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Birth AsphyxiaHBB-PromptNCT03577054

Development of a Mobile Application for HBB Prompt Study

A study testing HBB Prompt and Low-Dose High Frequency training in people with Birth Asphyxia and Neonatal Death, run by Mbarara University of Science and Technology at 1 site in Uganda.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study applies an iterative user-centred design approach involving frontline birth attendants to create a mobile application ("HBB Prompt") to improve skills retention after initial newborn stabilization training through the Helping Babies Breathe (HBB) program. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Birth Asphyxia, Neonatal Death
What is being tested?
HBB Prompt and Low-Dose High Frequency training
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
1 siteUganda
Study dates
14 May 2018to 30 Jun 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Frontline birth attendants involved in the delivery or care of babies in the maternity ward, theater or pediatric wards with a possibility of involvement in newborn resuscitation.

Who cannot join

  • Health workers providing care in other wards other than maternity and pediatrics.

Trial locations and contacts

1 site in 1 country.

Francis Bajunirwe, PhD contact

+256772576396

fbaj@must.ac.ug

Uganda1 site, 1 recruiting
  • Mbarara University of Science and Technology

    Mbarara

    Santorino Data, MBChB, MMed, 256712214458, sdata@must.ac.ug

    Santorino Data, MBChB, MMed

    Recruiting

Other trials in Uganda

About this study

Official title: Development of a Mobile Application Through User Centered Design to Improve Helping Babies Breath Skills Retention

This study applies an iterative user-centred design approach involving frontline birth attendants to create a mobile application ("HBB Prompt") to improve skills retention after initial newborn stabilization training through the Helping Babies Breathe (HBB) program. HBB Prompt will then be piloted at one site after HBB training and skills retention will be compared with a control site without HBB Prompt after HBB training.

Read the detailed description

Helping Babies Breathe (HBB) is a newborn stabilization course that has been shown to reduce neonatal mortality by up to 47%. Such mortality impact is however not sustained due to rapid skills deterioration.

The investigators propose to improve sustainability of HBB's impact by increasing skills retention with an innovative mobile application called HBB Prompt. HBB Prompt will be an interactive tool that guides frontline providers through the steps needed to save newborn babies at birth. HBB Prompt will facilitate individual and group training in health facilities using the Low Dose High Frequency model (LDHF) for resuscitation skills retention.

The investigators will robustly develop HBB Prompt by integrating human factors and user-centered design approaches. The investigators will engage end-users and HBB Master Trainers to iteratively collect feedback to develop HBB Prompt for both individual and small group resuscitation practice. The iterative approach will mitigate the common scenario of mobile health (mHealth) solutions unable to achieve sustained success at scale due to lack of comprehensive input from frontline users.

The investigators will pilot the app at a single centre and compare it to a control site for HBB skills retention at different time points after initial HBB training.

Being tested
HBB Prompt, Low-Dose High Frequency training
Keywords
Helping Babies Breathe, newborn resuscitation, skills retention, mobile health, user-centred design
Medical subject headings
Asphyxia Neonatorum, Perinatal Death

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • HBB PromptBehavioural

    Also called mobile app

    Mobile app developed through user-centred design in phase 1 of this study

  • Low-Dose High Frequency trainingBehavioural

    Also called LDHF

    Participants will be encouraged to practice their HBB skills daily

Study groups in NCT03577054
Study groupRoleWhat they receive
HBB PromptExperimentalThe investigators will train frontline health providers in Helping Babies Breathe (HBB) 2.0 and Essential Care for Every Baby (ECEB). Providers will undergo ECEB training in addition to HBB as these training programs are recommended by the Uganda Ministry of Health to be offered together. Providers at this hospital will have access to the most updated version of HBB Prompt (beta) after HBB training. Participants in will be asked to achieve a minimum practice target of once per day (low-dose high frequency training). The recommended frequency to use the app will be once per shift.
Receives: Behavioral: HBB Prompt; Behavioral: Low-Dose High Frequency training
ControlPlacebo comparatorThe investigators will train frontline health providers in Helping Babies Breathe (HBB) 2.0 and Essential Care for Every Baby (ECEB). Providers will undergo ECEB training in addition to HBB as these training programs are recommended by the Uganda Ministry of Health to be offered together. The control group will not have exposure to the HBB Prompt app post training. Participants in will be asked to achieve a minimum practice target of once per day (low-dose high frequency training).
Receives: Behavioral: Low-Dose High Frequency training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Helping Babies Breathe Objective Structured Clinical Exam (OSCE) B score

    standardized comprehensive evaluation of HBB skills, 17 out of 23 constitutes a pass score with 23 being the highest score. The OSCE B is a standard Helping Babies Breathe assessment tool that comprises the steps required in successfully assisting a neonate in its transition after birth

    Measured: 12 months from initial HBB training

Secondary outcomes (13)
  1. OSCE B score

    standardized comprehensive evaluation of HBB skills, 17 out of 23 constitutes a pass score

    Measured: immediately before initial HBB training

  2. OSCE B score

    standardized comprehensive evaluation of HBB skills, 17 out of 23 constitutes a pass score

    Measured: immediately after initial HBB training

  3. OSCE B score

    standardized comprehensive evaluation of HBB skills, 17 out of 23 constitutes a pass score

    Measured: 3 months from initial HBB training

  4. OSCE B score

    standardized comprehensive evaluation of HBB skills, 17 out of 23 constitutes a pass score

    Measured: 6 months from initial HBB training

  5. HBB 2.0 Knowledge Check

    18 questions pertaining to newborn resuscitation

    Measured: at unannounced visits within 12 months of training

  6. Bag and mask ventilation skills check

    evaluation of bagging skills to assist breathing - score out of 14

    Measured: at unannounced visits within 12 months of training

  7. Bag and mask ventilation quality measures with AIR Device

    Augmented Infant Resuscitator (AIR) to objectively measure quality of newborn resuscitation during every ventilation epoch. AIR records time stamped data on ventilation quality, such as presence of air leak or obstruction and ventilation rate (www.air-device.com)

    Measured: at unannounced visits within 12 months of training

  8. OSCE A

    standardized evaluation of resuscitation skills (slightly different scenario than for OSCE B), 9 out of 12 constitutes a pass score

    Measured: at unannounced visits within 12 months of training

  9. App analytics - pattern of usage

    automated reports from the app regarding usage of different components of the app

    Measured: during 12 months after initial training in intervention arm only

  10. App analytics - frequency of usage

    frequency of access to different parts of the app, duration of app usage

    Measured: during 12 months after initial training in intervention arm only

  11. App analytics - trends of performance

    time trends of knowledge checks and simulation evaluations as noted in the app

    Measured: during 12 months after initial training in intervention arm only

  12. Frequency of practice

    for both intervention and control arms, log-books will be reviewed for frequency of practice and in the intervention arm, this will be compared to what is reported through the app

    Measured: during 12 months after initial training

  13. Exit focus group feedback on barriers and facilitators to HBB training and skills maintenance

    both intervention and control group participants will be interviewed to provide feedback on facilitators and barriers to HBB skills maintenance, and in the intervention arm, whether HBB Prompt helped or hindered their skills maintenance

    Measured: at end of study (12 months from the start)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jul 2018
  2. Study start14 May 2018
  3. Primary completion30 Apr 2019 (estimated)
  4. Study completion30 Jun 2019 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel Assignment
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03577054
Sponsor's protocol ID
MUST 16/09-17
Acronym
HBB-Prompt
Status last verified
Jul 2018
First submitted
15 May 2018
Last updated
6 Jul 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Msemo G, Massawe A, Mmbando D, Rusibamayila N, Manji K, Kidanto HL, Mwizamuholya D, Ringia P, Ersdal HL, Perlman J. Newborn mortality and fresh stillbirth rates in Tanzania after helping babies breathe training. Pediatrics. 2013 Feb;131(2):e353-60. doi: 10.1542/peds.2012-1795. Epub 2013 Jan 21.

    PubMed 23339223
  • Kc A, Wrammert J, Clark RB, Ewald U, Vitrakoti R, Chaudhary P, Pun A, Raaijmakers H, Malqvist M. Reducing Perinatal Mortality in Nepal Using Helping Babies Breathe. Pediatrics. 2016 Jun;137(6):e20150117. doi: 10.1542/peds.2015-0117.

    PubMed 27225317
  • Goudar SS, Somannavar MS, Clark R, Lockyer JM, Revankar AP, Fidler HM, Sloan NL, Niermeyer S, Keenan WJ, Singhal N. Stillbirth and newborn mortality in India after helping babies breathe training. Pediatrics. 2013 Feb;131(2):e344-52. doi: 10.1542/peds.2012-2112. Epub 2013 Jan 21.

    PubMed 23339215
  • Bang A, Patel A, Bellad R, Gisore P, Goudar SS, Esamai F, Liechty EA, Meleth S, Goco N, Niermeyer S, Keenan W, Kamath-Rayne BD, Little GA, Clarke SB, Flanagan VA, Bucher S, Jain M, Mujawar N, Jain V, Rukunga J, Mahantshetti N, Dhaded S, Bhandankar M, McClure EM, Carlo WA, Wright LL, Hibberd PL. Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time? BMC Pregnancy Childbirth. 2016 Nov 22;16(1):364. doi: 10.1186/s12884-016-1141-3.

    PubMed 27875999
  • Reisman J, Arlington L, Jensen L, Louis H, Suarez-Rebling D, Nelson BD. Newborn Resuscitation Training in Resource-Limited Settings: A Systematic Literature Review. Pediatrics. 2016 Aug;138(2):e20154490. doi: 10.1542/peds.2015-4490. Epub 2016 Jul 7.

    PubMed 27388500
  • Mduma E, Ersdal H, Svensen E, Kidanto H, Auestad B, Perlman J. Frequent brief on-site simulation training and reduction in 24-h neonatal mortality--an educational intervention study. Resuscitation. 2015 Aug;93:1-7. doi: 10.1016/j.resuscitation.2015.04.019. Epub 2015 May 6.

    PubMed 25957942
  • Arabi AM, Ibrahim SA, Ahmed SE, MacGinnea F, Hawkes G, Dempsey E, Ryan CA. Skills retention in Sudanese village midwives 1 year following Helping Babies Breathe training. Arch Dis Child. 2016 May;101(5):439-42. doi: 10.1136/archdischild-2015-309190. Epub 2016 Jan 29.

    PubMed 26826172
  • Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, Simon WM, Weiner GM, Zaichkin JG. Part 13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S543-60. doi: 10.1161/CIR.0000000000000267. No abstract available.

    PubMed 26473001
  • FDIs, I. (2009). 9241-210 (2009). Ergonomics of human system interaction-Part 210: Human-centered design for interactive systems (formerly known as 13407). International Organization for Standardization (ISO). Switzerland.

  • Krueger RA, Casey MA. Focus Groups: A practical guide for applied research. 4th ed. California: Sage Publications Inc., 2008.

  • Chan NH, Merali HS, Mistry N, Kealey R, Campbell DM, Morris SK, Data S. Development of a novel mobile application, HBB Prompt, with human factors and user-centred design for Helping Babies Breathe skills retention in Uganda. BMC Med Inform Decis Mak. 2021 Feb 4;21(1):39. doi: 10.1186/s12911-021-01406-z.

    PubMed 33541340
  • Merali HS, Chan NH, Mistry N, Kealey R, Campbell D, Morris SK, Data S. Designing and evaluating a novel mobile application for Helping Babies Breathe skills retention in Uganda: comparative study protocol. BMJ Paediatr Open. 2019 Sep 3;3(1):e000561. doi: 10.1136/bmjpo-2019-000561. eCollection 2019.

    PubMed 31549001

Questions about this trial

What is this clinical trial studying?

A study testing HBB Prompt and Low-Dose High Frequency training in people with Birth Asphyxia and Neonatal Death, run by Mbarara University of Science and Technology at 1 site in Uganda.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 6 Jul 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Uganda. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Francis Bajunirwe, PhD (+256772576396, fbaj@must.ac.ug), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Helping Babies Breathe Objective Structured Clinical Exam (OSCE) B score (time frame: 12 months from initial HBB training). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03577054, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jul 2018.

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