Rotheram‐Borus 2014b.
| Study characteristics | |
| Methods |
tudy design: cluster‐RCT Duration of study: the study was conducted from 2009 to 2014. Country: South Africa Income classification: upper‐middle‐income country Geographical scope: urban—townships in Cape Town Healthcare setting: participant's homes |
| Participants | 1. Age: 18+; mean 26.4, SD 5.5 2. Gender: female 3. Socioeconomic background: 46.8% had a monthly household income > 2000 rand. 4. Educational background: mean highest education level (SD)—10.3 (1.8) Inclusion criteria: a. pregnant women and their children; b. age 18 or older; c. informed consent. Exclusion criteria: a. psychosis, neurological damage, inability to communicate with interviewer; b. inability to give consent. Note: at baseline, the intervention and control group prevalence for Edinburgh Postnatal Depression Scale (EPDS) > 18, there were 204 mothers (16.5%; 1238 total). Stated purpose: to test a mother‐to‐mother intervention during pregnancy and after delivery with mothers in South Africa |
| Interventions |
Name: Philani Title/name of PW and number: community health workers (CHWs) 1. Selection: CHWs were selected to have good social/communication skills, problem‐solving skills, and thriving children (positive deviants). 2. Educational background: CHWs were women with 10th‐ to 12th‐grade education around 40 years old (range 34 to 59). 3. Training: CHWs were trained for 1 month in cognitive‐behavioural change strategies and role‐playing using an intervention manual and watching videotapes of common challenging situations that CHWs might face during home visits. Specifically, a CHW has trained in 1) foundational skills in behaviour change; 2) application of key health information about HIV, alcohol use, malnutrition, and general maternal and child health; and 3) coping with their own life challenges. 4. Supervision: CHWs were certified and supervised biweekly with random observations of home visits. 5. Incentives/remuneration: CHWs worked 20 hours weekly and were paid R1250 a month (about 150 USD). Prevention type: indicated prevention – at baseline, there were 204 mothers (16.5%; 1238 total) with EPDS > 18; those affected by psychosis, neurological damage, or inability to communicate with interviewer were excluded. Intervention details: eight health messages were delivered regarding healthy pregnancy, HIV/TB testing and PMTCT, reducing alcohol use and malnutrition, and encouraging breastfeeding, with the aim to deliver these messages in at least four antenatal visits and four postnatal visits within the first two months of life. On average, CHWs made six antenatal visits (SD = 3.8), five postnatal visits between birth and 2 months postbirth (SD = 1.9), and afterward about 1.4 visits/month (range: 0.1 to 6.4 visits/month). Sessions lasted on average 31 minutes each. Control: usual care – standard clinic care in Cape Town is accessible and provides free HIV testing, dual regimen therapies for WLH, consistent access to milk tins (formula), TB and CD4 cell testing, cotrimoxazole for infants until HIV testing, HIV polymerase chain reaction (PCR) testing for infants at six weeks, postnatal visits at one week, treatment for WLH, and HIV testing for partners of WLH. |
| Outcomes |
Participants’outcomes of interest for this review
Carers’ outcomes of interest for this review Nil Economic outcomes Nil Time points: baseline, post‐intervention (1‐6 months) |
| Notes |
Source of funding: this work was supported by NIAAA grant R01 AA017104, the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) NIMH grant P30 MH58107; the UCLA Center for AIDS Research (CFAR) grant P30 AI028697; and the National Center for Advancing Translational Sciences through UCLA CSTI Grant UL1 TR000124. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. Notes on validation of instruments (screening and outcomes): the EPDS is a widely validated and established tool. Additional information: none Handling the data: they are found in the “analysis details” docx. Prospective trial registration number: NCT00996528 |