Facilitators and challenges in recruiting pregnant women to an infant obesity prevention programme delivered via telephone calls or text messages

A 3-arm randomised controlled trial implemented in 2017, recruited participants from four Local Health Districts (LHDs) in New South Wales (NSW) to test an early obesity prevention program delivered via telephone calls (telephone) or text messages (SMS). This sub-study explored participants’ experience and satisfaction with the program. A multimethod design was used. Quantitative satisfaction questions were completed by participants when their child was six-months old. A purposive sample of participants with varying satisfaction levels was invited for in-depth qualitative interviews. Data were analysed using Excel (quantitative) and inductive thematic analysis (qualitative). Of the 1155 participants recruited: 947 (293 telephone; 338 SMS; 316 control) completed the six-month survey; 34 (14 telephone; 13 SMS; 7 control) were interviewed. Participants’ overall program satisfaction was 100% (telephone) and 85% (SMS). Participants’ qualitative responses demonstrated appreciation of: personalised stage-based information; opportunity to communicate with health professionals (telephone); linked Healthy Beginnings booklets and SMS mostly as nudges (SMS). There is a clear need for stage-based information, and supplemented modes of delivery i.e., text messages along with telephone calls; with text messages solely seen as nudges or reminders. However, individual preferences vary according to information needs at any given time, time constraints on new mothers and hence, multiple modes of information provision are recommended in order to reach a wider population and for better engagement. Choice and flexibility in mode of delivery has the potential to provide equitable access to information, empowering women with infants to practice recommended health behaviours for infant obesity prevention.

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Mobile health messaging service and helpdesk for South African mothers (MomConnect): history, successes and challenges

BMJ Global Health ◽

10.1136/bmjgh-2017-000559 ◽

2018 ◽

Vol 3 (Suppl 2) ◽

pp. e000559 ◽

Cited By ~ 24

Author(s):

Peter Barron ◽

Joanne Peter ◽

Amnesty E LeFevre ◽

Jane Sebidi ◽

Marcha Bekker ◽

...

Keyword(s):

Pregnant Women ◽

South African ◽

Mobile Health ◽

Health Workers ◽

Digital Health ◽

Universal Coverage ◽

Text Messages ◽

Time Data ◽

Department Of Health ◽

Early Decision

MomConnect is a flagship programme of the South African National Department of Health that has reached over 1.5 million pregnant women. Using mobile technology, MomConnect provides pregnant and postpartum women with twice-weekly health information text messages as well as access to a helpdesk for patient queries and feedback. In just 3 years, MomConnect has been taken to scale to reach over 95% of public health facilities and has reached 63% of all pregnant women attending their first antenatal appointment. The helpdesk has received over 300 000 queries at an average of 250 per day from 6% of MomConnect users. The service is entirely free to its users. The rapid deployment of MomConnect has been facilitated by strong government leadership, and an ecosystem of mobile health implementers who had experience of much of the content and technology required. An early decision to design MomConnect for universal coverage has required the use of text-based technologies (short messaging service and Unstructured Supplementary Service Data) that are accessible via even the most basic mobile phones, but cumbersome to use and costly at scale. Unlike previous mobile messaging services in South Africa, MomConnect collects the user’s identification number and facility code during registration, enabling future linkages with other health and population databases and geolocated feedback. MomConnect has catalysed additional efforts to strengthen South Africa’s digital health architecture. The rapid growth in smartphone penetration presents new opportunities to reduce costs, increase real-time data collection and expand the reach and scope of MomConnect to serve health workers and other patient groups.

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Trial collaborators’ perceptions of the process of delivering Healthy Beginnings advice via telephone calls or text messages

Health Promotion Journal of Australia ◽

10.1002/hpja.562 ◽

2021 ◽

Author(s):

Mahalakshmi Ekambareshwar ◽

Sarah Taki ◽

Seema Mihrshahi ◽

Louise Baur ◽

Li Ming Wen ◽

...

Keyword(s):

Text Messages ◽

Telephone Calls

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Promoting Antenatal Care Attendance Through a Text Messaging Intervention in Samoa: Quasi-Experimental Study

JMIR mhealth and uhealth ◽

10.2196/15890 ◽

2020 ◽

Vol 8 (6) ◽

pp. e15890

Author(s):

Jessica L Watterson ◽

Diego Castaneda ◽

Caricia Catalani

Keyword(s):

Data Analysis ◽

Maternal Health ◽

Antenatal Care ◽

Pregnant Women ◽

Text Messaging ◽

Individual Characteristics ◽

Text Messages ◽

Quasi Experimental ◽

Text Messaging Intervention ◽

Sms Text Messaging

Background Antenatal care (ANC) has the potential to improve maternal health, but it remains underutilized and unevenly implemented in many low- and middle-income countries. Increasingly, text messaging programs for pregnant women show evidence that they can improve the utilization of ANC during pregnancy; however, gaps remain regarding how implementation affects outcomes. Objective This study aimed to assess facilitators and barriers to implementation of an SMS text messaging intervention for pregnant women in Samoa and to assess its impact on ANC attendance. Methods This study took place in Upolu, Samoa, from March to August 2014 and employed a quasi-experimental design. Half (n=3) of the public antenatal clinics on the island offered adult pregnant women the SMS text messaging intervention, with 552 women registering for the messages. At the comparison clinics (n=3), 255 women registered and received usual care. The intervention consisted of unidirectional text messages containing health tips and appointment reminders. The outcome of interest was the number of attended antenatal visits. Implementation data were also collected through a survey of the participating midwives (n=7) and implementation notes. Data analysis included a comparison of women’s baseline characteristics between the two groups, followed by the use of negative binomial regressions to test for associations between participation in the intervention and increased ANC attendance, controlling for individual characteristics and accounting for the clustering of women within clinics. Results The comparison of ANC attendance rates found that women receiving the SMS text messaging intervention attended 15% fewer ANC visits than the comparison group (P=.004), controlling for individual characteristics and clustering. Data analysis of the implementation process suggests that barriers to successful implementation include women registering very late in pregnancy, sharing their phone with others, and inconsistent explanation of the intervention to women. Conclusions These results suggest that unidirectional text messages do not encourage, and might even discourage, ANC attendance in Samoa. Interpreted with other evidence in the literature, these results suggest that SMS text messaging interventions are more effective when they facilitate better communication between patients and health workers. This study is an important contribution to our understanding of when SMS text messaging interventions are and are not effective in improving maternal health care utilization.

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Increasing the uptake of cervical screening at cornerstone medical practice

BMJ Open Quality ◽

10.1136/bmjoq-2020-001126 ◽

2021 ◽

Vol 10 (3) ◽

pp. e001126

Author(s):

Adeola Oyegbite ◽

Jessica Roberts ◽

Joanna Bircher

Keyword(s):

Statistical Significance ◽

Cervical Screening ◽

Text Message ◽

Text Messages ◽

Similar Response ◽

Practice List ◽

North West ◽

Screening Uptake ◽

Information Leaflets ◽

Telephone Calls

BackgroundNationally, cervical screening uptake is suboptimal, even though research shows that the programme is highly effective at preventing cervical cancer.Local problemCornerstone is a small practice located in Salford in the North West of England. Historically, screening uptake here has been lower than average. There were 656 eligible women on our practice list and 177 of them were unscreened at the start of the project. The largest group of non-white British or Irish people on our list (13) spoke Polish as their first language.MethodsWe used quality improvement methods: the model for improvement, a driver diagram and Plan, Do, Study, Act cycles. Specifically, we targeted 177 women who were previously non-responders, as well as keeping up the regular screening service. We managed to contact 120 women during the project.InterventionsWe tested different methods of inviting women to attend cervical screening: telephone calls, text messages and letters. Later, a video link was also included in the text invitation. Information leaflets about the tests were added to letters. The letter was also translated into Polish.ResultsUptake improved and the aim was reached. Telephone calls from the nurse increased uptake but took time away from other work, so was not a sustainable change for our practice. A letter stating evidence basis for the test, and a letter translated into Polish showed limited improvement. Sending letters with information leaflets and text messages with video links achieved similar response rates with no statistical significance when we analysed the data. Offering extended hours and flexible appointment times showed very positive results.ConclusionsThe text message with a video attached was adopted as an effective method for targeting persistent non-responders.The project in its second year is being scaled up across the Primary Care Network.

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