Ashcroft Nicki, Shelus Victoria, Garg Himanshu, McLarnon-Silk Courtney, Jennings Victoria H
Institute for Reproductive Health, Georgetown University, Washington, DC, USA.
Institute for Reproductive Health, New Delhi, India.
Mhealth. 2017 May 22;3:20. doi: 10.21037/mhealth.2017.05.01. eCollection 2017.
CycleTel Family Advice (CFA), an SMS-based service designed to improve knowledge of fertility and family planning (FP), was delivered to over 100,000 people in India from April to August 2015. The goal of CFA was to increase knowledge on a range of reproductive health topics, e.g., the menstrual cycle, fertility, and FP, and to increase positive perceptions and use of FP. This paper focuses on the best practices and operational challenges for providing an SMS service based on the implementation experience of CFA.
The implementation process for CFA was well documented, specifically program design, commercial partnerships, formative research, design of messages, and recruitment of users. The impact of CFA on knowledge, attitudes, and behaviors was assessed through phone surveys before and after message delivery.
Programmatic data and phone surveys resulted in several operational findings, particularly in the areas of user behavior, partnership management, and mHealth research. While there were improvements in knowledge, there were not significant changes in FP use and couple communication.
The intervention yielded insights into designing an mHealth intervention as well as the opportunities and challenges of implementing a stand-alone SMS-based service with a broad audience. Lessons learned were that (I) SMS-based interventions, without other supporting systems, may not lead to high user engagement or behavior change; (II) partnerships with private sector technical platforms can help overcome the difficult problem of marketing and outreach, but they bring limitations to user interface and dependencies on a commercial structure; (III) collecting demographic data required to provide tailored content may be a barrier to user acquisition; and (IV) while phone surveys are useful for evaluation of mHealth interventions, reaching users is challenging and response rates are low.
CycleTel家庭咨询服务（CFA）是一项旨在提高生育和计划生育（FP）知识的短信服务，于2015年4月至8月在印度向超过10万人提供。CFA的目标是增加一系列生殖健康主题的知识，例如月经周期、生育能力和计划生育，并增强对计划生育的积极认知和使用。本文基于CFA的实施经验，重点探讨提供短信服务的最佳实践和运营挑战。
CFA的实施过程有详细记录，特别是项目设计、商业伙伴关系、形成性研究、短信设计和用户招募。通过在短信发送前后进行电话调查，评估CFA对知识、态度和行为的影响。
项目数据和电话调查得出了一些运营结果，特别是在用户行为、伙伴关系管理和移动健康研究领域。虽然知识有所提高，但计划生育的使用和夫妻沟通没有显著变化。
该干预措施为设计移动健康干预措施以及实施面向广大受众的独立短信服务的机遇和挑战提供了见解。吸取的经验教训是：（I）没有其他支持系统的基于短信的干预措施可能不会导致高用户参与度或行为改变；（II）与私营部门技术平台的伙伴关系有助于克服营销和推广的难题，但它们给用户界面带来限制，并依赖商业结构；（III）收集提供定制内容所需的人口统计数据可能是获取用户的障碍；（IV）虽然电话调查对评估移动健康干预措施有用，但联系用户具有挑战性且回复率较低。
