Risk of Bias in Randomized Controlled Trials: An Analysis of Parent-Targeted Postnatal Education Interventions from Low and Middle-Income Countries

Authors

  • Justine Dol, Ms Faculty of Health, Dalhousie University
  • Britney Beniot, Dr. Rankin School of Nursing, St. Francis Xavier University
  • Brianna Richardson, Ms. School of Nursing, Faculty of Health, Dalhousie University
  • Gail Tomblin Murphy, Dr. Nova Scotia Health Authority
  • Megan Aston, Dr School of Nursing, Faculty of Health, Dalhousie University
  • Douglas McMillan, Dr. Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University and IWK Health Centre
  • Jacqueline Gahagan, Dr. School of Health and Human Performance, Faculty of Health, Dalhousie University
  • Marsha Campbell-Yeo, Dr School of Nursing, Faculty of Health, Dalhousie University

Abstract

Randomized controlled trials (RCTs) are vulnerable to internal and external bias, particularly when examining complex health behavioural interventions. The effects of postnatal education interventions on parent’s knowledge of caring for their newborn in low-and middle-income countries (LMICs) is a growing area of study. Therefore, the aim of this review was to assess the risk of bias (RoB) in such studies. MedLine, CINAHL, and SCOPUS were searched from January 2000 - October 2017 using key words such as RCT, parent-targeted, postnatal, education, interventions, and LMICs. Two reviewers screened title and abstracts and full text of eligible studies. Outcomes of interest were RoB measured using the Cochrane RoB tool, as well as intervention fidelity and contamination bias. Data were descriptively analyzed with 29 RCTs included. Highest risk of bias was in participant (55%) and personnel (76%) blinding with the lowest risk of bias in random sequence generation (76%), and attrition bias (72%). Overall, 89.7% of studies on postnatal parent-targeted education interventions in LMICs had a high RoB score in at least one domain. While difficult to avoid such biases, opportunities can be sought to minimize these during the design and conduct of future studies in this area.

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Published

2020-07-04

How to Cite

Dol, J., Beniot, B., Richardson, B., Tomblin Murphy, G., Aston, M., McMillan, D., Gahagan, J., & Campbell-Yeo, M. (2020). Risk of Bias in Randomized Controlled Trials: An Analysis of Parent-Targeted Postnatal Education Interventions from Low and Middle-Income Countries. Global Health: Annual Review, 1(5), 5. Retrieved from https://journals.mcmaster.ca/ghar/article/view/2301

Issue

Section

Issue 5: Reproductive, Maternal, Newborn, and Child Health