scholarly journals Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia

10.2196/27603 ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. e27603
Author(s):  
Zeleke Abebaw Mekonnen ◽  
Kassahun Alemu Gelaye ◽  
Martin Were ◽  
Binyam Tilahun
Keyword(s):  
Randomized Controlled Trial ◽  
Mobile Phone ◽  
Controlled Trial ◽  
Intervention Group ◽  
Text Message ◽  
Northwest Ethiopia ◽  
Health Interventions ◽  
Care Group ◽  
Randomized Controlled ◽  
Routine Childhood

Background Nonattendance at vaccination appointments is a big challenge for health workers as it is difficult to track routine vaccination schedules. In Ethiopia, 3 out of 10 children have incomplete vaccination and the timely receipt of the recommended vaccines is low. Thus, innovative strategies are required to reach the last mile where mobile technology can be effectively utilized to achieve better compliance. Despite this promising technology, little is known about the role of text message–based mobile health interventions in improving the complete and timely receipt of routine childhood vaccinations in Ethiopia. Objective This trial aimed to determine the effect of mobile phone text message reminders on the completion and timely receipt of routine childhood vaccinations in northwest Ethiopia. Methods A two-arm, parallel, superiority randomized controlled trial was conducted in 9 health facilities in northwest Ethiopia. A sample size of 434 mother-infant pairs was considered in this trial. Randomization was applied in selected health facilities during enrollment with a 1:1 allocation ratio by using sealed and opaque envelopes. Participants assigned to the intervention group received mobile phone text message reminders one day before the scheduled vaccination visits. Owing to the nature of the intervention, blinding of participants was not possible. Primary outcomes of full and timely completion of vaccinations were measured objectively at 12 months. A two-sample test of proportion and log-binomial regression analyses were used to compare the outcomes between the study groups. A modified intention-to-treat analysis approach was applied and a one-tailed test was reported, considering the superiority design of the trial. Results A total of 426 participants were included for the analysis. We found that a higher proportion of infants in the intervention group received Penta-3 (204/213, 95.8% vs 185/213, 86.9%, respectively; P<.001), measles (195/213, 91.5% vs 169/213, 79.3%, respectively; P<.001), and full vaccination (176/213, 82.6% vs 151/213, 70.9%, respectively; P=.002; risk ratio 1.17, 95% lower CI 1.07) compared to infants in the usual care group. Similarly, a higher proportion of infants in the intervention group received Penta-3 (181/204, 88.7% vs 128/185, 69.2%, respectively; P<.001), measles (170/195, 87.1% vs 116/169, 68.6%, respectively; P<.001), and all scheduled vaccinations (135/213, 63.3% vs 85/213, 39.9%, respectively; P<.001; risk ratio 1.59, 95% lower CI 1.35) on time compared to infants in the usual care group. Of the automatically sent 852 mobile phone text messages, 764 (89.7%) were delivered successfully to the participants. Conclusions Mobile phone text message reminders significantly improved complete and timely receipt of all recommended vaccines. Besides, they had a significant effect in improving the timely receipt of specific vaccines. Thus, text message reminders can be used to supplement the routine immunization program in resource-limited settings. Considering different contexts, studies on the implementation challenges of mobile health interventions are recommended. Trial Registration Pan African Clinical Trial Registry PACTR201901533237287; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5839

scholarly journals Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia (Preprint)

2021 ◽  
Author(s):  
Zeleke Abebaw Mekonnen ◽  
Kassahun Alemu Gelaye ◽  
Martin Were ◽  
Binyam Tilahun
Keyword(s):  
Randomized Controlled Trial ◽  
Mobile Phone ◽  
Controlled Trial ◽  
Intervention Group ◽  
Text Message ◽  
Northwest Ethiopia ◽  
Health Interventions ◽  
Care Group ◽  
Randomized Controlled ◽  
Routine Childhood

BACKGROUND Nonattendance at vaccination appointments is a big challenge for health workers as it is difficult to track routine vaccination schedules. In Ethiopia, 3 out of 10 children have incomplete vaccination and the timely receipt of the recommended vaccines is low. Thus, innovative strategies are required to reach the last mile where mobile technology can be effectively utilized to achieve better compliance. Despite this promising technology, little is known about the role of text message–based mobile health interventions in improving the complete and timely receipt of routine childhood vaccinations in Ethiopia. OBJECTIVE This trial aimed to determine the effect of mobile phone text message reminders on the completion and timely receipt of routine childhood vaccinations in northwest Ethiopia. METHODS A two-arm, parallel, superiority randomized controlled trial was conducted in 9 health facilities in northwest Ethiopia. A sample size of 434 mother-infant pairs was considered in this trial. Randomization was applied in selected health facilities during enrollment with a 1:1 allocation ratio by using sealed and opaque envelopes. Participants assigned to the intervention group received mobile phone text message reminders one day before the scheduled vaccination visits. Owing to the nature of the intervention, blinding of participants was not possible. Primary outcomes of full and timely completion of vaccinations were measured objectively at 12 months. A two-sample test of proportion and log-binomial regression analyses were used to compare the outcomes between the study groups. A modified intention-to-treat analysis approach was applied and a one-tailed test was reported, considering the superiority design of the trial. RESULTS A total of 426 participants were included for the analysis. We found that a higher proportion of infants in the intervention group received Penta-3 (204/213, 95.8% vs 185/213, 86.9%, respectively; <i>P</i>&lt;.001), measles (195/213, 91.5% vs 169/213, 79.3%, respectively; <i>P</i>&lt;.001), and full vaccination (176/213, 82.6% vs 151/213, 70.9%, respectively; <i>P</i>=.002; risk ratio 1.17, 95% lower CI 1.07) compared to infants in the usual care group. Similarly, a higher proportion of infants in the intervention group received Penta-3 (181/204, 88.7% vs 128/185, 69.2%, respectively; <i>P</i>&lt;.001), measles (170/195, 87.1% vs 116/169, 68.6%, respectively; <i>P</i>&lt;.001), and all scheduled vaccinations (135/213, 63.3% vs 85/213, 39.9%, respectively; <i>P</i>&lt;.001; risk ratio 1.59, 95% lower CI 1.35) on time compared to infants in the usual care group. Of the automatically sent 852 mobile phone text messages, 764 (89.7%) were delivered successfully to the participants. CONCLUSIONS Mobile phone text message reminders significantly improved complete and timely receipt of all recommended vaccines. Besides, they had a significant effect in improving the timely receipt of specific vaccines. Thus, text message reminders can be used to supplement the routine immunization program in resource-limited settings. Considering different contexts, studies on the implementation challenges of mobile health interventions are recommended. CLINICALTRIAL Pan African Clinical Trial Registry PACTR201901533237287; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5839

scholarly journals Research and Implementation Lessons Learned From a Youth-Targeted Digital Health Randomized Controlled Trial (the ARMADILLO Study)

10.2196/13005 ◽  
2019 ◽  
Vol 7 (8) ◽  
pp. e13005
Author(s):  
Lianne Gonsalves ◽  
Winnie Wangari Njeri ◽  
Megan Schroeder ◽  
Jefferson Mwaisaka ◽  
Peter Gichangi
Keyword(s):  
Randomized Controlled Trial ◽  
Digital Health ◽  
Controlled Trial ◽  
Text Message ◽  
Health Interventions ◽  
World Health ◽  
Intervention Period ◽  
Implementation Challenges ◽  
Randomized Controlled ◽  
Client Side

Background Evidence is lacking on the efficacy of sexual and reproductive health (SRH) communication interventions for youth (aged 15-24 years), especially from low- and middle-income countries. Therefore, the World Health Organization initiated the Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) program, a free, menu-based, on-demand text message (SMS, short message service) platform providing validated SRH content developed in collaboration with young people. A randomized controlled trial (RCT) assessing the effect of the ARMADILLO intervention on SRH-related outcomes was implemented in Kwale County, Kenya. Objective This paper describes the implementation challenges related to the RCT, observed during enrollment and the intervention period, and their implications for digital health researchers and program implementers. Methods This was an open, three-armed RCT. Following completion of a baseline survey, participants were randomized into the ARMADILLO intervention (arm 1), a once-a-week contact SMS text message (arm 2), or usual care (arm 3, no intervention). The intervention period lasted seven weeks, after which participants completed an endline survey. Results Two study team decisions had significant implications for the success of the trial’s enrollment and intervention implementation: a hands-off participant recruitment process and a design flaw in an initial language selection menu. As a result, three weeks after recruitment began, 660 participants had been randomized; however, 107 (53%) participants in arm 1 and 136 (62%) in arm 2 were “stuck” at the language menu. The research team called 231 of these nonengaging participants and successfully reached 136 to learn reasons for nonengagement. Thirty-two phone numbers were found to be either not linked to our participants (a wrong number) or not in their primary possession (a shared phone). Among eligible participants, 30 participants indicated that they had assumed the introductory message was a scam or spam. Twenty-seven participants were confused by some aspect of the system. Eleven were apathetic about engaging. Twenty-four nonengagers experienced some sort of technical issue. All participants eventually started their seven-week study period. Conclusions The ARMADILLO study’s implementation challenges provide several lessons related to both researching and implementing client-side digital health interventions, including (1) have meticulous phone data collection protocols to reduce wrong numbers, (2) train participants on the digital intervention in efficacy assessments, and (3) recognize that client-side digital health interventions have analog discontinuation challenges. Implementation lessons were (1) determine whether an intervention requires phone ownership or phone access, (2) digital health campaigns need to establish a credible presence in a busy digital space, and (3) interest in a service can be sporadic or fleeting. Clinical Trial International Standard Randomized Controlled Trial Number (ISRCTN): 85156148; http://www.isrctn. com/ISRCTN85156148

scholarly journals Effectiveness of a 3-Month Mobile Phone–Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Anna Ek ◽  
Christina Alexandrou ◽  
Emmie Söderström ◽  
Patrick Bergman ◽  
Christine Delisle Nyström ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Mobile Phone ◽  
Controlled Trial ◽  
Vigorous Physical Activity ◽  
Intervention Group ◽  
Active Transportation ◽  
Randomized Controlled ◽  
Behavior Change Program

BACKGROUND Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking. OBJECTIVE The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA). METHODS For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months. RESULTS No effect on MVPA was observed after 3 months (<i>P</i>=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; <i>P</i>=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was &gt;5 minute MVPA per day. CONCLUSIONS No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA. CLINICALTRIAL ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12889-018-5658-4

scholarly journals Pharmacist-led counselling intervention to improve antiretroviral drug adherence in Pakistan: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zeenat Fatima Chatha ◽  
Usman Rashid ◽  
Sharon Olsen ◽  
Fakhar ud Din ◽  
Amjad Khan ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Care Group ◽  
People Living With Hiv ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Cell Counts ◽  
Cd4 Cell

Abstract Background Pakistan is facing a growing population of people living with human immunodeficiency (HIV). In this randomized controlled trial, we investigate if a pharmacist-led intervention can increase adherence to antiretroviral therapy (ART) for people living with HIV (PLWH). Methods Adults with HIV, who have been taking ART for more than 3 months were randomly assigned to receive either a pharmacist-led intervention or their usual care. Measures of adherence were collected at 1) baseline 2) just prior to delivery of intervention and 3) 8 weeks later. The primary outcomes were CD4 cell count and self-reported adherence measured with the AIDS Clinical Trial Group (ACTG) questionnaire. Results Post-intervention, the intervention group showed a statistically significant increase in CD4 cell counts as compared to the usual care group (p = 0.0054). In addition, adherence improved in the intervention group, with participants being 5.96 times more likely to report having not missed their medication for longer periods of time (p = 0.0086) while participants in the intervention group were 7.74 times more likely to report missing their ART less frequently (p < 0.0001). Conclusions The findings support the improvement in ART adherence and HIV management. Trial registration The trial is registered with Australian New Zealand Clinical Trials Registry (ACTRN12618001882213). Registered 20 November 2018.

scholarly journals Text Message Reminders Increase Appointment Adherence in a Pediatric Clinic: A Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Chia-Lei Lin ◽  
Nila Mistry ◽  
Jordana Boneh ◽  
Hong Li ◽  
Rina Lazebnik
Keyword(s):  
Randomized Controlled Trial ◽  
African American ◽  
Controlled Trial ◽  
Intervention Group ◽  
Text Message ◽  
Text Messages ◽  
Pediatric Practice ◽  
Appointment Adherence ◽  
Randomized Controlled ◽  
Text Message Reminder

Background. High no-show rates can burden clinic productivity and affect patient care. Although multiple studies have shown that text messages improve appointment adherence, very little research has focused on low-income and predominantly African American populations in resident clinic settings. Objectives. To determine whether incorporating a text message reminder reduces the no-show rate at an urban, pediatric resident clinic. Methods. A randomized controlled trial was conducted at a tertiary level ambulatory pediatric practice between August 2014 and February 2015. Following a demographic survey, 170 patients were enrolled. Patients were randomized into control or intervention groups. All patients received the standard voice message appointment reminder, but the intervention group additionally received a text message reminder. The primary outcome was no-show rate. Results. 95.3% of the participants were African American, and the overall no-show rate was 30.8%. No-show rate was significantly lower in the intervention group (23.5%) than the control group (38.1%) representing a difference of 14.6% (p=0.04). No demographic factors were found to alter the association between no-show rate and text message intervention. Conclusions. Text message reminders effectively improve show rates at a resident pediatric practice with high no-show rates, representing a promising approach to improving appointment adherence.

Effectiveness of Mobile Phone-Based Support on Exclusive Breastfeeding and Infant Growth in Nigeria: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Daprim S Ogaji ◽  
Adaku O Arthur ◽  
Innocent George
Keyword(s):  
Randomized Controlled Trial ◽  
Mobile Phone ◽  
Usual Care ◽  
Exclusive Breastfeeding ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
The Difference ◽  
And Control

Abstract Background This study examined whether mobile phone-based support improve the rates, duration of exclusive breastfeeding (EBF) as well as infant growth patterns in Nigeria. Methods A 6-month prospective randomized controlled trial with 75 participants assigned to receive ‘usual care’ or ‘mobile phone-based support in addition to usual care’ EBF rates and duration as well as anthropometric measurements of infants before and after intervention were compared using proportions and mean differences. Results Attrition rates of 10.7% and 14.7% were observed in the intervention and control groups, respectively. Treatment groups were identical in all baseline characteristics and participants in the intervention group showed a slower rate of decline in the practice of EBF. The mean difference of 0.6 months (95% confidence interval: −0.22, 1.42) in EBF duration between intervention and control groups was not statistically significant (t = 1.45; p = 0.149). Similarly, the difference in the EBF rates at the 6th month for the intervention (55.2%) and control (46.8%) groups was not statistically significant (χ2 = 0.623; p = 0.430). Although the intervention group had significantly higher mean weight (p = 0.030) and length (p = 0.044) at the 6th month, the difference in the gain in weight and length of these infants over the period was only significant for the weight (p = 0.044). Although the incidence of adverse clinical nutritional status was more in the control group, these differences were not statistically significant. Conclusion Mobile phone-based intervention has positive effects on the rate and duration of EBF as well as the growth of young infants. Sustaining this simple and cheap technology will improve infant wellbeing especially in resource-constrained settings.

scholarly journals A mobile phone-based multimedia intervention to support maternal health is acceptable and feasible among illiterate pregnant women in Uganda: Qualitative findings from a pilot randomized controlled trial

2021 ◽  
Vol 7 ◽  
pp. 205520762098629
Author(s):  
Angella Musiimenta ◽  
Wilson Tumuhimbise ◽  
Niels Pinkwart ◽  
Jane Katusiime ◽  
Godfrey Mugyenyi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Maternal Health ◽  
Mobile Phone ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Intervention Group ◽  
Randomized Controlled ◽  
Clinic Appointment ◽  
Pilot Randomized Controlled Trial

Background Uganda’s maternal mortality rate remains unacceptably high. Mobile phones can potentially provide affordable means of accessing maternal health services even among the otherwise hard-to-reach populations. Evidence about the acceptability and feasibility of mobile phone-based interventions targeting illiterate women, however, is limited. Objective To assess the acceptability and feasibility of a mobile phone-based multimedia application (MatHealth app) to support maternal health amongst illiterate pregnant women in rural southwestern Uganda. Methods 80 pregnant women initiating antenatal care from Mbarara regional referral hospital were enrolled in a pilot randomized controlled trial and followed until six weeks after delivery. The 40 women in the intervention group received a MatHealth app composed of educational videos/audios, clinic appointment reminders, and the calling function. Qualitative interviews on acceptability of this technology were carried out with 30 of the intervention participants. An inductive, content analytic approach was used to analyze qualitative data. Quantitative feasibility data were recorded and summarized descriptively. Results Participants reported that the intervention is acceptable as it enabled them adopt good maternal health practices, enhanced social support from spouses, provided clinic appointment reminders, and facilitated communication with healthcare providers. Challenges included: phone sharing (74%), accidental deletion of the application 15 (43%), lack of electricity 15 (43%), and inability to set up a reminder function 20 (57%). Conclusion The MatHealth app is an acceptable and feasible intervention among illiterate women, in a resource limited setting. Future efforts should focus on optimized application design, spouse orientation, and incorporating economic support to overcome the challenges we encountered.

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