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The KAP 2 Study: Preliminary Results from a Pragmatic Cluster Randomized Trial of a Community Education Intervention to Support Childhood Anemia Control in India

2017· article· en· W2982284915 on OpenAlexaff
Arun S. Shet, Merrick Zwarenstein, Aniket Vijay Rao, Paul Jebaraj, Kartika Arumugam, Maya Mascarenhas, Neil Klar, R Galanti

Bibliographic record

VenueBlood · 2017
Typearticle
Languageen
FieldMedicine
TopicIron Metabolism and Disorders
Canadian institutionsWestern University
Fundersnot available
KeywordsMedicineAnemiaCluster randomised controlled trialRandomized controlled trialPediatricsCluster (spacecraft)Intervention (counseling)Environmental healthPopulationFamily medicineSurgeryInternal medicineNursing

Abstract

fetched live from OpenAlex

Abstract Introduction: Childhood anemia is a public health concern, particularly in India and in Africa, countries that account for 80% of the global burden. Usual treatment of childhood anemia in India consists of monthly distribution of Iron and Folic acid (IFA) tablets according to National Iron + Initiative guidelines. This approach is hampered in part by lack of anemia awareness, dietary practices, and poor adherence to IFA in the target population. To support anemia control efforts, we developed a novel community-centered education and counseling intervention optimized for delivery by village lay health workers (LHWs) to mothers of anemic children. The intervention consisted of five monthly sessions covering: a] anemia awareness education b] adherence counseling and assessment, c] dietary modification to improve iron intake, and d] hygiene and sanitation. Methods: We evaluated the effectiveness of this intervention in a pragmatic cluster randomized controlled trial. Sixty villages selected at random from the study area in Karnataka, South India were randomly allocated to either intervention + usual anemia treatment (n=30) or usual anemia treatment alone (n=30). A cluster (randomization unit) was defined as a village from the study area together with its Anganwadi Daycare Center (ADC), and the corresponding LHW in charge of the ADC. LHWs in the intervention group were specifically trained to administer the intervention to mothers of anemic children in addition to usual anemia care. Hemoglobin at baseline and endpoint was used to define anemia (Hb Results: From 55 finally included villages (intervention=28; control=27), a total of 1144 children were screened. The overall anemia prevalence was 47% (n=534; intervention=303; control=231). Baseline characteristics of the anemic children are presented in Table 1. Hypoferremia (ferritin 5 mg/L; n=55) all sTfR/log Ferritin values were >1.03 (median=2.7; 1.85, 4.20) suggesting functional IDA. Overall loss to follow up in the trial was low (3%) but was greater in the usual treatment group (n=12 vs. 5). According to an intention to treat analysis, children receiving the intervention had a significantly higher anemia cure rate compared with children receiving usual treatment (55.7% vs. 41.4%; p Conclusion: At the end of 6 months, the intervention combined with usual anemia treatment was more effective in curing anemia than usual treatment alone. This trial suggests that community education may positively interact with usual anemia treatment practices to achieve better childhood anemia control in India. Download : Download high-res image (323KB) Download : Download full-size image Disclosures No relevant conflicts of interest to declare.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.006
Threshold uncertainty score0.020

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0040.005
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0020.002
Bibliometrics0.0010.001
Science and technology studies0.0010.001
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0060.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.010
GPT teacher head0.302
Teacher spread0.292 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2017
Admission routes1
Has abstractyes

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