Evaluation of a community-based mobile video breastfeeding intervention in Khayelitsha, South Africa: The Philani MOVIE cluster-randomized controlled trial

In South Africa, breastfeeding promotion is a national health priority. Regular perinatal home visits by community health workers (CHWs) have helped promote exclusive breastfeeding (EBF) in underresourced settings. Innovative, digital approaches including mobile video content have also shown promise...

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Vydáno v:PLoS medicine Ročník 18; číslo 9; s. e1003744
Hlavní autoři: Adam, Maya, Johnston, Jamie, Job, Nophiwe, Dronavalli, Mithilesh, Le Roux, Ingrid, Mbewu, Nokwanele, Mkunqwana, Neliswa, Tomlinson, Mark, McMahon, Shannon A., LeFevre, Amnesty E., Vandormael, Alain, Kuhnert, Kira-Leigh, Suri, Pooja, Gates, Jennifer, Mabaso, Bongekile, Porwal, Aarti, Prober, Charles, Bärnighausen, Till
Médium: Journal Article
Jazyk:angličtina
Vydáno: San Francisco Public Library of Science 28.09.2021
Public Library of Science (PLoS)
Témata:
Babies
Breast feeding
Breastfeeding & lactation
Care and treatment
Childrens health
Clinical trials
Community
Community health services
Coronaviruses
Counseling
COVID-19
Diabetes
E-health
Education
Educational aspects
Health aspects
Health promotion
Infants
Intervention
Low income groups
Maternal health services
Medical personnel
Medical research
Medicine and Health Sciences
Methods
Mothers
Nutrition research
Pandemics
People and Places
Performance evaluation
Research and Analysis Methods
Statistical analysis
Streaming media
Technology application
Telemedicine
Time use
Workers
South Africa
ISSN:1549-1676, 1549-1277, 1549-1676
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Shrnutí:In South Africa, breastfeeding promotion is a national health priority. Regular perinatal home visits by community health workers (CHWs) have helped promote exclusive breastfeeding (EBF) in underresourced settings. Innovative, digital approaches including mobile video content have also shown promise, especially as access to mobile technology increases among CHWs. We measured the effects of an animated, mobile video series, the Philani MObile Video Intervention for Exclusive breastfeeding (MOVIE), delivered by a cadre of CHWs ("mentor mothers"). We conducted a stratified, cluster-randomized controlled trial from November 2018 to March 2020 in Khayelitsha, South Africa. The trial was conducted in collaboration with the Philani Maternal Child Health and Nutrition Trust, a nongovernmental community health organization. We quantified the effect of the MOVIE intervention on EBF at 1 and 5 months (primary outcomes), and on other infant feeding practices and maternal knowledge (secondary outcomes). We randomized 1,502 pregnant women in 84 clusters 1:1 to 2 study arms. Participants' median age was 26 years, 36.9% had completed secondary school, and 18.3% were employed. Mentor mothers in the video intervention arm provided standard-of-care counseling plus the MOVIE intervention; mentor mothers in the control arm provided standard of care only. Within the causal impact evaluation, we nested a mixed-methods performance evaluation measuring mentor mothers' time use and eliciting their subjective experiences through in-depth interviews. This trial measured the effect of a video-based, mobile health (mHealth) intervention, delivered by CHWs during home visits in an underresourced setting. The videos replaced about two-fifths of CHWs' direct engagement time with participants in the intervention arm. The similar outcomes in the 2 study arms thus suggest that the videos were as effective as face-to-face counselling, when CHWs used them to replace a portion of that counselling. Where CHWs are scarce, mHealth video interventions could be a feasible and practical solution, supporting the delivery and scaling of community health promotion services.
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I have read the journal’s policy and the authors of this manuscript have the following competing interests: MT is a member of PLOS Medicine’s Editorial Board. The other co-authors have declared no competing interests.
These authors are joint senior authors on this work.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1003744