSAs and CGVs and no evidence suggested coordination between HSAs and CGVs around (vulnerable) newborn baby visits, as described by one HSA.</p><p><strong>Conclusions: </strong>This research shows that Care Groups, despite being well-known, remain an under-appreciated and un-integrated volunteer cadre. Policy reform in relation to Care Groups in Malawi is needed to improve volunteer engagement regarding breastfeeding and overall support of newborns and vulnerable infants.</p>","PeriodicalId":73254,"journal":{"name":"HRB open research","volume":"6 ","pages":"44"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}