Background: The immunization uptake rates in Pakistan are much lower than desired. Major reasons include lack of awareness, parental forgetfulness regarding schedules, and misinformation regarding vaccines. In light of the COVID-19 pandemic and distancing measures, routine childhood immunization (RCI) coverage has been adversely affected, as caregivers avoid tertiary care hospitals or primary health centers. Innovative and cost-effective measures must be taken to understand and deal with the issue of low immunization rates. However, only a few smartphone-based interventions have been carried out in low- and middle-income countries (LMICs) to improve RCI. Objective: The primary objectives of this study are to evaluate whether a personalized mobile app can improve children’s on-time visits at 10 and 14 weeks of age for RCI as compared with standard care and to determine whether an artificial intelligence model can be incorporated into the app. Secondary objectives are to determine the perceptions and attitudes of caregivers regarding childhood vaccinations and to understand the factors that might influence the effect of a mobile phone–based app on vaccination improvement. Methods: A mixed methods randomized controlled trial was designed with intervention and control arms. The study will be conducted at the Aga Khan University Hospital vaccination center. Caregivers of newborns or infants visiting the center for their children’s 6-week vaccination will be recruited. The intervention arm will have access to a smartphone app with text, voice, video, and pictorial messages regarding RCI. This app will be developed based on the findings of the pretrial qualitative component of the study, in addition to no-show study findings, which will explore caregivers’ perceptions about RCI and a mobile phone–based app in improving RCI coverage. Results: Pretrial qualitative in-depth interviews were conducted in February 2020. Enrollment of study participants for the randomized controlled trial is in process. Study exit interviews will be conducted at the 14-week immunization visits, provided the caregivers visit the immunization facility at that time, or over the phone when the children are 18 weeks of age. Conclusions: This study will generate useful insights into the feasibility, acceptability, and usability of an Android-based smartphone app for improving RCI in Pakistan and in LMICs.
Research question: The current study investigates the income elasticities and socio-economic determinants of direct and indirect sports expenditure categories by means of a log normal hurdle regression. Research methods: The data stem from a representative sample of 3005 Flemish families with school-aged children, gathered through a sports-specific survey. A log normal hurdle regression was used to calculate the determining factors and expenditure elasticities of expenditure on sports participation. Results and findings: The results indicate that income, education and the age of the youngest child are positively related to almost all sports expenditure categories, while the number of family members and degree of urbanisation are significant for only a number of the expenditure categories. The elasticity value of the direct sports expenses is smaller than is the case for indirect sports expenditure. Between the expenditure categories large differences exist, as relatively large elasticities are found for sports holidays, transport and sports food and drinks, as opposed to low values of sports events, sports club membership, entrance fees for sports infrastructure, sports camps, clothing, footwear and equipment. Implications: The fact that income significantly influences all expenditure categories demonstrates that further policy intervention is required to make sports consumption more accessible to lower income groups. Sports enterprises and policymakers need to be aware that negative income shifts have a more profound impact on the indirect expenditure categories, and that certain sports activities (e.g. participation events) are relatively more favoured by low-income groups than is the case for sports club membership
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This experimental study with a pre-post and follow-up design evaluates the financial education program “SaveWise” for ninth grade students in the Netherlands (n = 713). SaveWise adopts a holistic approach, emphasizing action rather than mere cognition. Benefitting from explicit instruction embedded in real-life contexts, students in the program set a personal savings goal and are coached on how to achieve it. The short-term treatment results indicated that SaveWise expanded the students’ level of financial knowledge; encouraged their intentions to save more, spend less and earn an income; and broadly improved their financial and savings behavior. The program demonstrated that it could serve as an effective and low-cost method to enhance the financial literacy of pre-vocational students, a financially vulnerable group. Although long-term effects were expressed only through financial socialization, this study offers evidence linking curricula to increased knowledge and improved behavior for a specific sample of students.
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