Browsing by Author "Umoren, Rachel"

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    eHBB: a randomised controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource-scarce settings
    (BMJ, 2021) Umoren, Rachel; Bucher, Sherri; Hippe, Daniel S; Ezenwa, Beatrice Nkolika; Fajolu, Iretiola Bamikeolu; Okwako, Felicitas M; Feltner, John; Nafula, Mary; Musale, Annet; Olawuyi, Olubukola A; Adeboboye, Christianah O; Asangansi, Ime; Paton, Chris; Purkayastha, Saptarshi; Ezeaka, Chinyere Veronica; Esamai, Fabian; Pediatrics, School of Medicine
    Objective To assess the impact of mobile virtual reality (VR) simulations using electronic Helping Babies Breathe (eHBB) or video for the maintenance of neonatal resuscitation skills in healthcare workers in resource-scarce settings. Design Randomised controlled trial with 6-month follow-up (2018–2020). Setting Secondary and tertiary healthcare facilities. Participants 274 nurses and midwives assigned to labour and delivery, operating room and newborn care units were recruited from 20 healthcare facilities in Nigeria and Kenya and randomised to one of three groups: VR (eHBB+digital guide), video (video+digital guide) or control (digital guide only) groups before an in-person HBB course. Intervention(s) eHBB VR simulation or neonatal resuscitation video. Main outcome(s) Healthcare worker neonatal resuscitation skills using standardised checklists in a simulated setting at 1 month, 3 months and 6 months. Results Neonatal resuscitation skills pass rates were similar among the groups at 6-month follow-up for bag-and-mask ventilation (BMV) skills check (VR 28%, video 25%, control 22%, p=0.71), objective structured clinical examination (OSCE) A (VR 76%, video 76%, control 72%, p=0.78) and OSCE B (VR 62%, video 60%, control 49%, p=0.18). Relative to the immediate postcourse assessments, there was greater retention of BMV skills at 6 months in the VR group (−15% VR, p=0.10; −21% video, p<0.01, –27% control, p=0.001). OSCE B pass rates in the VR group were numerically higher at 3 months (+4%, p=0.64) and 6 months (+3%, p=0.74) and lower in the video (−21% at 3 months, p<0.001; −14% at 6 months, p=0.066) and control groups (−7% at 3 months, p=0.43; −14% at 6 months, p=0.10). On follow-up survey, 95% (n=65) of respondents in the VR group and 98% (n=82) in the video group would use their assigned intervention again. Conclusion eHBB VR training was highly acceptable to healthcare workers in low-income to middle-income countries and may provide additional support for neonatal resuscitation skills retention compared with other digital interventions.
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    Engagement design in studies on pregnancy and infant health using social media: Systematic review
    (Elsevier, 2020-05-08) Shieh, Carol; Khan, Israt; Umoren, Rachel; School of Nursing
    Social media utilization is prevalent among reproductive-age women. The literature on how researchers engage women in studies using social media platforms is scarce. This systematic review analyzed participant engagement design in studies using social media and focused on pregnancy and infant health. Methods: A literature search of EBSCO and PubMed databases was conducted. Included studies had to be completed with quantitative data, focus on pregnancy, postpartum or infant health, and use social media in the research process. A matrix of three engagement designs (passive, interactive, independent) and three research processes (recruitment, data analysis, intervention) was used for analysis. Findings: Thirty-one articles that reported 30 studies met the inclusion criteria. Of these, four were randomized controlled trials (RCT), four were non-RCT interventions, and 22 were observational/descriptive studies. The main purpose of using social media was for recruitment (n = 16), data analysis (n = 6), intervention (n = 8), or both recruitment and intervention (n = 1). Passive engagement was a fundamental design approach in all studies to access a data source that was either the participant or the data provided by the participants in social media. Interactive engagement, mostly for recruitment and intervention, was to engage participants in completing study enrollment or in interacting with the study team or fellow participants. Independent engagement involved off-line activities and appeared sporadically in intervention studies. Conclusions: Passive and interactive engagement designs are more frequently used than independent engagement design. Researchers should select suitable designs when studying pregnancy and infant health using social media.
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    Health Care Perspectives from Burmese Refugees
    (Office of the Vice Chancellor for Research, 2015-04-17) McHenry, Megan S.; Dixit, Avika; Holliday, Rachael; Umoren, Rachel; Litzelman, Debra
    Background: Indianapolis is home to one of the largest Burmese Chin refugee populations outside of Myanmar. Out of the 10,000 Burmese in Indianapolis, over 8,000 are of Chin ethnicity, which is 20% of all Burmese Chin living in the United States. Providers caring for these refugees share concerns that this population may have difficulty accessing care because of language barriers. The goal of this study was to better understand Burmese adult and adolescent views of the U.S. healthcare system Methods: This was a qualitative study that used the phenomenological approach to understand the experience of Burmese refugees. Six focus groups were held from March to May 2013. Discussions were facilitated by MM, in the presence of a trained Burmese interpreter. Any Burmese refugees living in Indianapolis were eligible to participate and were recruited from the Southport Public Library, Burmese-specific ESL courses, and the Burmese community center. Transcripts from focus groups were individually coded by three authors (MM, AD, RH) using NVivo10 (QSR International). Codes with kappa agreements of 96% or more were the foundation for thematic analysis. Findings: Participants were predominantly Chin in ethnicity consisting of 16 adults (all females) and 17 adolescents (10 females, 7 males). Each focus group had between 2-10 participants. Qualitative data analysis identified themes relating to their experience accessing the healthcare system: 1) Time (long wait times at the clinic, pharmacy, and emergency departments) 2) Language barriers (heavy reliance on English-speaking community members, preferences in interpreting services) 3) Relationships with heath care providers (traditional medicines, trust in physicians). Adults often ask adolescents to interpret for them. Adolescents felt comfortable with this responsibility, and some noted frustration when they were not allowed to interpret in clinics or emergency rooms. Concerns with long wait times were common and compounded by difficulties in obtaining an appropriate interpreter. Many of the adult participants preferred an internet-based video interpreting service over in-person interpreters because of increased dialect options, as well as shorter wait times. Although traditional medicines and healing techniques were used in refugee camps and occasionally in Indianapolis, most Burmese place trust with western medicine and report valuing and complying with physician recommendations. Many have a basic understanding of good health practices and the causes of illness. This is seen most consistently in the adolescent groups. Interpretation: Overall, Burmese Chin have adapted to their new home. Although they experience common frustrations with the healthcare system, these frustrations were exacerbated by long waits for an interpreter. Resources, such as a phone or video-based interpreter, are available in most health care facilities and preferred by the Burmese. More research is needed to better understand the challenges of the Burmese population residing in the United States. Funding:AAP Resident CATCH Grant: McHenry
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    Using Mobile Virtual Reality Simulation to Prepare for In-Person Helping Babies Breathe Training: Secondary Analysis of a Randomized Controlled Trial (the eHBB/mHBS Trial)
    (JMIR, 2022-07) Ezenwa, Beatrice Nkolika; Umoren, Rachel; Fajolu, Iretiola Bamikeolu; Hippe, Daniel S.; Bucher, Sherri; Purkayastha, Saptarshi; Okwako, Felicitas; Esamai, Fabian; Feltner, John B.; Olawuyi, Olubukola; Mmboga, Annet; Nafula, Mary Concepta; Paton, Chris; Ezeaka, Veronica Chinyere; BioHealth Informatics, School of Informatics and Computing
    Background: Neonatal mortality accounts for approximately 46% of global under-5 child mortality. The widespread access to mobile devices in low- and middle-income countries has enabled innovations, such as mobile virtual reality (VR), to be leveraged in simulation education for health care workers. Objective: This study explores the feasibility and educational efficacy of using mobile VR for the precourse preparation of health care professionals in neonatal resuscitation training. Methods: Health care professionals in obstetrics and newborn care units at 20 secondary and tertiary health care facilities in Lagos, Nigeria, and Busia, Western Kenya, who had not received training in Helping Babies Breathe (HBB) within the past 1 year were randomized to access the electronic HBB VR simulation and digitized HBB Provider’s Guide (VR group) or the digitized HBB Provider’s Guide only (control group). A sample size of 91 participants per group was calculated based on the main study protocol that was previously published. Participants were directed to use the electronic HBB VR simulation and digitized HBB Provider’s Guide or the digitized HBB Provider’s Guide alone for a minimum of 20 minutes. HBB knowledge and skills assessments were then conducted, which were immediately followed by a standard, in-person HBB training course that was led by study staff and used standard HBB evaluation tools and the Neonatalie Live manikin (Laerdal Medical). Results: A total of 179 nurses and midwives participated (VR group: n=91; control group: n=88). The overall performance scores on the knowledge check (P=.29), bag and mask ventilation skills check (P=.34), and Objective Structured Clinical Examination A checklist (P=.43) were similar between groups, with low overall pass rates (6/178, 3.4% of participants). During the Objective Structured Clinical Examination A test, participants in the VR group performed better on the critical step of positioning the head and clearing the airway (VR group: 77/90, 86%; control group: 57/88, 65%; P=.002). The median percentage of ventilations that were performed via head tilt, as recorded by the Neonatalie Live manikin, was also numerically higher in the VR group (75%, IQR 9%-98%) than in the control group (62%, IQR 13%-97%), though not statistically significantly different (P=.35). Participants in the control group performed better on the identifying a helper and reviewing the emergency plan step (VR group: 7/90, 8%; control group: 16/88, 18%; P=.045) and the washing hands step (VR group: 20/90, 22%; control group: 32/88, 36%; P=.048). Conclusions: The use of digital interventions, such as mobile VR simulations, may be a viable approach to precourse preparation in neonatal resuscitation training for health care professionals in low- and middle-income countries.