As countries pursue UNAIDS’s 90-90-90 target for ending the AIDS epidemic, success is dependent on learning how to deliver effective care. We describe a learning network and mechanisms used to foster communication and sharing of ideas and results across 6 countries in the Partnership for HIV-Free Survival. The network used 2 forms of peer exchange, in-person and virtual, and a variety of knowledge management mechanisms to harvest and spread key learning. Key learning included valuable insights on how to design and convene a multicountry learning network, including top enablers of success and practical insights on the network’s value. The network was instrumental in accelerating learning about improving care. Our experience shows the value of creating a quality improvement–driven, multicountry learning network to accelerate the pace of improving care systems. Government ownership and adaptation of collaborative learning efforts to the country context must be considered when designing future networks.
Community health workers, also known as fieldworkers (FWs), are frontline health-care providers in Bangladesh, where unmet need in family planning outcomes related to maternal and child health are high. A digital health intervention provided netbook computers to Bangladeshi FWs with eLearning courses and an eToolkit, which included material on family planning, maternal, newborn, and child health topics to enhance FWs’ knowledge and skills. To understand how the intervention affected FW’s knowledge and counseling behavior, this pre-poststudy measured FWs’ knowledge related to family planning, maternal, newborn, child health, and counseling on family topics before and after the pilot. Bivariate analyses were used to determine changes in FW knowledge, and multivariate analyses were conducted to determine changes in behavior, comparing knowledge and behaviors prepilot to postpilot. Comparing mean knowledge scores after and before the pilot, the difference in mean scores was significant ( p < .05) related to knowledge of benefits of birth spacing (1.26) and benefits of a small family (1.3) and related to maternal health, anemia prevention (0.95), and recommended number of antenatal care visits (0.13). Regarding newborn and child health, the difference in mean scores was significantly ( p < .05) related to knowledge of proper attachment for breastfeeding (3.56) and signs of adequate breast milk supply (1.08). Postintervention, FWs were significantly more likely to counsel couples on all available contraceptive options (adjusted odds ratio: 4.64; 95% CI [3.16, 6.83]) and birth spacing benefits (adjusted odds ratio: 4.54; 95% CI [3.17, 6.50]). Digital health training approaches can improve FWs’ knowledge and counseling skills within an international context, specifically in low-resource settings.
It is well documented that many ethnic minorities do not meet national physical activity (PA) recommendations, but it is unclear what factors are related to this inactivity. This cross‐sectional study used baseline data from Healthy Bodies, Healthy Souls, a 3‐year trial to reduce the risk for diabetes in a low‐to‐moderate income, urban African‐American (AA) population centered on churches. We evaluated whether a cohort of non‐diabetic, AA adults (N = 136) from a larger randomized group trial are meeting recommended levels of PA as defined by the American College of Sports Medicine and the American Heart Association. Participants self‐reported PA using the International Physical Activity Questionnaire, long form. Data analysis revealed that the majority (63.2%) of participants did not expend the recommended > 7.5 MET (metabolic equivalents) hours/week (median = 3.48 METs) and there were no differences by gender or age. The data indicated a significant relationship (p = 0.015) between income (>$30,000/year) and PA (OR=3.1, 95%CI=1.2–7.8) demonstrating that while individual risk factors play a role in predicting health‐seeking behaviors, there are larger social patterns associated with engagement in PA.Grant Funding Source: American Diabetes Association Clinical Research Award
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