Influence of short message service reminders on utilisation of focused antenatal care among women in rural Kenya: a randomised controlled trial

2021 ◽  
pp. 1-11
Author(s):  
Eliphas Gitonga ◽  
Jackim Nyamari ◽  
Peterson Warutere ◽  
Anthony Wanyoro
Keyword(s):  
Randomised Controlled Trial ◽  
Antenatal Care ◽  
Short Message Service ◽  
Controlled Trial ◽  
Short Message ◽  
Focused Antenatal Care ◽  
Message Service ◽  
Rural Kenya ◽  
Randomised Controlled ◽  
Antenatal Visits

Background/aims The short message service is a part of mobile health, which is defined as medical and public health practices that are supported by mobile devices, such as mobile phones, personal digital assistants, and other wireless devices. Mobile health has documented positive outcomes on other health services, including focused antenatal care. The focused antenatal care model emphasises quality of care rather than quantity of antenatal visits, and the World Health Organization recommends a minimum of four targeted antenatal visits. This study examines the influence of short message service reminders on utilisation of focused antenatal care in rural Kenya. Methods This was a randomised controlled trial with 118 respondents in each of two study arms, intervention and control, conducted in Tharaka Nithi, Kenya. The study group were pregnant women attending their first antenatal care visit in Tharaka sub-county health facilities. The intervention was three short message service reminders a week before the scheduled visit. Structured questionnaires were used to collect baseline and exit interviews. The chi-square test and logistic regression were used to check associations between uptake of antenatal care and participant characteristics at 5% significance level. Results Three quarters (75%) of the respondents in the intervention group completed the four targeted antenatal visits, whereas only 10% of respondents attended the required four visits in the control group. None of the sociodemographic variables were found to have any association or influence on focused antenatal care attendance. Short message reminders increased the chances of attending the recommended visits by 27 times (P<0.001). Conclusions Short message service reminders have a positive influence on utilisation of focused antenatal care. This research paper recommends that policymakers and health managers use short message service reminders to increase the uptake of focused antenatal care.

scholarly journals Text messaging to help women with overweight or obesity lose weight after childbirth: the intervention adaptation and SMS feasibility RCT

2020 ◽  
Vol 8 (4) ◽  
pp. 1-152
Author(s):  
Caroline McGirr ◽  
Ciara Rooney ◽  
Dunla Gallagher ◽  
Stephan U Dombrowski ◽  
Annie S Anderson ◽  
...  
Keyword(s):  
Public Health ◽  
Weight Loss ◽  
Randomised Controlled Trial ◽  
Active Control ◽  
Postpartum Period ◽  
Short Message Service ◽  
Controlled Trial ◽  
Short Message ◽  
Message Service ◽  
Randomised Controlled

Background There is a need to develop weight management interventions that fit seamlessly into the busy lives of women during the postpartum period. Objective The objective was to develop and pilot-test an evidence- and theory-based intervention, delivered by short message service, which supported weight loss and weight loss maintenance in the postpartum period. Design Stage 1 involved the development of a library of short message service messages to support weight loss and weight loss maintenance, with personal and public involvement, focusing on diet and physical activity with embedded behaviour change techniques, and the programming of a short message service platform to allow fully automated intervention delivery. Stage 2 comprised a 12-month, single-centre, two-arm, pilot, randomised controlled trial with an active control. Setting This study was set in Northern Ireland; women were recruited via community-based approaches. Participants A total of 100 women with overweight or obesity who had given birth in the previous 24 months were recruited. Interventions The intervention group received an automated short message service intervention about weight loss and weight loss maintenance for 12 months. The active control group received automated short message service messages about child health and development for 12 months. Main outcome measures The main outcomes measured were the feasibility of recruitment and retention, acceptability of the intervention and trial procedures, and evidence of positive indicative effects on weight. Weight, waist circumference and blood pressure were measured by the researchers; participants completed a questionnaire booklet and wore a sealed pedometer for 7 days at baseline, 3, 6, 9 and 12 months. Outcome assessments were collected during home visits and women received a voucher on completion of each of the assessments. Qualitative interviews were conducted with women at 3 and 12 months, to gather feedback on the intervention and active control and the study procedures. Quantitative and qualitative data were used to inform the process evaluation and to assess fidelity, acceptability, dose, reach, recruitment, retention, contamination and context. Results The recruitment target of 100 participants was achieved (intervention, n = 51; control, n = 49); the mean age was 32.5 years (standard deviation 4.3 years); 28 (28%) participants had a household income of < £29,999 per annum. Fifteen women became pregnant during the follow-up (intervention, n = 9; control, n = 6) and withdrew from the study for this reason. At the end of the 12-month study, the majority of women remained in the study [85.7% (36/42) in the intervention group and 90.7% (39/43) in the active control group]. The research procedures were well accepted by women. Both groups indicated a high level of satisfaction with the short message service intervention that they were receiving. There was evidence to suggest that the intervention may have a positive effect on weight loss and prevention of weight gain during the postpartum period. Limitations The interviews at 3 and 12 months were conducted by the same researchers who collected other outcome data. Conclusions An evidence- and theory-based intervention delivered by short message service was successfully developed in conjunction with postpartum women with overweight and obesity. The intervention was acceptable to women and was feasible to implement in the 12-month pilot randomised controlled trial. The progression criteria for a full randomised controlled trial to examine effectiveness and cost-effectiveness were met. Future work Some minor refinements need to be made to the intervention and trial procedures based on the findings of the pilot trial in preparation for conducting a full randomised controlled trial. Trial registration Current Controlled Trial ISRCTN90393571. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 4. See the NIHR Journals Library website for further project information. The intervention costs were provided by the Public Health Agency, Northern Ireland.

scholarly journals A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project

BMJ ◽  
1996 ◽  
Vol 312 (7030) ◽  
pp. 546-553 ◽  
Author(s):  
J. Sikorski ◽  
J. Wilson ◽  
S. Clement ◽  
S. Das ◽  
N. Smeeton
Keyword(s):  
Randomised Controlled Trial ◽  
Antenatal Care ◽  
Controlled Trial ◽  
Care Project ◽  
Randomised Controlled ◽  
Antenatal Visits

scholarly journals Group antenatal care (Pregnancy Circles) for diverse and disadvantaged women: study protocol for a randomised controlled trial with integral process and economic evaluations

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Meg Wiggins ◽  
Mary Sawtell ◽  
Octavia Wiseman ◽  
Christine McCourt ◽  
Sandra Eldridge ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Randomised Controlled Trial ◽  
Antenatal Care ◽  
Standard Care ◽  
Controlled Trial ◽  
Trial Registration ◽  
Secondary Outcome ◽  
The World ◽  
Randomised Controlled

Abstract Background Group antenatal care has been successfully implemented around the world with suggestions of improved outcomes, including for disadvantaged groups, but it has not been formally tested in the UK in the context of the NHS. To address this the REACH Pregnancy Circles intervention was developed and a randomised controlled trial (RCT), based on a pilot study, is in progress. Methods The RCT is a pragmatic, two-arm, individually randomised, parallel group RCT designed to test clinical and cost-effectiveness of REACH Pregnancy Circles compared with standard care. Recruitment will be through NHS services. The sample size is 1732 (866 randomised to the intervention and 866 to standard care). The primary outcome measure is a ‘healthy baby’ composite measured at 1 month postnatal using routine maternity data. Secondary outcome measures will be assessed using participant questionnaires completed at recruitment (baseline), 35 weeks gestation (follow-up 1) and 3 months postnatal (follow-up 2). An integrated process evaluation, to include exploration of fidelity, will be conducted using mixed methods. Analyses will be on an intention to treat as allocated basis. The primary analysis will compare the number of babies born “healthy” in the control and intervention arms and provide an odds ratio. A cost-effectiveness analysis will compare the incremental cost per Quality Adjusted Life Years and per additional ‘healthy and positive birth’ of the intervention with standard care. Qualitative data will be analysed thematically. Discussion This multi-site randomised trial in England is planned to be the largest trial of group antenatal care in the world to date; as well as the first rigorous test within the NHS of this maternity service change. It has a recruitment focus on ethnically, culturally and linguistically diverse and disadvantaged participants, including non-English speakers. Trial registration Trial registration; ISRCTN, ISRCTN91977441. Registered 11 February 2019 - retrospectively registered. The current protocol is Version 4; 28/01/2020.

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