Maternal & Child Health

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Browsing Maternal & Child Health by Subject "Caregiver led training for caregivers of children with cerebral palsy"

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    Feasibility, non-inferiority and effects of a caregiver-led training program for caregivers of children with cerebral palsy
    (Kamuzu University of Health Sciences, 2022-09-28) Bakuwa, Takondwa Connis
    Type of Study The proposed study is a convergent parallel mixed methods design that will be conducted in two phases. Problem There is critical shortage of rehabilitation professionals in low-resource settings comprehensive training of caregivers is inadequate. Hence therapeutic inputs for children in these areas remains limited. Despite the emerging use of caregivers to support training of fellow caregivers of children with CP, the strength of this model of caregiver training has not been adequately evaluated. Broad objective To assess the implementation outcomes of a caregiver-led training program for caregivers of children with CP in Namwera, Mangochi, Malawi. Specific objectives 1. To explore the acceptability of the carer-to-carer training program delivered to caregivers of children with CP from Namwera Mangochi Malawi over a period of 5-days 2. To determine change in knowledge on CP among caregivers of children with CP from Namwera Mangochi, Malawi following a 5-day training using the Carer-to-Carer training package 3. To describe adaptations made to the carer-to-carer training package following initial delivery over a 5-day training programme 4. Compare levels of knowledge, skills and quality of life between caregivers trained by a fellow caregiver and caregivers trained by a therapist using the C2CTP in Mangochi Malawi over a period of seven weeks 5. Compare levels activity and participation between children with CP whose caregivers were trained by a fellow caregiver and those whose caregivers were trained by a therapist using the C2CTP in M6. Explore the perceptions of caregivers of children with CP involved in the C2CTP training program either as participants or facilitators regarding the perceived effects of the program delivered over seven weeks in Namwera, Mangochi, Malawi. Methodology Phase one, which is the feasibility study, will describe three things, acceptability, adaptation and ability of training to change caregivers’ level of knowledge on CP. Acceptability will be explored qualitatively using in-depth interviews and reported as themes, adaptation will be analyzed and reported using the template for Intervention Description and Replication. Change in knowledge will be assessed using a questionnaire on Knowledge designed by Malamulele Onward Organisation and reported as means and standard deviation. Phase two will investigate non-inferiority of the caregiver-led training program through a two-armed randomised controlled trial where the active control group will be a therapist-led training program. Paired t-tests will be used to compare changes in caregiver level outcomes such as quality of life (PedsQolFIM), caregiver knowledge on CP (standard CP knowledge questionnaire). Child level outcomes such as Pediatric Inventory of Disability (PEDI) and Participation (CASP, PMP) will also be assessed and compared using paired tests. Non-inferiority of the caregiver-led training program will be tested margin of 4.5 points on the PedsQolFIM. Parallel to the RCT will be a qualitative study that will explore the experience of all participants and facilitators of the training program. Inductive analysis will be employed to generate themes in this regard. Expected Findings This study will describe the feasibility of a caregiver-led training program in Malawi. It will also determine whether the program in not inferior to a therapist-led training program. Therefore, it will provide useful insight that can inform the design and capacity building required to support caregiver-led training programs for caregivers of children with CP. In addition to this, the study will provide useful qualitative insight on the effects and value of a caregiver-led training program for children with CP. Dissemination All data generated from both phases of the study will be orally presented to all stakeholders of the program including Mangochi district hospital, Tiyende Pamodzi group, Malamulele Onward organisation. The results will also be shared with the larger community of practice through attendance of conferences at local regional and international levels. A copy of the results will be shared with the College of Medicine Research Ethics Committee. In addition to that, the results will be sent to a peer review journal for publicationangochi Malawi over a period of seven weeks.