K4Health
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This Digital Health Resource Library houses three legacy collections previously maintained by the Knowledge for Health (K4Health) Project. K4Health’s work was made possible by the support of the American People through the United States Agency for International Development (USAID) . K4Health was supported from 2008-2019 by USAID's Office of Population and Reproductive Health, Bureau for Global Health, under cooperative agreements with the Johns Hopkins University. K4Health was implemented by the Johns Hopkins Center for Communication Programs (CCP) in collaboration with FHI 360, Management Sciences for Health (MSH), and IntraHealth International. The K4Health Project ended in September 2019.
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Browsing K4Health by Subject "Birth spacing"
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- ItemEfficacy of a randomized cell phone-based counseling intervention in postponing subsequent pregnancy among teen mothers.(2011-11-28) Katz, Kathy S; Rodan, Margaret; Milligan, Renee; Tan, Sylvia; Courtney, Lauren; Gantz, Marie; Blake, Susan M; McClain, Lenora; Davis, Maurice; Kiely, Michele; Subramanian, SivaAdolescent mothers in Washington DC have a high rate of subsequent teen pregnancies often within 24 months Children of teen mothers are at risk for adverse psychosocial outcomes When adolescents are strongly attached to parents schools and positive peers they may be less likely to repeat a pregnancy This study tested the efficacy of a counseling intervention delivered by cell phone and focused on postponing subsequent teen pregnancies by strengthening healthy relationships reproductive practices and positive youth assets The objective of this study was to compare time to a repeat pregnancy between the intervention and usual care groups and secondarily to determine whether treatment intensity influenced time to subsequent conception Primiparous pregnant teens ages 15 19 were recruited in Washington DC Of 849 teens screened 29 3 n 249 met inclusion criteria consented to participate and completed baseline measures They were then randomized to the intervention N 124 or to usual care N 125 Intervention group teens received cell phones for 18 months of counseling sessions and quarterly group sessions Follow up measures assessed subsequent pregnancy through 24 months post delivery A survival analysis compared time to subsequent conception in the two treatment groups Additional models examined the effect of treatment intensity By 24 months 31 of the intervention and 36 of usual care group teens had a subsequent pregnancy Group differences were not statistically significant in intent to treat analysis Because there was variability in the degree of exposure of teens to the curriculum a survival analysis accounting for treatment intensity was performed and a significant interaction with age was detected Participants who were aged 15 17 years at delivery showed a significant reduction in subsequent pregnancy with increased levels of intervention exposure P Under 0 01 but not those 18 years Adolescents 18 years faced considerable challenges to treatment success Individual social and contextual factors are all important to consider in the prevention of repeat teen pregnancy Cell phone based approaches to counseling may not be the most ideal for addressing complex socially mediated behaviors such as this except for selective subgroups A lack of resources within the community for older teens may interfere with program success
- ItemMicrofluidic CD4+ and CD8+ T lymphocyte counters for point-of-care HIV diagnostics using whole blood.(2013-12-05) Watkins, Nicholas N; Hassan, Umer; Damhorst, Gregory; Ni, Hengkan; Vaid, Awais; Rodriguez, William; Bashir, RashidRoughly 33 million people worldwide are infected with HIV disease burden is highest in resource limited settings One important diagnostic in HIV disease management is the absolute count of lymphocytes expressing the CD4 and CD8 receptors The current diagnostic instruments and procedures require expensive equipment and trained technicians In response we have developed microfluidic biochips that count CD4 and CD8 lymphocytes in whole blood samples without the need for off chip sample preparation The device is based on differential electrical counting and relies on five on chip modules that in sequence chemically lyses erythrocytes quenches lysis to preserve leukocytes enumerates cells electrically depletes the target cells CD4 or CD8 with antibodies and enumerates the remaining cells electrically We demonstrate application of this chip using blood from healthy and HIV infected subjects Erythrocyte lysis and quenching durations were optimized to create pure leukocyte populations in less than 1 min Target cell depletion was accomplished through shear stress based immunocapture using antibody coated microposts to increase the contact surface area and enhance depletion efficiency With the differential electrical counting method device based CD4 and CD8 T cell counts closely matched control counts obtained from flow cytometry over a dynamic range of 40 to 1000 cells l By providing accurate cell counts in less than 20 min from samples obtained from one drop of whole blood this approach has the potential to be realized as a handheld battery powered instrument that would deliver simple HIV diagnostics to patients anywhere in the world regardless of geography or socioeconomic status
- ItemMobile Alliance for Maternal Action (MAMA) Lessons Learned(2018-05-14) Radha, R; Liu, A; Ollis, S; Sullivan, EUnderp This document highlights key operational lessons learned from four country programs Bangladesh South Africa India and Nigeria that implemented the Mobile Alliance for Maternal Action MAMA approach The MAMA approach uses age and stage based messaging directed toward pregnant women new mothers and families to foster behavior change and improve maternal and child health outcomes This report aims to share operational lessons that country program implementers learned and the strategies they used to overcome implementation challenges Under p