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

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dc.contributor.authorGoga, Ameenaen_ZA
dc.contributor.authorDoherty, Tanyaen_ZA
dc.contributor.authorManda, Samuelen_ZA
dc.contributor.authorNkwenika, Tshifhiwaen_ZA
dc.contributor.authorHaskins, Lynen_ZA
dc.contributor.authorJohn, Vaughnen_ZA
dc.contributor.authorEngebretsen, Ingunn M. S.en_ZA
dc.contributor.authorFeucht, Uteen_ZA
dc.contributor.authorDhansay, Alien_ZA
dc.contributor.authorRollins, Nigelen_ZA
dc.contributor.authorKroon, Maxen_ZA
dc.contributor.authorSanders, Daviden_ZA
dc.contributor.authorKauchali, Shuaiben_ZA
dc.contributor.authorTylleskär, Thorkilden_ZA
dc.contributor.authorHorwood, Christianeen_ZA
dc.date.accessioned2022-05-05T10:32:48Zen_ZA
dc.date.available2022-05-05T10:32:48Zen_ZA
dc.date.issued2020-10en_ZA
dc.descriptionCITATION: Goga, Ameena 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, 10:e034770, doi:10.1136/bmjopen-2019-034770.en_ZA
dc.descriptionThe original publication is available at: https://bmjopen.bmj.comen_ZA
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.versionPublisher's versionen_ZA
dc.format.extent13 pagesen_ZA
dc.identifier.citationGoga, Ameena 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, 10:e034770, doi:10.1136/bmjopen-2019-034770en_ZA
dc.identifier.otherdoi:10.1136/bmjopen-2019-034770en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125185en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherBMJ Publishingen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectBreastfeeding --Health aspects -- South Africaen_ZA
dc.subjectBreastfeeding -- South Africa --Immunological aspects.en_ZA
dc.subjectHIV infections --Transmission -- South Africaen_ZA
dc.subjectHIV infections --Prevention -- South Africaen_ZA
dc.subjectAIDS (Disease) in infants --Prevention -- South Africaen_ZA
dc.subjectHIV-positive women -- South Africaen_ZA
dc.subjectMedical policy -- South Africaen_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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