Impact - Translation of RCT and Systematic Reviews Research Results

Thu, 02/10/2022 - 13:04

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Naturally, quality researchers who seek publication are required to use language and explanation that meets the high quality standards required by the peer reviewers for leading journals; and by the publishers of those journals themselves, There are standards that must be met. Of course many of us do not understand that language - odds ratios, standardized mean differences, risk ratios, z scores, p scores and many more. We asked an expert in social science quantitative research - Andrés Esteban Ochoa Toasa - Data Scientist at UNICEF New York - to provide some translations. In the left column is the original data quoted from the relevant paper. In the right column is the translation so that we can all understand.

For an outline of this overall process, including the selection criteria and impact data for other UNICEF Goals, please click on this link.

	Quote from published paper	Translated text
1
2	... mean scores in self-reported iron and folic acid consumption in the control arm had decreased from 0.39 to 0.31 (21% decrease; not significant). In the intervention arm, mean scores increased from 0.39 to 1.62 (315% increase; … The difference between the two arms was statistically significant. … Each of the three norms" (descriptive, injunctive and collective) "also improved at significantly higher rates in the intervention than in the control arm.	Iron and folic acid consumption increased by 315% for participating women in Odisha India in an intervention through teaching, training, tuning, and talking on topics related to anemia control. The intervention looked to bring change in descriptive norms or people's perceptions about a behavior, injunctive norms or the pressure to conform to that behavior, and collective norms or the notion that people in the community conform with a behavior.
3	Proportion with at least one vaccine (OR 12.13 95% CI 6.03–24.41p<0.001). However, there was no evidence of an impact on the proportion of children up-to-date with vaccination (p = 0.69). It was effective in improving timeliness of Pentavalent 3 (OR 1.55; 95% CI: 1.14, 2.12; p = 0.005) and Measles (OR 2.81; 96% CI: 1.93–4.1; p<0.001) vaccination. The odds of completing Pentavalent vaccination increased (OR = 1.66 95% CI: 1.08,2.55). Improving timeliness of Pentavalent 3 (OR 1.55; 95% CI: 1.14, 2.12; p = 0.005) and Measles (OR 2.81; 96% CI: 1.93–4.1; p<0.001) vaccination. The odds of completing Pentavalent vaccination increased (OR = 1.66 95% CI: 1.08,2.55)	... significantly reduced the number of children who were not vaccinated, increased by 6.6% the number of children with at least one vaccine ... increased by 5% the total number of children who received on time Pentavelent 3 ... had an effect of a 22% increase in the timeliness for the Measles vaccine. Children were also 0.66 times more likely to have completed their pentavalent vaccinations.
4	Reductions in neonatal mortality of around 30% (aOR 0.68, 95% CI 0.59 to 0.78; aOR 0.69, 95% CI 0.53 to 0.89; aOR: 0.69, 95% CI 0.57 to 0.83), with greater reductions among more marginalised families (aOR: 0.41, 95% CI 0.28 to 0.59)....[F]ound more studies with positive effects as the level of community participation increased from informing community members (n=2/7) or consulting them (n=1/2) to building a partnership (9/12). Similarly,...found more studies with positive effects when interventions aimed to increase community capabilities (n=7/9) rather than focusing only on building individual (n=1/2) or group capabilities (2/7). Lastly ,...found more studies with positive effects through open or community-based groups (n=7/10) compared with SHGs (4/9)	NOTE: Should not be included directly, this study does not calculate an effect but reviews qualitatively the cited studies to qualify the RCTs as good quality or not. If the figures included want to be used, then each of those studies qualified need to be included separately
5	In intervention clusters, more pregnant women and children attained minimum dietary diversity (adjusted odds ratio [aOR] for women 1·39, 95% CI 1·03–1·90; for children 1·47, 1·07–2·02), more mothers washed their hands before feeding children (5·23, 2·61–10·5), fewer children were underweight at 18 months (0·81, 0·66–0·99), and fewer infants died (0·63, 0·39–1·00)	In India, it was observed in a RCT study in 120 clusters with around 1,000 individuals in each, that in clusters where home visits and participatory groups took place, mothers were over 5 times more likely to wash their hands, and that their odds of attaining minimum dietary diversity increased by 39%, compared to clusters without home visits and participatory groups. Children also saw a 19% reduction in those underweight at 18 months and 37% fewer infants died, compared to clusters without intervention
6	There was a large reduction in the combined prevalence of type 2 diabetes and intermediate hyperglycaemia in the PLA group compared with the control group at the end of the study (adjusted [for stratification, clustering, and wealth] odds ratio [aOR] 0·36 [0·27-0·48]), with an absolute reduction of 20·7% (95% CI 14·6-26·7). Among 2470 adults with intermediate hyperglycaemia at baseline, 2100 (85%) were followed-up at 2 years. The 2-year cumulative incidence of diabetes in this cohort was significantly lower in the PLA group compared with control (aOR 0·39, 0·24-0·65), representing an absolute incidence reduction of 8·7% (3·5-14·0)	In a RCT study in Bangladesh carried in 96 villages covering roughly 125,000 individuals, researchers found that in villages where participatory community mobilisation was implemented a 20.7% reduction in the prevalence of type 2 diabetes and intermediate hyperglycaemia took place, compared to villages with usual care. It also found that for 2100 participating adults with intermediate hyperglycaemia, there was a 8.7% reduction in the 2-year cumulative incidence of diabetes for those participating in participatory community mobilisation, compared to those with only usual care.
7	Inappropriate use of antimalarial drugs after a negative test was reduced from 84% (201/239) in the control group to 52% (413/796) in the basic-training group (unadjusted RR 0·63, 0·28–1·43; p=0·25) and to 31% (232/759) in the enhanced-training group (0·29, 0·11–0·77; p=0·02).	In Cameroon, clinicians in 46 health facilities received basic and enhanced training on Malaria's rapid diagnostic tests. A significant reduction of 53% of inappropiate use of antimalarial drugs was found on patients whose doctors received enhanced training, compared to doctors who did not received training and use microscopy only. Basic training did not have a significant effect.
8	Compared to 8% being incorrectly prescribed a malarial drug in the control group there was an absolute 4% (95% CI 1% to 6%; P = 0.008) reduction for the intervention focusing on prescribers only (Health Workers arm), and a 4% reduction (95% CI 1% to 6%; P = 0.005) for the intervention focusing on both the prescribers and patients (HWP arm).	In northeast Tanzania, prescribers and patients in 36 primary healthcare facilities received training in small interactive peer-group sessions on Malaria's rapid diagnostic tests compared to standard RDT training. They also received performance and motivational SMSs at later stages, related to their training performance. For those participating, both in trainings with groups with only prescribers and groups with prescribers and patients, there was a 4% reduction in patients being incorreclty prescribed a recommended antimalarial drug compared to the control group of prescribers who received only standard RDT training.
9	The neonatal mortality rate was 22% lower in facility intervention and community intervention groups than control clusters (OR = 0.78, 95% CI 0.60–1.01), and the perinatal mortality rate was 16% lower in community intervention clusters (OR = 0.84, 95% CI 0.72–0.97)	In Malawi, in clusters where there were women's groups to mobilize communities around maternal and newborn health and where health centers went through a quality improvement intervention, there was a 22% reduction in neonatal mortality rate. In clusters with only quality improvement interventions of health centers, perinatal mortality rate was 16% lower than in communities without women's groups nor quality improvement of their health centers
10	... significantly improved childhood immunisation coverage (RR=1.16; 95% CI: 1.10 to 1.21; I2=90.4%) (including) timely receipt of childhood vaccines (RR=1.21; 95% CI: 1.12 to 1.30; I2=87.3%)	In a meta-study reviewing 13 RCTs and 3 non-RCTs involving a total of 32 712 infants, it was estimated that SMS reminders increased immunisation coverage for about 16% compared to families who did not receive SMS reminders. In smaller sample of the same studies, with only 12 of the studies and 25 527 infants, the use of SMS reminders were found to have improved timeliness of of the receipt of childhood vaccines by 21%, compared to families of children who did not receive SMS. Furthermore, the study found that SMS reminders where 18.1% more effective in increasing coverage in lower middle countries than upper middle income countries, and a 27.1% increase in coverage for low income countries compared to the same upper middle income countries. The study also found that sending more than 2 SMS reminders increased timeliness of vaccine reception by 91%, compared to those that did not receive any SMS.
11	education of parents improves vaccination coverage in low and middle-income countries ( … RR 1.36, 95%CI 1.14 to 1.62; I2 = 65%)	NOTE: Should not be included directly, this study does not calculate an effect but reviews qualitatively the cited studies to qualify the RCTs as good quality or not. If the figures included want to be used, then each of those studies qualified need to be included separately
12	education of parents improves vaccination coverage in low and middle-income countries ( … RR 1.36, 95%CI 1.14 to 1.62; I2 = 65%)	A meta-study of six RCT studies that took place in India, Nepal, and Pakistan, with trials that included a total of 4248 participants, found that when interventions on education in communities and health facilities of the importance of childhood vaccinations took place, they had an average 36% increase in childhood vaccination coverage of the children of participating parents.
14	... relative to factual information, recent misinformation induced a decline in intent of 6.2 percentage points (95th percentile interval 3.9 to 8.5) in the UK and 6.4 percentage points (95th percentile interval 4.0 to 8.8) in the USA among those who stated that they would definitely accept a vaccine	A study with 8,001 respondents on an online panel in the UK and USA, found that there was a 6.2%-6.4% reduction in the total number of people who previously answered 'definitely' to taking the vaccine after being exposed to misinformation relating to COVID-19, compared to people who did not receive such misinformation. The study also observed a 5.7% reduction in those that previously responded definitely to accept the vaccine to protect others
15	The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55).	In Zanzibar, Tanzania, in a study with 2,550 participants, pregnant women who received tailored-to-gestancy-stage SMSs with health information and appointment reminders and who also had vouchers to contact their local health care provider, increased by 13% the total number of women who received four or more antenatal care visits compared to those that did not receive the SMSs and vouchers.
16	Pooled effect sizes indicated positive benefits of parenting interventions on child cognitive development (SMD = 0.32, 95% CI [confidence interval]: 0.23, 0.40, P < 0.001), language development (SMD = 0.28, 95% CI: 0.18 to 0.37, P < 0.001), motor development (SMD = 0.24, 95% CI: 0.15 to 0.32, P < 0.001), socioemotional development (SMD = 0.19, 95% CI: 0.10 to 0.28, P < 0.001), and attachment (SMD = 0.29, 95% CI: 0.18 to 0.40, P < 0.001) and reductions in behavior problems (SMD = -0.13, 95% CI: -0.18 to -0.08, P < 0.001). Positive benefits were also found on parenting knowledge (SMD = 0.56, 95% CI: 0.33 to 0.79, P < 0.001), parenting practices (SMD = 0.33, 95% CI: 0.22 to 0.44, P < 0.001), and parent–child interactions (SMD = 0.39, 95% CI: 0.24 to 0.53, P < 0.001).	A meta-analysis of 102 RCTs estimated parenting interventions to have a 12.55% average increase on child cognitive development (SMD =0.32), an 11.03% average increase on language development (SMD=0.28), a 9.48% average increase on motor development (SMD=0.24), a 7.53% average increase in socioemotional development (SMD=0.19), a 11.41% average increase in attachment (SMD 0.29) and a 5.17% decrease in behavior problems, compared to children that did not have parenting interventions. The study also detected positive effects related to parents skills and behaviors with a 21.23% average increase in parenting knowledge, a 12.93% average increase in parenting practices and a 15.17% increase in parent-child interactions, compare to parents that did not go through parenting interventions.
17	Women's groups practising participatory learning and action (PLA) improved behaviours during and after home deliveries, including the use of safe delivery kits (odds ratio [OR] 2.92, 95% CI 2.02–4.22; I2 = 63.7%, 95% CI 4.4%–86.2%), use of a sterile blade to cut the umbilical cord (1.88, 1.25–2.82; 67.6%, 16.1%–87.5%), birth attendant washing hands prior to delivery (1.87, 1.19–2.95; 79%, 53.8%–90.4%), delayed bathing of the newborn for at least 24 hours (1.47, 1.09–1.99; 68.0%, 29.2%–85.6%), and wrapping the newborn within 10 minutes of delivery (1.27, 1.02–1.60; 0.0%, 0%–79.2%)	When doing meta-analysis of multiple studies, women attending participatory learning and action (PLA) for maternal and newborn health in women´s group were almost three times more likely to use safe delivery kits than those not attending. They were also about two times more likely to use of a sterile blade to cut the umbilical cord, have a birth attendant washing hands prior to delivery. In a smaller effect, but still significant, they were about 1.5 times more likely to delay bathing of the newborn for at least 24 hours and about 1,25 times more likely to wrap the newborn within 10 minutes of delivery
18	"The odds of a child being wasted were significantly lower in the double cash (DC) arm after 6 mo (odds ratio [OR] = 0.52; 95% CI 0.29, 0.92; p = 0.02) compared to the control group (CG). Mean weight for height (WHZ) significantly improved in both the fresh food voucher (FFV) and DC arms at 6 mo (FFV: z-score = 0.16; 95% CI 0.05, 0.26; p = 0.004; DC: z-score = 0.11; 95% CI 0.00, 0.21; p = 0.05) compared to the CG. Significant differences on the primary outcome were seen only at 6 mo. All three intervention groups showed similar significantly lower odds of being stunted (height-for-age z-score [HAZ] < -2) at 6 mo (DC: OR = 0.39; 95% CI 0.24, 0.64; p < 0.001; FFV: OR = 0.41; 95% CI 0.25, 0.67; p < 0.001; SC: OR = 0.36; 95% CI 0.22, 0.59; p < 0.001) and at 1 y (DC: OR = 0.53; 95% CI 0.35, 0.82; p = 0.004; FFV: OR = 0.48; 95% CI 0.31, 0.73; p = 0.001; SC: OR = 0.54; 95% CI 0.36, 0.81; p = 0.003) compared to the CG. Significant improvement in height-for-age outcomes were also seen for severe stunting (HAZ < -3) and mean HAZ."	After 6 months, families with children who received double cash interventions had the odds of their children being wasted reduced by 48%. Double cash interventions also increased the average weight of the children on the intervention in about 6.36% in 6 months, compared to those without an intervention. Fresh food vouchers also increased the average weight of children in the invervention in 4.38% during the same period. All children in the three interventions reduced in more than half the likelihood of a children being stunted compared to those that did not received cash transfers. For example, those receiving fresh food bouchers reduced their odds of being stunted by 59%. Children who received standard cash transfers saw their odds of being stunted reduced by 64%. Children with double cash transfer also reduced their odds of being stunted by 61%.
19	At endline, there was a risk difference of 38.9% (95% CI 32·2–45·6, p<0·001) between the reported prevalence of exclusive breastfeeding in the intervention group and that of the control group.	An RCT in Burkina Faso, with 2288 breastfeeding mothers participating, researchers found a 38.9% increase on mothers exclusively breastfeeding, for those in intervention groups compared to control groups. The intervention group had health workers and community health volunteers trained to give interpersonal communication and community mobilisation activities to breastfeeding mothers on knowledge about breastfeeding practices and benefits, to increase their expertise in breastfeeding, and to improve the mother's perceptions of social norms related to breastfeeding. Control groups had health workers and volunteers without any additional training.
20	Early breast feeding (EBF) based on 24-h recall at 12 weeks in the intervention and control clusters were 79% and 35%, respectively, in Burkina Faso; 82% and 44% in Uganda; and 10% and 6% in South Africa. EBF based on 7-day recall in the intervention and control clusters were 77% and 23% respectively, in Burkina Faso; 77% and 34% in Uganda; and 8% and 4% in South Africa. At 24 weeks, 24-h recall were 73% in the intervention cluster and 22% in the control cluster in Burkina Faso; 59% and 15% in Uganda; and 2% and <1% in South Africa. EBF based on 7-day recall were 71% in the intervention cluster and 9% in the control cluster in Burkina Faso; 51% and 11% in Uganda; and 2% and <1% in South Africa.	An Randomized controlled trial in Burkina Faso, Uganda, and South Africa with 2,579 mothers and their infants found that exclusive breastfeeding counselling by peer counsellors led to to doubling the prevalence rates of early breast feeding, after 12 weeks of the intervention.
21	“Compared with controls, health education led to improved treatment school students' self-efficacy (p-value = 0.013), presumed life satisfaction five years from the present (p-value = 0.001), aspirations gap for a socially and mentally healthy future (p-value = 0.036), and the Health-Related Quality of Life (p-value = 0.036).”	A randomized controlled trial involving 140 lower secondary schools in Vietnam found that students receiving a monthtly stand-alone health education showed significant differences in the students self efficacy, life satisfaction, aspirations gap, and health related quality of life. The students in the intervention showed significant increases with a 1.6% higher increase in life satisfaction, 5.2% increase on student's expectations regarding their future and 3.1% in higher aspirations gap, all compared to the control group. The students also showed a significant health related to quality 2.7% increase compared to the control group. Health related knowledge also increased by 2%. The student group who showed the greatest increase was male students who significantly increased their aspirations 7.1%
22	“A positive impact on child dietary diversity was observed (B (SE) = 0.39 (0.15), p = 0.01; 95% CI 0.09–0.68).”	A Randomized controlled trial in Malawi with 24 clusters with 1,791 households, in the age group 0-23 months, showed that children dietary diversity increased with the intervention of pairs of trained volunteers facilitating nutrition education session in their home villages among group of caregivers with children 5-18 months of age, with materials adapted from UNICEF community based IYCF counseling cards template for Africa. The intervention resulted in 1-15 percentage points significant gains across all good groups compared to those not receiving the sessions. In particular, the consumption of eggs increased by 10%, groudnuts by 15% compared to the control group. The intervention also showed a 12% increase in WHO's indicator on minimum dietary diversity for the clusters that received the intervention compared to those that did not.
23	At 24 mo of age, children who received unconditional cash transfer (UCT) + liquid nutritional supplement (LNS) [rate ratio (RR): 0.85; 95% CI: 0.74, 0.97; P = 0.015) and UCT + LNS + social and behaviour change communication (SBCC) (RR: 0.86; 95% CI: 0.77, 0.96; P = 0.007) had a significantly lower risk of being stunted compared with the UCT alone arm.	A Randomized controlled trial in Pakistan with 1,729 children found that at 24 months of age, families of children who received unconditional cash transfers, liquids nutritional supplement, and social and behaviour change communication had a 15% reduction in the rate of being stunted compared to children that received the cash transfer alone.
24	“Compared to the control group, women in the intervention group reported: less past-year physical (OR 0.37, p<0.001) and sexual IPV (OR 0.34, p<0.001); and greater attendance (IRR 1.09, p<0.001) and male accompaniment at antenatal care (IRR 1.50, p<0.001). Women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); higher levels of men’s participation in childcare and household tasks (women: beta 0.39, p<0.001; men: beta 0.33, p<0.001); and less dominance of men in decision-making.”	An RCT study in Rwanda with 1,200 couples where engaged in participatory, small group sessions of critical reflection and dialogue to engage men in maternal and child health. 21 months after the intervention, the study showed significant results related to intimate partner violence (IPV) with a 26% reduction on those reporting experiencing physical violence in the previous 12 months compared to the control group. Sexual violence also reported a 25% reduction between control and intervention group. Males also shown a 1.09 higher incidence rate to attend to antenatal care and 1.50 greater incidence rate accompany to antenatal care compared to control groups. Both men and women also reported significant measures related to less child punishment, greater contraceptive use, and more participatin in childcare and household tasks, including less dominance of men in decision-making, compared to the control groups.
25	Complimentary Feeding (CF) improvements were significantly greater in the intensive than in the non-intensive group [difference-in-difference impact estimate: 16.3, 14.7, 22.0, and 24.6 percent for minimum dietary diversity, minimum meal frequency, minimum acceptable diet, and consumption of iron-rich foods, respectively]. In the intensive group, CF practices were high: 50.4% for minimum acceptable diet, 63.8% for minimum diet diversity, 75.1% for minimum meal frequency, and 78.5% for consumption of iron-rich foods.	In a study with a cross-sectional survey of 1,100 households and 2,190 children in Bangladesh, found that complementary feeding was substantially improved with intensive programs including interpersonal counseling, mass media and community mobilization, compared to less intensive interventions. The study found a 16.3 increase in minimum dietary diversity, a 14.7% increase in minimum meal frequency, 22% increase in minimum acceptable diet and 24.6% in consumption of iron-rich foods, compared to non-intensive areas.
26	Greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P< 0.05] and minimum acceptable diet (8.0 pps; P< 0.05).	A study that observed differences over time with 1,500 surveys for children 6-24 months old and 24-60 months old in Vietnam, that tested the difference between intensive complementary feeding interventions with interpersonal counseling, mass media and community mobilization found significant differences in minimum dietary diversity with a 6.4% increase.and a 8% difference in minimum acceptable diet compared to nonintensive interventions.
27	Compared to care as usual, CHW (Community Health Worker) home visits increased early initiation of breastfeeding (EIBF) (OR: 1.50; 95% CI: 1.12, 1.99; n = 10 RCTs) and exclusive breastfeeding (EBF) (OR: 4.42; 95% CI: 2.28, 8.56; n = 9 RCTs) and mother/peer groups were effective for improving children’s minimum dietary diversity (OR: 2.34; 95% CI: 1.17, 4.70; n = 4) and minimum meal frequency (OR: 2.31; 95% CI: 1.61, 3.31; n = 3).”	A meta-analysis of 83 studies from low and middle income countries between 1997 and 2018 on nutrition-specific intervention on delivery platforms, found that compared to care as usual, community health worker visits increased early initiation of breastfeeding and breastfeeding with those receiving the intervention 1.5 times more likely to have early initiation breastfeeding compared to those with usual care and also being 4.42 times mores likely to exclusively breastfeed. Mother/peer groups also led to people receiving it to be 2.34 times more likely to have improved minimum dietary diversity and 2.31 times more likely to have achieved minimum meal frequency. Overall, interpersonal community platforms on both modalities showed to have reduce the likelihood of <5 wasting by 33% and for recipients of intervention to be 2.13 times more likely to have positive early initiation results and 2.43 times more likely to have exclusive breatfeeding.
28	There was an increase in the proportion of children consuming at least four of seven food groups in the AGRI-NUT (adjusted relative risk [RR] 1·19, 95% CI 1·03 to 1·37, p=0·02) and AGRI-NUT+PLA (1·27, 1·11 to 1·46, p=0·001) groups, but not AGRI (1·06, 0·91 to 1·23, p=0·44), compared with the control group....An increase in the proportion of mothers consuming at least five of ten food groups was seen in the AGRI (adjusted RR 1·21, 1·01 to 1·45) and AGRI-NUT+PLA (1·30, 1·10 to 1·53) groups compared with the control group, but not in AGRI-NUT (1·16, 0·98 to 1·38).	A Randomized controlled trial with 4,736 mother-child dyads in 148 clusters in Odisha, India, found an increas in the consumption of at least four of seven food groups using nutrition-sensitive agriculture videos, nutrition specific videos and participatory learning and action cycle meetings and videos. Children who observed the agriculture nutritition-sensitive videos and nutirition specific videos were 1.19 times higher relative incidence (risk) of consuming four of seven groups. Those who additional to agriculture nutrition-sensitive videos and nutrition-specific videos also received the participatory meetings had 1.27 times higher relative incidence (risk) of consuming at least four or seven food groups.
29	Children improved more on gross motor (d=0.162, 95% CI 0.065 to 0.260), communication (d=0.081, 95% CI 0.005 to 0.156), problem solving (d=0.101, 95% CI 0.002 to 0.179) and personal-social development (d=0.096, 95% CI −0.015 to 0.177) on the ASQ-3. ... Families showed increased father engagement (OR=1.592, 95% CI 1.069 to 2.368), decreased harsh discipline (incidence rate ratio, IRR=0.741, 95% CI 0.657 to 0.835) and intimate partner violence (IRR=0.616, 95% CI:0.458 to 0.828)	A randomized controlled trial in Rwanda with 1,049 families measured the effect of home-visiting interventions for families in extreme poverty who have chldren between 6-36 months, in 284 clusters across 3 districts in the country. The study found small effects in the Standard Mean Differences (<0.3) for gross motor skills on the children (SMD=0.162), communication (SMD=0.081), problem solving (SMD=0.101), and personal development (SMD=0.096), than compared to control groups. However, it found large significant effects where fathers were more 1.59 times more likely to be engaged with their children upbringing and a 26% reduction in the risk rate of children experiencing harsh discipline and a 39% in the risk rate of intimitate partner violence, compared to control group with usual care
30	“[W]omen from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04) and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57–1.58, p = 0.05), and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01). Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03) and 18-month (AOR = 0.51, p = 0.004) follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02).”	An RCT study in India with 1081 couples in 50 geographic clusters in Maharashtra, India found that couples exposed to Counseling Husbands to Achieve Reproductive Health and Marital (CHARM) Equity, showed significant results relaed to use of contraceptives and intimate partner violence (IPV) attitudes and behaviors. 9 months after the intervention, women whose husband participated in CHARM were 1.77 more likely to report having discussed the use of contraception with their husbands and to be 1.57 more likely to be using modern contraceptive methods both at 9 and 18 months after CHARM, compared to couples whose husband was not exposed to CHARM. Similary, men that participated in CHARM showed a 36% reduction in accepting intimate partner violence at 9 month from the intervention and 49% reduction after 18 months, compared to men who did not participate in CHARM.
31	improved knowledge across all continuum-of-care domains. Exposure to IPC paper-based tools (n=2002) was associated with a twofold increased odds of IFA consumption (OR 2.3, 95% CI 1.7 to 3.2) and contraceptive use (OR 1.8, 95% CI 1.2 to 2.8). Women exposed to both tools were generally at least twice as likely to subsequently discuss the messages with others.	A study in Bihar, India, with 4,610 participants found that the use of Health tools like mobile audio messaging and paper-based job aids by front-line workers providing community health education to mothers significantly impacted the mothers's behaviours. There was a 30% reduction in mothers who didn't remember the health messages, compared to the intervention group. Mothers exposed to the messages were about 5 times more likely to have knowledge of neumonia care, about 2 times more likely to have knowledge of growth monitoring, about 1.5 times more likely to know about vaccines, tetanus toxoid, and complementary feeding, and finally 1.3 times more likely to know about birth preparedness that mothers who were not exposed to the mobile phone based aid. In terms of their behaviours, women who were exposed to the mobile phones mHealth messages were 2 times more likely to use contraception and 1.5 times more likely to take IFA tablets than those who were not exposed. For mothers exposed to the paped-based jobs aid, they also show significant results with mothers being 3 times more likelty to know how to use ORS and zinc to diarrhoea compared to those unexposed and they were 1.8 times more likely to currently using contraception or 1.4 times mores likely to plan to use contraception than those without exposure to the aid. Overall, there was also an effect to disperse the knowlede throughtout the community as women exposed to either tool were two times more likely to have discussed the health topics with others after the exposure.
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