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Cycle 5 (2016 Deadline)

Capacity building of health care providers in Egypt to counsel pregnant women and their families regarding smoking cessation and second hand smoking avoidance

PI: Wagida Anwar (, Ain Shams University School of Medicine
U.S. Partner: Scott Sherman, New York University
U.S. Partner: Cheryl Oncken, University of Connecticut
Project Dates: January 2017 - December 2019

Project Overview:

The overarching aim of this project is to develop and disseminate an evidence-based healthcare professional training program to counsel smokers (both men and women) to stop smoking and establish smoke-free homes via developing the capacity of physicians and nurses who counsel pregnant women in greater Cairo. The intervention target group includes pregnant mothers in households with a current smoker. This will help to achieve better maternal and child health outcomes through women either quitting smoking and/or establishing a smoke-free home. The project team also aims to create capacity for widespread dissemination by developing and testing a train-the-trainer program and creating a network of professionals and organizations, including the Ministry of Health. The proposed intervention is capitalizing on the “teachable moment concept,” with health professionals providing advice in a situation where men and women alike are likely more receptive for behavioral change interventions that can affect the health of their unborn baby. The intervention includes the following activities: (1) developing and implementing a core training curriculum for physicians and nurses to be implemented in antenatal care visits; (2) creating capacity for dissemination by developing a train-the-trainer model and adapting a health/social service-based follow-up protocol to be implemented by the nursing staff; and (3) developing a monitoring and evaluation plan for core program activities and follow-up activities by the trainers.

This project has multiple development implications in Egypt. The direct improvement in the health and well-being of pregnant women and children should have a positive economic impact . Tobacco use has indirect effects on health by increasing the risk of poverty at the individual, household, and national levels. The capacity building components of this project are also directed towards empowering young investigators in the field of science and research to help prepare future leaders in those fields. Through a partnership between the Ministry of Health, the Syndicates of Physicians and of Nurses, and prominent universities, the research team hopes that the results of this project will lead to policy changes to promote its sustainability.

Summary of Recent Activities:

As of June 2019, the team finalized the training materials needed for their planned Training of Trainers (TOT) for healthcare professionals in the greater Cairo area. The materials explain the project goals to health providers, pregnant women who smoke, and related official stakeholders, and they explain the results expected after the data collection and analysis are complete. U.S. partner Dr. Cheryl Oncken and her colleague Dr. Erin Mead of the University of Connecticut contributed to this effort by traveling to Egypt in March 2019 thanks to funds provided under a PEER Partner Cooperation Supplement. The materials have been translated into Arabic to be used for training. Meanwhile, two graduate students were trained on the data collection tool that will be used during the baseline surveys for the pregnant women. In May 2019, the team held a workshop to finalize the survey for implementation and pilot testing. Discussions focused on testing the form by field supervisor teams, training data collectors, and explaining the role of the field supervisors during data collection. Based on the discussions, the researchers modified the selection criteria for smoking versus non-smoking women and revised the survey questionnaire to remove repetitive questions. As a follow-up to the workshop, they also conducted role-playing sessions during which project participants could practice their data collection and interviewing techniques.

Now that the project is finally moving into its active data collection phase, several new ASU faculty members have been added to the team. They include Prof. Amany Mokhtar (head of the training curriculum developer group), Dr. Wafaa M. Hassan (head of the data collection and analysis group), Dr. Esraa Ibrahim Saad, Dr. Hadeer M. Madboly, and Dr. Maha Magdi. In addition, four medical residents and ten undergraduate students have been recruited to serve as data collectors and assist with focus group discussions. During the remainder of 2019, the project team will launch their baseline survey and begin training health professionals in hospitals where the baseline assessment has been completed. A no-cost extension will be needed due to the delays encountered in project implementation.

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