Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study

dc.contributor.authorLau, Yan K
dc.contributor.authorCassidy, Tali
dc.contributor.authorHacking, Damian
dc.contributor.authorBrittain, Kirsty
dc.contributor.authorHaricharan, Hanne J
dc.contributor.authorHeap, Marion
dc.date.accessioned2015-01-17T06:13:42Z
dc.date.available2015-01-17T06:13:42Z
dc.date.issued2014-08-21
dc.date.updated2015-01-15T17:52:58Z
dc.description.abstractAbstract Background Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa’s high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits, and how to be healthy during pregnancy. Methods Participants recruited were pregnant women attending a primary health care facility in Cape Town. A controlled clinical trial was carried out where the intervention group (n = 102) received text messages staggered according to the week of pregnancy at the time of recruitment. The control group (n = 104) received no text messages. These text messages contained antenatal health information, and were delivered in English, Xhosa or Afrikaans, according to the preference of each participant. A baseline knowledge questionnaire with nine questions was administered prior to the intervention. The same questionnaire was used with added health-related behaviour questions for the intervention group at exit. A modified intention-to-treat analysis was done. To compare the control and intervention group’s knowledge, Fisher’s exact tests and two-sample t-tests tests were carried out for binary and continuous outcomes, respectively. A focus group of seven participants from the intervention group was then conducted to gain more insight into how the text messages were perceived. Results There was substantial loss to follow-up during the study with only 57% of the participants retained at exit. No statistically significant difference was detected between the control and intervention group in any of the nine knowledge questions at exit (all p > 0.05). Responses from the focus group indicated that the text messages acted as a welcome reminder and a source of positive motivation, and were perceived as extended care from the health care provider. Conclusions While the intervention failed to improve antenatal health knowledge, evidence from self-reported behaviour and the focus group suggests that text messages have the potential to motivate change in health-seeking behaviour. One should be mindful of loss to follow-up when rolling out mobile health interventions in developing country settings. Trial registration Pan African Clinical Trials Registry PACTR201406000841188 . Registered 3 June 2014.en_ZA
dc.identifier.apacitationLau, Y. K., Cassidy, T., Hacking, D., Brittain, K., Haricharan, H. J., & Heap, M. (2014). Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study. <i>BMC Pregnancy and Childbirth</i>, http://hdl.handle.net/11427/12258en_ZA
dc.identifier.chicagocitationLau, Yan K, Tali Cassidy, Damian Hacking, Kirsty Brittain, Hanne J Haricharan, and Marion Heap "Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study." <i>BMC Pregnancy and Childbirth</i> (2014) http://hdl.handle.net/11427/12258en_ZA
dc.identifier.citationBMC Pregnancy and Childbirth. 2014 Aug 21;14(1):284en_ZA
dc.identifier.issn1471-2393en_ZA
dc.identifier.ris TY - Journal Article AU - Lau, Yan K AU - Cassidy, Tali AU - Hacking, Damian AU - Brittain, Kirsty AU - Haricharan, Hanne J AU - Heap, Marion AB - Abstract Background Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa’s high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits, and how to be healthy during pregnancy. Methods Participants recruited were pregnant women attending a primary health care facility in Cape Town. A controlled clinical trial was carried out where the intervention group (n = 102) received text messages staggered according to the week of pregnancy at the time of recruitment. The control group (n = 104) received no text messages. These text messages contained antenatal health information, and were delivered in English, Xhosa or Afrikaans, according to the preference of each participant. A baseline knowledge questionnaire with nine questions was administered prior to the intervention. The same questionnaire was used with added health-related behaviour questions for the intervention group at exit. A modified intention-to-treat analysis was done. To compare the control and intervention group’s knowledge, Fisher’s exact tests and two-sample t-tests tests were carried out for binary and continuous outcomes, respectively. A focus group of seven participants from the intervention group was then conducted to gain more insight into how the text messages were perceived. Results There was substantial loss to follow-up during the study with only 57% of the participants retained at exit. No statistically significant difference was detected between the control and intervention group in any of the nine knowledge questions at exit (all p > 0.05). Responses from the focus group indicated that the text messages acted as a welcome reminder and a source of positive motivation, and were perceived as extended care from the health care provider. Conclusions While the intervention failed to improve antenatal health knowledge, evidence from self-reported behaviour and the focus group suggests that text messages have the potential to motivate change in health-seeking behaviour. One should be mindful of loss to follow-up when rolling out mobile health interventions in developing country settings. Trial registration Pan African Clinical Trials Registry PACTR201406000841188 . Registered 3 June 2014. DA - 2014-08-21 DB - OpenUCT DO - 10.1186/1471-2393-14-284 DP - University of Cape Town J1 - BMC Pregnancy and Childbirth LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 SM - 1471-2393 T1 - Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study TI - Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study UR - http://hdl.handle.net/11427/12258 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2393-14-284
dc.identifier.urihttp://hdl.handle.net/11427/12258
dc.identifier.vancouvercitationLau YK, Cassidy T, Hacking D, Brittain K, Haricharan HJ, Heap M. Antenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods study. BMC Pregnancy and Childbirth. 2014; http://hdl.handle.net/11427/12258.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderLau et al.; licensee BioMed Central Ltd.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceBMC Pregnancy and Childbirthen_ZA
dc.titleAntenatal health promotion via short message service at a Midwife Obstetrics Unit in South Africa: a mixed methods studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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