Gates Open Research

<ns3:p>Background Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on developing and evaluating the effectiveness of human-centered design (HCD) solutions to improve maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia. Methods Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on developing and evaluating the effectiveness of human-centered design (HCD) solutions to improve maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia. Conclusions and Implications Our sequential approach to evaluating initial solutions, which in turn will inform the enhancement of solutions, will provide practical insights into how solutions are accepted among vulnerable women and how they can be better integrated into women’s lives and health systems. This will inform equity-focused practice and policies targeting populations experiencing greater barriers to accessing care and provide insights into system strengthening in rural areas. Our findings will be disseminated to the Ethiopian Ministry of Health and its partners to inform large-scale implementation at the national level.</ns3:p>

Bee-Ah Kang

Habtamu Tamene

Yihunie Lakew

Daryl Stephens

Rajiv Rimal

Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study

开发和评估以人为本的设计解决方案，以提高埃塞俄比亚奥罗米亚州脆弱孕产妇的母婴健康服务利用率：一项准实验研究的方案

<ns3:p>Background Resistance monitoring is a key element in controlling vector-borne diseases. The World Health Organization (WHO) and Centres for Disease Control and Prevention (CDC) have each developed bottle bioassay methods for determining insecticide susceptibility in mosquito vectors which are used globally. Methods This study aimed to identify variations in bottle bioassay methodologies and assess the potential impact on the data that is generated. Our approach involved a systematic examination of existing literature and protocols from WHO and CDC, with a focus on the specifics of reported methodologies, variation between versions, and reported outcomes. Building on this, we experimentally evaluated the impact of several variables on bioassay results. Results Our literature review exposed a significant inconsistency in the how bioassay methods are reported, hindering reliable interpretation of data and the ability to compare results between studies. The experimental research provided further insight by specifically identifying two key factors that influence the outcomes of bioassays: mosquito dry weight and relative humidity (RH). This finding not only advances our comprehension of these assays but also underscores the importance of establishing precisely defined methodologies for resistance monitoring. The study also demonstrates the importance of controlling bioassay variables, noting the significant influence of wing length, as an indicator of mosquito size, on mortality rates in standardized bioassays. Conclusions Generating data with improved protocol consistency and precision will not only deepen our understanding of resistance patterns but also better inform vector control measures. We call for continued research and collaboration to refine and build consensus on bioassay techniques, to help bolster the global effort against vector-borne diseases like malaria.</ns3:p>

Giorgio Praulins

Annabel Murphy-Fegan

Jack Gillespie

Frank Mechan

Katherine Gleave

Rosemary Lees

Unpacking WHO and CDC Bottle Bioassay Methods: A Comprehensive Literature Review and Protocol Analysis Revealing Key Outcome Predictors

解构世卫组织和疾控中心瓶生物测定方法：综合文献回顾与方案分析揭示关键结果预测因素

<ns3:p>Background Tobacco use trends among adolescents in low- and middle-income countries, and in particular narrowing gender gaps, highlight the need for interventions to prevent and/or reduce tobacco use among adolescent girls. We evaluated a social marketing program in Ghana discouraging tobacco use among adolescent girls and additionally investigated the pathways influencing smoking behaviors to identify programmatic opportunities for impact. Leveraging the data collected through the stepped wedge cluster randomized trial and panel survey of 9000 girls aged 13–19 , we sought to apply machine learning (ML) techniques to identify the most important variables for predicting initiation of smoking. Methods To identify predictors of smoking initiation we sought to develop a model which could accurately differentiate smokers from non-smokers and evaluated various ML approaches for training classifier algorithms to achieve this. We selected a Synthetic Minority Over-sampling Technique (SMOTE) because it optimized the recall and precision of the model. We then utilized the technique of feature importance for greater insight into how the model arrived at its decisions and to rank the most important variables for predicting smokers. To explore different dimensions of smoking behavior, including initiation and continuation, we trained our model by using several combinations of target outcomes and input variables from the panel survey. Results The resulting features of smokers highlight the importance of girls’ independence and connectivity, social environment, and peer influence on likelihood of smoking, and in particular subsequent initiation. These results were largely consistent with our formative research findings based on qualitative interviews informed by behavioral science. Conclusions This novel application of ML techniques demonstrates how data science approaches can generate new programmatic insights from rigorous evaluation data, especially when data collection is informed by behavioral theory. Such insights about the relative importance of different features can be valuable input for program planning and outreach.</ns3:p>

Sara V. Flanagan

Ariadna Vargas

Jana Smith

Application of machine learning techniques to profile smoking behavior of adolescent girls in Ghana

加纳少女吸烟行为特征的机器学习技术应用

<ns3:p>Faced with declining donor funding for HIV, low- and middle-income countries must identify efficient and cost-effective ways to integrate HIV prevention programs into public health systems for long-term sustainability. In Zambia, donor support to the voluntary medical male circumcision (VMMC) program, which previously funded non-governmental organizations as implementing partners, is increasingly being directed through government structures instead. We developed a framework to understand how the behaviors of individual decision-makers within the government could be barriers to this transition. We interviewed key stakeholders from the national, provincial, and district levels of the Ministry of Health, and from donors and partners funding and implementing Zambia’s VMMC program, exploring the decisions required to attain a sustainable VMMC program and the behavioral dynamics involved at personal and institutional levels. Using pattern identification and theme matching to analyze the content of the responses, we derived three core decision-making phases in the transition to a sustainable VMMC program: 1) developing an alternative funding strategy, 2) developing a policy for early-infant (0–2 months) and early-adolescent (15–17 years) male circumcision, which is crucial to sustainable HIV prevention; and 3) identifying integrated and efficient implementation models. We formulated a framework showing how, in each phase, a range of behavioral dynamics can form barriers that hinder effective decision-making among stakeholders at the same level (e.g., national ministries and donors) or across levels (e.g., national, provincial and district). Our research methodology and the resulting framework offer a systematic approach for in-depth investigations into organizational decision-making in public health programs, as well as development programs beyond VMMC and HIV prevention. It provides the insights necessary to map organizational development and policy-making transition plans to sustainability, by explaining tangible factors such as organizational processes and systems, as well as intangibles such as the behaviors of policymakers and institutional actors.</ns3:p>

Nishan Gantayat

James Baer

Alok Gangaramany

Steve Kretschmer

Rasi Surana

Alick Samona

Njekwa Mukamba

Bright Jere

Tina Chinsenga

Ram Prasad

Stephen Goetschius

Saransh Sharma

Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision program

开发理解艾滋病预防项目向可持续性过渡中政策决策行为框架：赞比亚自愿医疗男性包皮环切项目案例研究

<ns3:p>Effective contraceptive education is essential to reducing unwanted pregnancy, increasing uptake of modern contraceptive methods, and thoughtfully planning desired births. New World Health Organization (WHO) and family planning organization guidelines recommend situating contraceptive education and counseling within a broader context of self-care that emphasizes individual agency and reproductive empowerment. Digital health interventions, and games for health specifically, have been validated as effective and scalable tools for self-guided and interactive health education, especially among younger tech-savvy individuals. Barbados currently supplements provider-based contraceptive counseling with analog materials (pamphlets and posters) and informational videos that play on a screen in the waiting room. As part of an implementation framework, this study seeks to conduct a formative evaluation of the What’s My Method? (WMM) game intervention as a tool to support contraceptive counseling and increase reproductive empowerment among childbearing persons in Barbados. We test-deployed the WMM game in Bridgetown, Barbados, conducting playtests and unstructured discussions with prototypes of the WMM game among three groups of stakeholders (youth contraception ambassadors: n=8; healthcare providers: n=7; and nursing students: n=27) to determine acceptability of the intervention, efficacy of the game as a learning tool, and willingness to adopt the tool in their healthcare context. Feedback on acceptability of the game was largely positive. Detailed constructive comments informed modifications and improvements to the game. The questionnaire used to assess contraceptive knowledge gain did not prove effective. Results indicate that the WMM game is well-received and accepted by the healthcare professionals who would be deploying it. This pilot testing has informed the design of the modified WMM for a randomized controlled trial (RCT) to test the deployment of the game in a healthcare setting.</ns3:p>

Elena Bertozzi

Clara Bertozzi-Villa

Erin Sabato

Nicole Alleyne

Sonia Watson-Miller

Tiffany Jordan

Anderson Langdon

Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What’s My Method?

支持避孕自我护理和生殖赋权：巴巴多斯数字健康游戏《我的方法是什么？》开发与预实施研究

ISSN	2572-4754
h-index	22

Publication Information	Publisher: F1000 Research Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2017，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%
Journal Fees	$1150Details
Average review cycle	网友分享经验：1 Weeks

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Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study

Unpacking WHO and CDC Bottle Bioassay Methods: A Comprehensive Literature Review and Protocol Analysis Revealing Key Outcome Predictors

Application of machine learning techniques to profile smoking behavior of adolescent girls in Ghana

Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision program

Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What’s My Method?

Developing and evaluating human-centered design solutions for enhancing maternal health service utilization among vulnerable pregnant women in Oromia, Ethiopia: Study protocol for a quasi-experimental study

Unpacking WHO and CDC Bottle Bioassay Methods: A Comprehensive Literature Review and Protocol Analysis Revealing Key Outcome Predictors

Developing a framework for understanding policy decision-making behaviors in the transition of an HIV prevention program towards sustainability: a case study from Zambia’s voluntary medical male circumcision program

Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What’s My Method?

Application of machine learning techniques to profile smoking behavior of adolescent girls in Ghana