Improving Alarm Sign Recognition and Care Access in Yucatan Communities
This project focuses on enhancing alarm sign recognition and timely care access for children under 5 in low-income Yucatan populations. Collaborating with the University of Yucatan, the interventions include community awareness programs and training for physicians to improve cause of death classifications. The study aims to elevate healthcare quality and mortality data accuracy, addressing challenges like delays in care-seeking and low awareness of alarm signs among caregivers. Community and hospital interventions are evaluated, with positive outcomes in knowledge enhancement and acceptance noted. Methodologies were adapted due to COVID-19, demonstrating adaptability and commitment to improving child health outcomes in underserved communities.
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Design and evaluation of community and health facility interventions to improve alarm sign recognition and timely care access in low-income Yucatan populations Dr. Bernardo Hern ndez Prado Dra. Elsa Rodr guez Angulo Investigador Asociado Profesora investigadora Instituto de Evaluaci n y M trica de la Salud Escuela de Salud P blica Universidad de Washington Universidad de Yucat n Abril 2020
Contents Background Interventions Community intervention evaluation analysis 2
Background Collaboration between IHME and University of Yucatan, Mexico Funded by W.K. Kellogg Foundation Previous study with the same group found: o Problems in the certification of causes of death o Low knowledge of signs of alarm for children among caregivers and delays in the search for care
Objectives Goal of this project: to improve both the health care and the quality of mortality information (i.e. cause of death classifications) for children under the age of 5 in Yucatan, Mexico, with a focus on low-income and indigenous communities. 2 interventions o Community intervention: Improve the knowledge and recognition of alarm signs and symptoms among caregivers of children under 5 through the design and dissemination of informational materials describing alarm signs for leading causes of death. o Hospital intervention: Develop and implement a short course to improve the certification of causes of death by physicians for deaths of children under the age of five. 4
Hospital intervention Training of physicians in certification of causes of death for children under 5 at Hospital Agust n O Hor n, M rida, Yucat n, M xico Good results o Increase in knowledge and confidence to fill a death certificate o Well accepted by participants and Hospital authorities Limitations o Small sample (n=41) o Pre-post design, without a comparison group 5
Community intervention Community intervention to increase knowledge of signs of alarms and provide tools for search for care to caregivers of children under 5. Delivery of the intervention had to be adjusted due to Covid-19 Experimental design, with pre and post measurements in 4 intervention and 4 comparison communities 474 participants Electronic data collection at baseline, in paper at follow-up (due to Covid) 6
Preliminary results: improvement in both groups, non-significant effect of intervention 7
Research project Question: did the community intervention had a differential impact across subgroups (education level, parity, SES) Need to use econometrics methods to assess the impact of the intervention (difference in difference models) Good opportunity for a thesis Project o Scientific paper (with student as first author if submitted within 2 months from graduation) o Guidance in analysis o Dataset available Good learning experience: o Analysis o Writing of a scientific paper 8
If interested, contact me Bernardo Hern ndez Prado Associate Professor bhp3@uw.edu 9
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