Explore the vast range of titles available.

The aim was to evaluate if the addition of video discharge instructions (VDIs) to usual verbal information improved the comprehension of information provided to caregivers of patients who consult for acute gastroenteritis (AGE). We conducted an open-label, parallel, randomized trial, enrolling patients who consulted for AGE at a tertiary hospital. First, caregivers answered a written test concerning AGE characteristics and management. They were randomly allocated to a control group, which received the usual verbal instructions, or to an intervention group, which additionally received VDI. After discharge, caregivers were contacted by telephone and answered the same test, satisfaction questions, and follow-up information. From September 2019 to March 2020, 139 patients were randomized, 118 completed follow-up. The mean score was 3.13 (SD 1.07) over 5 points in the initial test and 3.96 (SD 0.96) in the follow-up test. Patients in the intervention group had a greater improvement (1.17 points, SD 1.11) than those in the control group (0.47 points, SD 0.94, p < 0.001). In the follow-up test, 49.1% in the intervention group and 18.6% in the control group answered all questions correctly (p < 0.001). There were no significant differences in return visits. Caregivers gave high satisfaction scores regardless of the allocation group.Conclusion: Video instructions improve caregivers’ understanding of discharge information.Trial registration: [NCT04463355, retrospectively registered July 9, 2020].What is Known:• Poor comprehension of discharge instructions leads to incorrect treatment after discharge, increased readmissions and a reduction of caregivers’ satisfaction.• Video discharge instructions are useful providing concise information independently of the patients’ health literacy level or communication skills of the health care providerWhat is New:• The addition of video discharge instructions to verbal instructions improves caregivers’ knowledge about AGE improved with respect to those who only receive verbal instructions• Video instructions do not add extra time to the emergency department visits

Caregivers’ nutrition knowledge and attitudes may influence the variety of foods available in the household and the quality of children’s diets. To test the link, this study collected data on caregivers’ (n 608) nutrition knowledge and feeding attitudes as well as the diets of their household and of their 2–5-year-old children in twelve rural communities nested in the three main agro-ecological zones of Ghana. Household foods and children’s animal source foods (ASF) consumed in the past 7 d were categorised into one of fourteen and ten groups, respectively. About 28 % of caregivers believed that their children needed to be fed only 2–3 times/d. Reasons for having adult supervision during child meal times, feeding diverse foods, prioritising a child to receive ASF and the perceived child benefits of ASF differed across zones (P<0·001). Households with caregivers belonging to the highest tertile of nutrition knowledge and attitude scores consumed more diverse diets compared with those of caregivers in the lowest tertile group (11·2 (sd 2·2) v. 10·0 (sd 2·4); P<0·001). After controlling for the effect of agro-ecological zone, caregivers’ nutrition knowledge and feeding attitudes positively predicted household dietary diversity and the frequency and diversity of children’s ASF intakes (P<0·001). The number of years of formal education of caregivers also positively predicted household dietary diversity and children’s ASF diversity (P<0·001). A key component to improving child nutrition is to understand the context-specific nutrition knowledge and feeding attitudes in order to identify relevant interventions.

Background Malaria remains a critical public health challenge globally, particularly in sub-Saharan Africa where it significantly contributes to morbidity and mortality among children under-five. In Ghana, efforts to promote the use of insecticide-treated nets (ITNs) as a preventive measure have been substantial but utilization rates remain suboptimal. This study examines the influence of caregivers' malaria-related knowledge on ITN use among children under the age of five years in a rural district of Ghana. Methods A community-based cross-sectional study was conducted in the Ahafo Ano South West District, Ghana, between June and October 2023. A total of 442 caregivers (mothers) of children under-five were selected using a two-stage sampling process. Data were collected through structured interviews and analysed using bivariate and multivariable logistic regression models to determine the association between caregivers’ malaria-related knowledge and ITN use among children. Results Out of 442 caregivers, 436 (98.6%) completed the survey. ITN use among children under-five the night before the survey was reported by 73.8% of caregivers. Overall, 36.8% of caregivers had good malaria-related knowledge, 41.2% had satisfactory knowledge, and 21.9% had poor knowledge. Multivariable analysis showed that caregivers with good malaria-related knowledge were 12 times more likely to use ITNs for their children (AOR = 12.06, 95% CI 2.30–53.20) compared to those with poor knowledge. Other significant predictors included education on ITN use, ITN ownership, child's age, and use of alternative malaria prevention methods. Conclusion This study highlights the critical role of caregiver malaria-related knowledge in promoting ITN use among children under-five in rural Ghana. Caregivers with better knowledge were significantly more likely to use ITNs, emphasizing the need for targeted health education programs. Such interventions should enhance awareness of malaria risks and ITN benefits, empower caregivers to use ITNs effectively, and reduce barriers to ITN access. These findings provide valuable insights for policymakers aiming to improve ITN utilization and reduce malaria morbidity and mortality in vulnerable populations.

Routine growth monitoring (RGM) for 9 to 24-month-old children enables early detection of developmental problems for corrective interventions. Unfortunately, many caregivers cease active RGM activities once they exhaust the government-recommended vaccines. The study aimed to find out the effects of health education using mobile technologies on caregivers’ knowledge of RGM. The study was quasi-experimental in design. Caregivers in interventional arm 1, received health education (HE) messages sent via a Short Text Message (STM). Caregivers in interventional arm 2, received HE messages using Voice Calls (VC). Control arms received the usual care. Post-intervention results revealed that there was an increase in the number of respondents who knew the importance of RGM for their children. Post-intervention analysis showed that caregivers in intervention arms 1 and 2 were more presumably to know when their children should be taken for RGM (OR = 3.000; 95% CI: 2.098 – 4.29), what is done during RGM visits to a child welfare clinic, the benefits of RGM, and problems associated with failure to engage in RGM compared to those in the control arm and at the beginning of the study. Health education using mobile technologies improved caregivers’ knowledge of routine growth monitoring.

Background In the drylands of northern Kenya, mothers strive to promote the health and nutritional wellbeing of their children, but face many challenges. Most studies, especially those focusing on (agro-)pastoralists, use a problem-lens, with recommended standard interventions to improve child nutrition that do not necessarily fit the local conditions. This study aims to explore (agro-)pastoral caregivers’ knowledge and their practical solutions in child nutrition and care, uncovering their routine and problem-solving actions. Methods The Activity Knowledge Analysis tool maps caregivers’ practices aimed at achieving their goals (routine actions), and identifies the challenges they face, underlying causes, and the problem-solving actions. We used this participatory tool in 18 Focus Group Discussion sessions with caregivers from Rendille, Burji and Borana communities in Marsabit County, Kenya. The discussions were recorded, transcribed and analysed using MAXQDA software. Results Mothers explained their routine actions which included age-appropriate feeding practices, maintaining hygiene, and facilitating the child’s developmental milestones to achieve their goal of having a healthy child. Some of the routine actions include providing special diets, responsive feeding; personal, food and environmental hygiene; massage, engagement in play and interaction to facilitate development. The challenges that mothers face include maintaining their own health, difficulties with feeding and delayed developmental milestones. These challenges are further compounded by contextual factors; poverty, time constraints and lack of support. To overcome the challenges, mothers used a range of problem-solving actions, including enriching their children’s diets, diversifying their income sources, borrowing food or money, and seeking social support from family members and the community. Conclusion Participatory approaches, such as the use of the Activity Knowledge Analysis tool, have proved useful in exploring caregivers’ knowledge, highlighting their problem-solving actions. These insights can be used to contextualize existing government and stakeholder interventions by incorporating community-led solutions and leveraging local structures for knowledge exchange and dissemination. This approach promotes the use of locally available resources and ensures cultural appropriateness, enhancing the adoption of practices to improve children’s health and nutritional status.

Postoperative gynecological patients often experience challenges during the transition from hospital to home due to suboptimal discharge planning. Family involvement plays an important role in supporting postoperative recovery; however, caregiver support and education are frequently unstructured and inconsistent. To evaluate the effectiveness of MIGYN (Mitra Interaktif Ginekologi), a family-based interactive chatbot, in improving family support and caregiver knowledge among postoperative gynecological patients. A quasi-experimental pre-post test study was conducted involving 34 caregivers of postoperative gynecological patients at Dr. Hasan Sadikin General Hospital, Bandung. Participants were divided into intervention and control groups (n = 17 each). Family support was measured using the Family Support Scale (FSS), while caregiver knowledge was assessed using a structured questionnaire. Data were analyzed using the Wilcoxon signed-rank test and Mann-Whitney -test. Both groups demonstrated improvements in family support and caregiver knowledge following the intervention period. Within-group analysis showed significant increases in family support and caregiver knowledge scores in both groups (p < 0.05). However, between-group analysis demonstrated a statistically significant difference only in caregiver knowledge (p = 0.003), with the intervention group showing greater improvement and a moderate effect size (r = 0.51). In contrast, family support did not differ significantly between groups (p = 0.447), with a small effect size (r = 0.13). MIGYN was associated with significant improvements in caregiver knowledge among postoperative gynecological patients, while improvements in family support were relatively comparable between groups. These findings suggest that MIGYN may serve as a digital discharge planning approach to support caregiver education and family involvement during postoperative recovery.

Background Children with sickle cell disease (SCD) are highly susceptible to severe infections due to functional asplenia. Special vaccines such as pneumococcal, Haemophilus influenzae type b (Hib), meningococcal, influenza and hepatitis B vaccines are recommended to reduce infection- related morbidity and mortality. However, uptake in low-resource settings remains suboptimal. Objective To assess caregivers’ knowledge, attitude and practices regarding special vaccination of children with SCD and determine factors associated with vaccination status. Methods A hospital-based cross-sectional study was conducted among 130 caregivers of children with SCD attending the University of Benin Teaching Hospital, Benin City. Data were collected using a structured questionnaire assessing socio-demographic characteristics, knowledge, attitude, vaccination history (vaccination cards reviewed) and barriers to uptake. Knowledge and attitude were graded using predefined scoring systems. Data were analysed using descriptive statistics, chi-square test for bivariate associations, and binary logistic regression to identify independent predictors of vaccination status. Statistical significance was set at p  < 0.05. Results Although 60.8% of caregivers knew that children with SCD are prone to serious infections, only 16.2% demonstrated good knowledge. Regarding vaccination practices, only 40.0% of children had received PCV, 31.5% meningococcal vaccine, and 13.8% Hib vaccine. Nearly half (49.2%) of the children were completely unvaccinated with any special vaccine, and only 3.1% were fully vaccinated. Most (78.5%) caregivers reported that a health worker had recommended special vaccines, and 86.9% expressed willingness to vaccinate if vaccines were free. Financial constraints (65.6%) emerged as the leading barrier to uptake. In bivariate analysis, caregivers’ knowledge ( p  < 0.001), attitude ( p  = 0.024), and family monthly income ( p  = 0.018) were significantly associated with vaccination status. On multivariate logistic regression, caregivers’ knowledge remained the only independently significant predictor of vaccination status. Compared with caregivers with good knowledge, those with poor knowledge had significantly lower odds of vaccinating their children (aOR = 0.111, 95% CI: 0.019–0.632; p  = 0.013). Conclusion Despite generally positive attitudes, poor knowledge and financial barriers contribute to low uptake of special vaccines among children with SCD. Subsidization and targeted caregiver education are recommended.

Background Utilization of long-lasting insecticidal nets (LLIN) has been associated with reduction of malaria incidence, especially among children. The 2013 Nigeria Demographic and Health Survey revealed Osun State had the least proportion (5.7%) of under-five children (U5) who slept under LLIN the night before the survey. A study was conducted to assess caregivers’ knowledge about LLIN, utilization of LLIN and factors influencing LLIN use among U5 in Osun State, Nigeria. Methods A cross-sectional study was carried out among 1020 mothers/caregivers of U5 selected from six communities in Osun State using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on socio-demographic characteristics, mothers’ knowledge about LLIN, ownership and utilization of LLIN and factors influencing use of LLIN in U5. Questions on knowledge about LLIN were scored and categorized into good (scored ≥ 5) and poor (score < 5) knowledge out of a maximum obtainable score of seven. Utilization of LLIN was defined as the proportion of U5 who slept under net the night before the survey. Data were analysed using descriptive statistics, Chi square test and logistic regression at α < 0.05. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers’ perspectives on utilization and factors affecting use of LLIN among U5. Results Majority of the respondents 588 (58.3%) fall between age 25–34 years, with a mean age of 30.0 ± 6.3 years. All were aware of LLIN but only 76.1% had good knowledge and 59.0% reported use of LLIN among their U5. Reported barriers to utilizing LLIN were; heat (96.4%), reactions to the chemical (75.5%) and unpleasant odour (41.3%). These were corroborated at FGD. Those with formal education [adjusted odds ratio (aOR) = 1.4; 95% CI 1.0–2.1] and those with good knowledge of LLIN (aOR = 1.8; 95% CI 1.4–2.5) were more likely to use LLIN than their counterparts without formal education and those with poor knowledge of LLIN respectively. Conclusions The level of knowledge of respondents about LLIN was high and the utilization of LLIN among U5 was above average, however, it is still far below the 80% target. Efforts should be made to further improve utilization of LLIN through intensified promotion and health education.

Background Early childhood caries disproportionately affects vulnerable groups and remains a leading cause of preventable hospital admissions for Western Australian children. The Western Australia State Oral Health Plan seeks to improve child oral health through universal and targeted health promotion initiatives with primary caregivers. These initiatives require evidence of primary caregiver oral health knowledge and behaviours and baseline data on early childhood caries. The objective of this systematic scoping review was to understand current oral health knowledge and practices of primary caregivers of children aged 0–4 years, identify influential socioecological determinants, and identify data on early childhood caries in the Western Australian context. Methods A systematic scoping review framework identified articles published between 2010 and 2021, using Scopus, PubMed, Medline, CINAHL, PsycINFO, selected article reference lists, and oral health websites. The lack of Western Australian specific literature prompted the inclusion of Australia-wide articles. Articles were screened via author consensus, with eight selected. Results Western Australia and nation-wide data on early childhood caries are limited and mostly dated. WA data from children aged 2–3 years, collected in 2006, suggests the prevalence is 2.9% in this state, with national data of children from 0 to 3 years, collected from 2006 and 2008, suggesting an early childhood caries prevalence of 3.4–8% of children aged 18 months, rising sharply by 36 months of age. Nationally, fewer than half the primary caregivers reported following evidence-based oral health recommendations for their young children. Perceptions of the role of dental services for young children tends to be focussed on treatment, rather than surveillance and prevention. Knowledge of dietary and oral hygiene practices is inconsistent and awareness of the Child Dental Benefit Schedule low. Young children’s oral health status is clearly associated with socioecological factors, including socioeconomic status. Conclusions Recent early childhood caries data and evidence of primary care-givers’ oral health knowledge and behaviours are unavailable in Western Australia, a similar situation exists nationwide. To realise the Western Australian and National Oral Health Plans, research is required to address this knowledge gap.

Caregiver recognition of pediatric respiratory red-flag signs remains suboptimal despite established international guidelines. The purpose of this study was to investigate caregiver awareness of pediatric respiratory red-flag signs and their intended emergency activation behaviors in China. We conducted a cross-sectional, mixed-mode survey involving 2,702 caregiver-child dyads across pediatric outpatient departments, emergency departments, and wards in Hubei Province, China. Data were collected using a validated questionnaire that measured awareness of 12 red-flag respiratory signs and emergency activation intentions across 5 clinical vignettes. Primary outcomes were adequate awareness (Awareness Index ≥0.70) and high emergency activation intention (Emergency Activation Intention Score (EAIS) ≥ 20). Data were analyzed using multivariable logistic regression. Adequate awareness was achieved by only 22.9% (  = 618) of the caregivers. Notably, symptom recognition varied substantially: identification rates were relatively high for cyanosis (71.0%) and severe chest indrawing (68.4%), but markedly lower for very low oxygen saturation (36.6%) and apnea (40.7%). Conversely, a majority of the cohort (  = 1,756, 65.0%) demonstrated appropriate emergency activation intentions. Caregivers exhibited a high propensity to contact emergency services during urgent scenarios (86-89%) while exercising suitable restraint during non-urgent presentations (12.3%). Multivariable analysis identified college education as the most robust predictor of adequate awareness (aOR = 3.41, 95% CI: 2.75-4.23,  < 0.001), followed by knowledge of the emergency number 120 (aOR = 1.67,  = 0.004) and a history of prior respiratory hospitalization (aOR = 1.34,  = 0.015). Furthermore, a distinct dose-response relationship regarding health literacy was observed, with adequate awareness being significantly more prevalent among caregivers with high health literacy compared to those with low health literacy (29.8% vs. 15.1%,  < 0.001). Finally, emergency activation rates were influenced by the clinical setting, as caregivers in the emergency department demonstrated significantly higher rates than those in outpatient environments (70.7% vs. 62.8%,  < 0.001). Despite appropriate emergency activation intentions, caregivers' limited recognition of red-flag symptoms highlights a critical knowledge-behavior gap. Targeted educational interventions addressing these specific deficits are essential to improving pediatric respiratory emergency outcomes.