OBJECTIVE: To evaluate the effect of home visits by community health workers (CHWs) on maternal and infant well being from pregnancy through the first 6 months of life for women living with HIV (WLH) and all neighborhood mothers. DESIGN AND METHODS: In a cluster randomized controlled trial in Cape Town townships, neighborhoods were randomized within matched pairs to either standard care, comprehensive healthcare at clinics (n=12 neighborhoods; n=169 WLH; n=594 total mothers); orPhilani Intervention Program, home visits by CHWs in addition to standard care (PIP; n=12 neighborhoods; n=185 WLH; n=644 total mothers). Participants were assessed during pregnancy (2% refusal) and reassessed at 1 week (92%) and 6 months (88%) postbirth. We analyzed PIP's effect on 28 measures of maternal and infant well being among WLH and among all mothers using random effects regression models. For each group, PIP's overall effectiveness was evaluated using a binomial test for correlated outcomes. RESULTS: Significant overall benefits were found in PIP compared to standard care among WLH and among all participants. Secondarily, compared to standard care, PIP WLH were more likely to complete tasks to prevent vertical transmission, use one feeding method for 6 months, avoid birth-related medical complications, and have infants with healthy height-for-age measurements. Among all mothers, compared to standard care, PIP mothers were more likely to use condoms consistently, breastfeed exclusively for 6 months, and have infants with healthy height-for-age measurements. CONCLUSION:PIP is a model for countries facing significant reductions in HIV funding whose families face multiple health risks.
RCT Entities:
OBJECTIVE: To evaluate the effect of home visits by community health workers (CHWs) on maternal and infant well being from pregnancy through the first 6 months of life for women living with HIV (WLH) and all neighborhood mothers. DESIGN AND METHODS: In a cluster randomized controlled trial in Cape Town townships, neighborhoods were randomized within matched pairs to either standard care, comprehensive healthcare at clinics (n=12 neighborhoods; n=169 WLH; n=594 total mothers); or Philani Intervention Program, home visits by CHWs in addition to standard care (PIP; n=12 neighborhoods; n=185 WLH; n=644 total mothers). Participants were assessed during pregnancy (2% refusal) and reassessed at 1 week (92%) and 6 months (88%) postbirth. We analyzed PIP's effect on 28 measures of maternal and infant well being among WLH and among all mothers using random effects regression models. For each group, PIP's overall effectiveness was evaluated using a binomial test for correlated outcomes. RESULTS: Significant overall benefits were found in PIP compared to standard care among WLH and among all participants. Secondarily, compared to standard care, PIP WLH were more likely to complete tasks to prevent vertical transmission, use one feeding method for 6 months, avoid birth-related medical complications, and have infants with healthy height-for-age measurements. Among all mothers, compared to standard care, PIP mothers were more likely to use condoms consistently, breastfeed exclusively for 6 months, and have infants with healthy height-for-age measurements. CONCLUSION:PIP is a model for countries facing significant reductions in HIV funding whose families face multiple health risks.
Authors: David L Olds; Harriet Kitzman; Robert Cole; JoAnn Robinson; Kimberly Sidora; Dennis W Luckey; Charles R Henderson; Carole Hanks; Jessica Bondy; John Holmberg Journal: Pediatrics Date: 2004-12 Impact factor: 7.124
Authors: David L Olds; JoAnn Robinson; Lisa Pettitt; Dennis W Luckey; John Holmberg; Rosanna K Ng; Kathy Isacks; Karen Sheff; Charles R Henderson Journal: Pediatrics Date: 2004-12 Impact factor: 7.124
Authors: Andy Haines; David Sanders; Uta Lehmann; Alexander K Rowe; Joy E Lawn; Steve Jan; Damian G Walker; Zulfiqar Bhutta Journal: Lancet Date: 2007-06-23 Impact factor: 79.321
Authors: Alexander C Tsai; Mark Tomlinson; Sarah Dewing; Ingrid M le Roux; Jessica M Harwood; Mickey Chopra; Mary Jane Rotheram-Borus Journal: Arch Womens Ment Health Date: 2014-03-30 Impact factor: 3.633
Authors: Mark Tomlinson; Mary Jane Rotheram-Borus; Ingrid M le Roux; Maryann Youssef; Sandahl H Nelson; Aaron Scheffler; Robert E Weiss; Mary O'Connor; Carol M Worthman Journal: Prev Sci Date: 2016-11
Authors: Teralynn Ludwick; Alison Morgan; Sumit Kane; Margaret Kelaher; Barbara McPake Journal: Health Policy Plan Date: 2020-10-01 Impact factor: 3.344
Authors: Joan Christodoulou; Mary Jane Rotheram-Borus; Alexandra K Bradley; Mark Tomlinson Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-03-26 Impact factor: 8.829
Authors: Linda Richter; Mary Jane Rotheram-Borus; Alastair Van Heerden; Alan Stein; Mark Tomlinson; Jessica M Harwood; Tamsen Rochat; Heidi Van Rooyen; W Scott Comulada; Zihling Tang Journal: AIDS Behav Date: 2014-04