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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:

During the last quarter of 2020, the team continued to conduct a baseline survey at three hospitals (Ain Shams University Hospital, Al Zaharaa University Hospital and Al Galaa Hospital), to collect information on pregnancy outcomes for women. Participating pregnant women were requested to provide telephone numbers, so the team could follow up with them after labor. The base line survey coordinator continued working on follow up calls, the remaining numbers of calls needed to be completed during this quarter are 262 participated pregnant women. Unfortunately, two research teams of those worked on the calls were affected with COVID 19 virus, so the coordinator had to conduct one more training session to two researchers to replace the affected researchers.

The team held two main staff meetings to come up with the plan of the next step regarding the possibility to continue with the training plan and the alternatives during the hospital closing level. The team discussed working with the Health Care Units, which are directed by Ministry of Health and visited by large number of pregnant women daily. This option requires a cooperation agreement between ASU and MOH in addition to MOH ethical committee approval to facilitate entering the units for our project team. As such, following these meetings, the principal investigator approached new collaborating groups. Several meetings were organized with the key responsible staff from Cairo University, Faculty of Medicine hospital and MOH who are involved in health education, training, ethical committee approval process. The team has taken steps to obtain the approvals needed to complete the project activities and coordinate with these organizations.

The team also began the first draft of the project publication based on the qualitative results. Results of the qualitative analysis were prepared to for submission. They also began, and will continue to, transfer training materials into an online format instead of face-to-face tools to account for current pandemic conditions.

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