Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Evaluating the Impact of a Community Health Worker Program in Neno, Malawi: A Stepped-Wedge Cluster Randomized Controlled Trial
Brief Summary: This protocol concerns the implementation and evaluation of an intervention designed to realign the existing cadre of Community Health Workers (CHW) in Neno District, Malawi to better support the care needs of the clients they serve. The proposed intervention is a 'Household Model' where CHWs will be assigned to households, rather than HIV or TB specific patients, and will be trained to provide support for a wider range of conditions including HIV, hypertension, diabetes, and pediatric malnutrition. The new model is designed to improve retention in care for clients with chronic, non-communicable diseases, along with increased uptake of women's health services and treatment for pediatric malnutrition, while sustaining the high retention rates for clients in the HIV program. Eleven sites (health centres and hospitals) were arranged into six clusters by estimated size of the catchment area populations, with a population range of 11,680 to 26,260 and an average population of 20,400. The order in which the intervention will be rolled out across the sites will be randomized so that the intervention can be evaluated in a stepped-wedge cluster randomized controlled trial. These clusters were grouped based mostly on geographic location but also on catchment area sizes, in order to maximize feasibility of training for the CHW team and not overload CHW training sessions with too many trainees.


Options:
A: Arm Label: Proactive Community Case Management (ProCCM); Type: EXPERIMENTAL; Interventions: Other: Proactive Community Case Management, Other: Removal of point-of-care user fees, Other: Infrastructure improvements at primary health centre, Other: Training of primary health centre staff | Arm Label: integrated Community Case Management (iCCM); Type: ACTIVE_COMPARATOR; Interventions: Other: Integrated Community Case Management, Other: Removal of point-of-care user fees, Other: Infrastructure improvements at primary health centre, Other: Training of primary health centre staff | Intervention Type: OTHER; Name: Proactive Community Case Management; Assigned to Arm(s): Proactive Community Case Management (ProCCM) | Intervention Type: OTHER; Name: Integrated Community Case Management; Assigned to Arm(s): integrated Community Case Management (iCCM) | Intervention Type: OTHER; Name: Removal of point-of-care user fees; Assigned to Arm(s): Proactive Community Case Management (ProCCM), integrated Community Case Management (iCCM) | Intervention Type: OTHER; Name: Infrastructure improvements at primary health centre; Assigned to Arm(s): Proactive Community Case Management (ProCCM), integrated Community Case Management (iCCM) | Intervention Type: OTHER; Name: Training of primary health centre staff; Assigned to Arm(s): Proactive Community Case Management (ProCCM), integrated Community Case Management (iCCM)
B: Arm Label: Zalewa; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Household model | Arm Label: Ligowe and Magaleta; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Household model | Arm Label: Neno District Hospital and Neno Parish; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Household model | Arm Label: Matope; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Household model | Arm Label: Matandani and Nsambe; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Household model | Arm Label: Luwani, Nkula, and Midzemba; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Household model | Intervention Type: BEHAVIORAL; Name: Household model; Assigned to Arm(s): Ligowe and Magaleta, Luwani, Nkula, and Midzemba, Matandani and Nsambe, Matope, Neno District Hospital and Neno Parish, Zalewa
C: Arm Label: Integrated mental health in primary care; Type: EXPERIMENTAL; Interventions: Behavioral: Integrated mental health in primary care | Arm Label: Psychiatric nurse-led specialist care; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Psychiatric nurse-led specialist care | Intervention Type: BEHAVIORAL; Name: Integrated mental health in primary care; Assigned to Arm(s): Integrated mental health in primary care | Intervention Type: BEHAVIORAL; Name: Psychiatric nurse-led specialist care; Assigned to Arm(s): Psychiatric nurse-led specialist care
D: Arm Label: Screening by community health workers; Type: ACTIVE_COMPARATOR; Interventions: Other: Active comparator: Screening by community health workers | Arm Label: Screening by mothers; Type: EXPERIMENTAL; Interventions: Other: Screening by mothers | Intervention Type: OTHER; Name: Screening by mothers; Assigned to Arm(s): Screening by mothers | Intervention Type: OTHER; Name: Active comparator: Screening by community health workers; Assigned to Arm(s): Screening by community health workers

Answer: B