Translating new evidence into clinical practice : a quasi-experimental controlled before–after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding counselling in South Africa

dc.contributor.authorGoga, Ameena Ebrahim
dc.contributor.authorDoherty, Tanya
dc.contributor.authorManda, S.O.M. (Samuel)
dc.contributor.authorNkwenika, Tshifhiwa
dc.contributor.authorHaskins, Lyn
dc.contributor.authorJohn, Vaughn
dc.contributor.authorEngebretsen, Ingunn M.S.
dc.contributor.authorFeucht, Ute Dagmar
dc.contributor.authorDhansay, Ali
dc.contributor.authorRollins, Nigel
dc.contributor.authorKroon, Max
dc.contributor.authorSanders, David
dc.contributor.authorKauchali, Shuaib
dc.contributor.authorTylleskär, Thorkild
dc.contributor.authorHorwood, Christiane
dc.date.accessioned2021-02-26T14:46:24Z
dc.date.available2021-02-26T14:46:24Z
dc.date.issued2020-08
dc.description.abstractOBJECTIVES: We report the effectiveness of a mentoring approach to improve health workers’ (HWs’) knowledge, attitudes and confidence with counselling on HIV and infant feeding. DESIGN: Quasi-experimental controlled before–after study. SETTING: Randomly selected primary healthcare clinics (n=24 intervention, n=12 comparison); two districts, South Africa. PARTICIPANTS: All HWs providing infant feeding counselling in selected facilities were invited. INTERVENTIONS: Three 1–2 hours, on-site workshops over 3–6 weeks. PRIMARY OUTCOME MEASURES: Knowledge (22 binary questions), attitude (21 questions—5-point Likert Scale) and confidence (19 questions—3-point Likert Scale). Individual item responses were added within each of the attitude and confidence domains. The respective sums were taken to be the domain composite index and used as a dependent variable to evaluate intervention effect. Linear regression models were used to estimate the mean score difference between intervention and comparison groups postintervention, adjusting for the mean score difference between them at baseline. Analyses were adjusted for participant baseline characteristics and clustering at health facility level. RESULTS: In intervention and comparison sites, respectively: 289 and 131 baseline and 253 and 114 follow-up interviews were conducted (August–December 2017). At baseline there was no difference in mean number of correctly answered knowledge questions; this differed significantly at follow-up (15.2 in comparison; 17.2 in intervention sites (p<0.001)). At follow-up, the mean attitude and confidence scores towards breast feeding were better in intervention versus comparison sites (p<0.001 and p=0.05, respectively). Controlling for confounders, interactions between time and intervention group and preintervention values, the attitude score was 5.1 points significantly higher in intervention versus comparison groups. CONCLUSION: A participatory, low-intensity on-site mentoring approach to disseminating updated infant feeding guidelines improved HWs’ knowledge, attitudes and confidence more than standard dissemination via a circular. Further research is required to evaluate the effectiveness, feasibility and sustainability of this approach at scale.en_ZA
dc.description.departmentPaediatrics and Child Healthen_ZA
dc.description.departmentStatisticsen_ZA
dc.description.librarianpm2021en_ZA
dc.description.sponsorshipWHO, National Research Foundation, South Africa and South African Medical Research Council.en_ZA
dc.description.urihttp://bmjopen.bmj.comen_ZA
dc.identifier.citationGoga A, Doherty T, Manda S, et al. Translating new evidence into clinical practice: a quasi-experimental controlled before–after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding counselling in South Africa. BMJ Open 2020;10:e034770. doi:10.1136/bmjopen-2019-034770.en_ZA
dc.identifier.issn2044-6055 (online)
dc.identifier.other10.1136/ bmjopen-2019-034770
dc.identifier.urihttp://hdl.handle.net/2263/78873
dc.language.isoenen_ZA
dc.publisherBMJ Publishing Groupen_ZA
dc.rights© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.en_ZA
dc.subjectHIV counsellingen_ZA
dc.subjectInfant feeding counsellingen_ZA
dc.subjectClinical practiceen_ZA
dc.subjectQuasi-experimenten_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectSouth Africa (SA)en_ZA
dc.subjectHealthcare workers (HCWs)en_ZA
dc.titleTranslating new evidence into clinical practice : a quasi-experimental controlled before–after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding counselling in South Africaen_ZA
dc.typeArticleen_ZA

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