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Drawing open the curtain on home-based interventions

机译:绘制在基于家庭的干预措施上打开窗帘

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摘要

Providing facility-based care to the billions of people living in Low- and Middle-Income Countries (LMICs) is a challenge due to the multitude of barriers people face in accessing these sites. Unaffordable transportation costs, limited child care options, poor health and inconsistent staffing and services of facilities are just some of the many reasons facility-based primary health care interventions struggle to recruit and retain patients in efficacious programs (1). Home-based interventions have been shown to be a viable alternative across a broad range of health initiatives including infectious disease (e.g., HIV screening), mental health (e.g., postpartum depression) and non-communicable disease risk reduction and education (e.g., obesity and nutrition) interventions (2-4). One of their key weaknesses is lack of cost-effectiveness. Multiple follow-up visits to the home are required to deliver the intervention and to ensure that uptake and behavioural change are taking place. A second limitation of home-based interventions is that they are typically one-size-fits-all. Lay health workers are trained in the intervention and the sessions and manuals are routinized to simplify deliver and to increase the likelihood of intervention fidelity. We believe a solution to these challenges is available in the use of passive sensor data to provide robust, evidence-based feedback on what happens in the home after the health worker walks out the door.
机译:为生活在低收入和中等收入国家(LMICS)的数十亿人提供基于融资的护理是在访问这些网站时面临的众多障碍的挑战。不适算的运输费用,有限的儿童保育选择,差的健康和不一致的员工配备和服务服务只是基于工厂的主要医疗干预措施的许多原因,以招募和保留有效计划(1)的患者的争议。由于包括传染病(例如,HIV筛查),心理健康(例如,产后抑郁症)和不传达的疾病减少和教育(例如,肥胖,患有广泛的健康倡议,横跨广泛的健康倡议(例如,HIV筛查)和非传染病风险(例如,肥胖症)是一种可行的替代方案和营养)干预措施(2-4)。其中一个关键的弱点是缺乏成本效益。需要对家庭进行多次后续访问来提供干预,并确保正在采取吸收和行为变革。对基于家庭的干预措施的第二个限制是它们通常是单尺寸适合的。卫生工作人员在干预方面接受培训,并经常审议会议和手册以简化交付,并增加干预保真度的可能性。我们认为,在使用被动传感器数据时可提供对这些挑战的解决方案,以提供卫生工作者走出门之后在家中发生的最强大,证据的反馈。

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