Household cost-benefit equations and sustainable universal childhood immunisation: a randomised cluster controlled trial in south Pakistan [ISRCTN12421731]

Andersson, Neil; Cockcroft, Anne; Ansari, Noor M; Omer, Khalid; Losos, Joe; Ledogar, Robert J.; Tugwell, Peter; Shea, Beverley

doi:10.1186/1471-2458-5-72

Cited by 16 publications

(16 citation statements)

References 17 publications

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“…The CASCADA expanded model responds to recognised limitations of the KAP model (Bentler & Speckart, 1979 ; Baranowski, Cullen, Nicklas, Thompson & Baranowski, 2003 ). We have used the CASCADA model in a trial of an intervention to increase vaccination uptake in Pakistan (Andersson et al, 2005 , 2009 ) and in a cross-sectional study in southern Africa (Mitchell, Cockcroft, Lamothe, & Andersson, 2010 ).…”

Section: Methodsmentioning

confidence: 99%

From knowledge to action: participant stories of a population health intervention to reduce gender violence and HIV in three southern African countries

Cameron

Cockcroft

Waichigo³

et al. 2014

AIDS Care

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This paper describes implementation research of an intervention in a complex HIV prevention randomised trial in southern Africa. Researchers collected stories of change attributed by 106 community members to an audio-drama edutainment intervention in 41 sites in Botswana, Namibia and Swaziland. The team analysed themes in the stories following a behaviour change model of conscious knowledge, attitudes, subjective norms, intention to change, agency, discussion and action (CASCADA). Storytellers attributed positive changes to the intervention in the areas of gender violence, multiple sexual partners, transactional and intergenerational sex and condom use. Their stories illustrate each of the steps in the CASCADA behaviour change model. As well as supporting an enabling environment for other interventions in the trial, the audio-drama also helped some participants to make personal changes. Collecting and discussing the stories were encouraging for the trial fieldworkers. Documenting the experiences of participants and framing the analysis of stories in an explicit behaviour change model allowed us to reflect on potential mechanisms and pathways through which the intervention impacts on individuals and communities. It helped in the design of the quantitative instruments to measure intermediate outcomes of the trial.

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Section: Methodsmentioning

confidence: 99%

From knowledge to action: participant stories of a population health intervention to reduce gender violence and HIV in three southern African countries

Cameron

Cockcroft

Waichigo³

et al. 2014

AIDS Care

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“…Separate articles discuss the protocol [1], baseline findings [2], and the outcome of the trial [3]. …”

Section: Introductionmentioning

confidence: 99%

Knowledge synthesis of benefits and adverse effects of measles vaccination: the Lasbela balance sheet

Ledogar¹,

Fleming²,

Andersson

2009

BMC Int Health Hum Rights

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BackgroundIn preparation for a cluster-randomized controlled trial of a community intervention to increase the demand for measles vaccination in Lasbela district of Pakistan, a balance sheet summarized published evidence on benefits and possible adverse effects of measles vaccination.MethodsThe balance sheet listed: 1) major health conditions associated with measles; 2) the risk among the unvaccinated who contract measles; 3) the risk among the vaccinated; 4) the risk difference between vaccinated and unvaccinated; and 5) the likely net gain from vaccination for each condition.ResultsTwo models revealed very different projections of net gain from measles vaccine. A Lasbela-specific combination of low period prevalence of measles among the unvaccinated, medium vaccination coverage and low vaccine efficacy rate, as revealed by the baseline survey, resulted in less-than-expected gains attributable to vaccination. Modelled on estimates where the vaccine had greater efficacy, the gains from vaccination would be more substantial.ConclusionSpecific local conditions probably explain the low rates among the unvaccinated while the high vaccine failure rate is likely due to weaknesses in the vaccination delivery system. Community perception of these realities may have had some role in household decisions about whether to vaccinate, although the major discouraging factor was inadequate access. The balance sheet may be useful as a communication tool in other circumstances, applied to up-to-date local evidence.

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“…The model views all intermediate steps between conscious knowledge and action as likely to be relevant, but not necessarily linearly related; the relative importance of the different steps varies with context. We have used the CASCADA model in resource-poor settings to support analysis and interpretation in cross-sectional studies examining health-related behaviours [ 38 , 39 ], to guide design of interventions [ 40 – 42 ] and as a framework for qualitative and quantitative analysis of intervention effects [ 43 , 44 ]. Figure 1 illustrates the way in which, according to the CASCADA model, the home visits will work to improve maternal outcomes.…”

Section: Methodsmentioning

confidence: 99%

Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial

Cockcroft

Omer

Gidado

et al. 2018

BMC Health Serv Res

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BackgroundMaternal mortality in Nigeria is one of the highest in the world. Access to antenatal care is limited and the quality of services is poor in much of the country. Previous research in Bauchi State found associations between maternal morbidity and domestic violence, heavy work in pregnancy, lack of knowledge about danger signs, and lack of spousal communication about pregnancy and childbirth. This cluster randomized controlled stepped-wedge trial will test the impact of universal home visits to pregnant women and their partners, and the added value of video edutainment.MethodsThe trial will take place in six wards of Toro Local Government Area in Bauchi State, Nigeria, randomly allocated into three waves of two wards each. Home visits will begin in wave 1 wards immediately; in wave 2 wards after one year; and in wave 3 wards after a further year. In each wave, one ward, randomly allocated, will receive video edutainment during the home visits. Female home visitors will contact all households in their catchment areas of about 300 households, register all pregnant women, and visit them every two months during pregnancy, after delivery and one year later. They will use android handsets to collect information on pregnancy progress, send this to a central server, and discuss with the women the evidence about household factors associated with higher maternal risks, using video clips in the edutainment wards. Male home visitors will contact the partners of the pregnant women and discuss with them the same evidence. We will compare outcomes between wave 1 and wave 2 wards at about one year, between wave 2 and wave 3 wards at about two years, and finally between wards with and without added edutainment. Primary outcomes will be complications in pregnancy and delivery, and child health at one year. Secondary outcomes include knowledge and attitudes, use of health services, knowledge of danger signs, and household care of pregnant women.DiscussionDemonstrating an impact of home visits and understanding potential mechanisms could have important implications for reducing maternal morbidity and mortality in other settings with poor access to quality antenatal care services.Trial registrationRegistration number: ISRCTN82954580. Registry: ISRCTN. Date of registration: 11 August 2017. Retrospectively registered.

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Household cost-benefit equations and sustainable universal childhood immunisation: a randomised cluster controlled trial in south Pakistan [ISRCTN12421731]

Cited by 16 publications

References 17 publications

From knowledge to action: participant stories of a population health intervention to reduce gender violence and HIV in three southern African countries

From knowledge to action: participant stories of a population health intervention to reduce gender violence and HIV in three southern African countries

Knowledge synthesis of benefits and adverse effects of measles vaccination: the Lasbela balance sheet

Impact of universal home visits on maternal and infant outcomes in Bauchi state, Nigeria: protocol of a cluster randomized controlled trial

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