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Table 1 Overview of the study design

From: Implementation and effectiveness of continuous kangaroo mother care: a participatory action research protocol

  Phase 1: Tracking C-KMC implementation Phase 2: Measuring effectiveness of C-KMC
Intervention Continuous kangaroo mother care
Study design Participatory action research Before-after comparison of non-C-KMC and C-KMC neonates
Aim To implement continuous KMC in the study setting and identify barriers / challenges to the implementation of C-KMC To investigate the effectiveness of C-KMC
Hypothesis Not applicable Continuous KMC:
1. reduces the length of hospital stay of preterm neonates / neonates <2500g
2. increases the rate of exclusive breastfeeding at discharge
Study setting General hospital in North West Iran, level III NICUa
Participants • Mothers with preterm neonates
• Nurses and midwives
• Managers and health policy makers
• Preterm neonates
Sampling • Purposive sampling
• Sample size: until data saturation is reached
• Consecutive sample (before and after C-KMC implementation)
• Sample size: 208 = 104 per group
Data collection tools 1. Interview guide (for focus group discussions and individual interviews)
2. Standardized progress-monitoring tool:
• Observations of service provision, care and records
• Interviews with health care providers (nurses, doctors, etc.)
Data collection sheet (questionnaire):
• Length of hospitalization (total and length of days in C-KMC)
• Feeding method(s) at discharge
• Other characteristics (e.g. gestational age and sex) – see Table 2 for details
Data collection process • Focus group discussions (health care providers and managers) and individual interviews (mothers)
• Application of the progress-monitoring tool
Completion of the data collection sheet using data from the neonates’ medical file
Data analysis • Qualitative content analysis
• Software: MAXQDA10
• Data with normal distribution: paired t-test; Pearson correlation coefficient; ANOVA
• Paired nominal data: McNemar’s test
• Software: SPSS version 24
Ethical considerations Written consent from participants before interviews and focus groups Consent from parents or hospital management to use data
Approval by the Ethics Committee of Tabriz University of Medical Sciences, Tabriz, Iran
  1. aNICU level III Neonatal intensive care unit that is capable of caring for neonates <32 weeks or <1500 g with professional personnel including neonatal nurses who are available 24 hours a day, ANOVA analysis of variance, SPSS Statistical Package for Social Sciences, C-KMC contionuse kangaroo mother care