1 / 24

Urbanisation and Health in China Forum 28-29 November 2013 The University of Sydney A/Prof. Mu Li

Innovative approach of delivering health promotion program in a urban setting: experience from a mobile phone short message healthy infant feeding promotion study. Urbanisation and Health in China Forum 28-29 November 2013 The University of Sydney A/Prof. Mu Li

edison
Download Presentation

Urbanisation and Health in China Forum 28-29 November 2013 The University of Sydney A/Prof. Mu Li

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Innovative approach of delivering health promotion program in a urban setting: experience from a mobile phone short message healthy infant feeding promotion study Urbanisation and Health in China Forum 28-29 November 2013 The University of Sydney A/Prof. Mu Li China Studies Centre and School of Public Health The University of Sydney

  2. Trend dataAcknowledgement • Shanghai based researchers Hong Jiang, Qiaozhen, Hu, Dongling Yang, Gengsheng He, Xu Qian • Sydney based researchers Mu Li, Li Ming Wen, Michael Dibley, Louise Baur

  3. Background Childhood obesity has become a major public health concern in China ( Li et al, Chin J Pediatr 2008) 1986 1996 2006

  4. Overweight and obesity prevalence in older children • For 7-15 year olds the national obesity prevalence: from less than 0.5% in 1985 to around 13% in 2005 in boys living in urban settings (Cui et al. Int J Pediatr Obe 2010)

  5. Shift in BMI at 95 percentile in children aged 6 years (Popkin AJCN 91 (supp):284S-288S, 2010)

  6. Comparison of Bp, waist C, Hip C and W/H C ratio in 3-6 y-o obese and normal weight children SBP DBP WC HipC W/HR N= Obes non-Obes ( Li et al, Chin J Paediatr 2008)

  7. Reported associated factors in China • Low exclusive breastfeeding and ‘any’ breastfeeding, 15.8% and 49.2% at 6 months, respectively • Started complementary food too early (before 4 months) or too late • Imbalanced complementary feeding, higher carbohydrate-based • Poor infant feeding knowledge and practices • Others • Delivery by C-section • High birth weight of the newborns • Higher BMI parents, particularly mother's pre-pregnancy BMI

  8. Protective effect of breastfeeding against childhood obesity • Arenz S, et al. Breast-feeding and childhood obesity - systematic review. Int J Obes. 2004;28:1247-56. • Dewey KG. Is Breastfeeding Protective Against Child Obesity? J Hum Lact. 2003;19(1):9-18. • Owen CG, et al. Effect of Infant Feeding on the Risk of Obesity Across the Life Course: A Quantitative Review of Published Evidence. Pediatrics. 2005;115(5):1367-77. • Koletzko B, et al. Can infant feeding choices modulate later obesity risk? Am J Clin Nutr. 2009;89(5):1502S-8.

  9. SMS or web-based interventions have proven to be effective in (mhealth, ehealth): • Behaviour change • smoke cessation • dietary behaviour change • physical activity and weight management • Patient management • patients’ blood pressure and diabetes management • Adhesion to anti-viral therapy • Disease surveillance

  10. The project • Aim: to evaluate the feasibility and effectiveness of SMS in support of breastfeeding and infant feeding in urban China

  11. Community health centre (CHC) 社区卫生服务中心: • A pregnant woman is required to register and receives the ‘Pregnant Women Healthcare Card’ around 12 weeks gestation at the CHC This is the best time to reach nearly 100% of the pregnant women. • After giving birth, the new mother is referred back to the CHC in her household registration area to be followed up by the CHC in the first 6 weeks. • CHC is also responsible for child growth and development check ups from 0-6 years: 4 scheduled health checks in the first year (around 2, 4, 6 and 9 months), twice yearly from 1-3 years, and yearly thereafter.

  12. MCH services in Shanghai pregnancy BF promotion 1 trimester CHC MH Dr register Antenatal class Antenatal class 2&3 trimester Maternity Hop Antenatal care 10 steps of successful BF childbirth Delivery Maternity Hop 1st month postpartum BF advice Home visit CHC MH Dr BF advice 6wks postpartum exam Maternity Hop Check up BF advice Up to 2 years CH /Paediatric Check up

  13. Short message service (SMS): • The advantages of using SMS to support interventions for new mothers: • avoidance of travel to health facilities and waiting time • flexible program delivery • messages can be delivered quickly and simultaneously to a large group of mothers • communication can be interactive between health providers and mothers with tailored response • relatively low cost

  14. The Intervention We developed a community-based health promotion program to support new mothers to breastfeed their babies and to adopt healthy infant feeding practices using SMS. The study was carried out in four Community Health Centers (CHCs). Two CHCs were assigned to the intervention group and two other CHCs were assigned as the control group.

  15. Communications technologies such as SMS have enabled us to deliver the innovative public health program.

  16. The pilot study and findings The participants: • Total 657 pregnant women recruited • Mean age 28 years, (range 20-42) • Education levels: 83% college or above • Professions: 48% professionals or management jobs • Intended time to return to work after giving birth: 73% by 6 months

  17. (Jiang et al Breastfeeding Medicine, 2012)

  18. *Mantel-Haenszel chi-square tests † (mean score 3.6; median score 4.0)

  19. (Yang et al. Maternal and Child Health Care of China. 26:4704-6, 2011)

  20. 86% responded that they would accepted breastfeeding and infant feeding information sent by SMS (Yang et al. Maternal and Child Health Care of China. 26:4704-6, 2011)

  21. (Jiang et al. Lancet 382 (Suppl.1):4. DOI: 10.1016/S0140-6736(13)62165-0, 2013) 4. Feasibility and acceptability Delivering health promotion intervention by SMS appears not only feasible but is well accepted by new mothers with a high retention rate of 89% at 12 months 5. Median duration of exclusive breastfeeding Compared with the control group, the intervention group had a significantly longer median duration of EBF at 6 months (11.41 weeks, 95% confidence interval [CI] 10.25 - 12.57 vs 8.87 weeks, 95% CI 7.84 - 9.89; P<0.001)

  22. 6. EBF and 6 months and introduction of solid foods before 4 months (Jiang et al. Lancet 382 (Suppl.1):4. DOI: 10.1016/S0140-6736(13)62165-0, 2013)

  23. Conclusion • There is a gap in pregnant women and new mothers’ awareness of the Who breastfeeding guidelines and knowledge on breastfeeding (Jiang et al, Breastfeeding Medicine, 2012) • The current health care can not meet the need (Yang et al, Chinese Maternal and Child healthcare 2011) • 95 % pregnant mothers in this study use mobile phone, 86% willing to receive health promotion SMS (Yang et al, Chinese Maternal and Child healthcare 2011) • Delivering health promotion intervention by SMS appears not only feasible but is well accepted by new mothers (Jiang et al, Lancet, 2013) • SMS health promotion intervention improves median exclusive breastfeeding duration and rate at 6 months and reduce early introduction of solid foods (Jiang et al, Lancet, 2013)

  24. Thank you 谢谢

More Related