McCarthy Ona L, Wazwaz Ola, Jado Iman, Leurent Baptiste, Edwards Phil, Adada Samia, Stavridis Amina, Free Caroline
Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Palestinian Family Planning and Protection Association, Industrial Zone, Wadi Al-Joze, Jerusalem, Palestine.
Trials. 2017 Oct 3;18(1):454. doi: 10.1186/s13063-017-2191-1.
Unintended pregnancy can negatively impact women's lives and is associated with poorer health outcomes for women and children. Many women, particularly in low- and middle-income countries, continue to face obstacles in avoiding unintended pregnancy. In the State of Palestine, a survey conducted in 2006 estimated that 38% of pregnancies are unintended. In 2014, unmet need for contraception was highest among young women aged 20-24 years, at 15%. Mobile phones are increasingly being used to deliver health support. Once developed, interventions delivered by mobile phone are often cheaper to deliver than face-to-face support. The London School of Hygiene and Tropical Medicine and the Palestinian Family Planning and Protection Association have partnered to develop and evaluate a contraceptive behavioural intervention for young women in Palestine delivered by mobile phone. The intervention was developed guided by behavioural science and consists of short, mobile phone text messages that contain information about contraception and behaviour change methods delivered over 4 months.
We will evaluate the intervention by conducting a randomised controlled trial. Five hundred and seventy women aged 18-24 years, who do not report using an effective method of contraception, will be allocated with a 1:1 ratio to receive the intervention text messages or control text messages about trial participation. The primary outcome is self-reported acceptability of at least one method of effective contraception at 4 months. Secondary outcomes include the use of effective contraception, acceptability of individual methods, discontinuation, service uptake, unintended pregnancy and abortion. Process outcomes include knowledge, perceived norms, personal agency and intervention dose received. Outcomes at 4 months will be compared between arms using logistic regression.
This trial will determine the effect of the intervention on young women's attitudes towards the most effective methods of contraception. If the intervention is found to be effective, the intervention will be implemented widely across Palestine. The results could also be used to design a larger trial to establish its effect on unintended pregnancy.
ClinicalTrials.gov, ID: NCT02905461 . Registered on 14 September 2016.
意外怀孕会对女性生活产生负面影响，且与妇女和儿童较差的健康结果相关。许多女性，尤其是低收入和中等收入国家的女性，在避免意外怀孕方面仍面临障碍。在巴勒斯坦国，2006年进行的一项调查估计，38%的怀孕属于意外怀孕。2014年，20至24岁年轻女性的避孕需求未得到满足的比例最高，为15%。手机越来越多地被用于提供健康支持。一旦开发出来，通过手机提供的干预措施往往比面对面支持的成本更低。伦敦卫生与热带医学院与巴勒斯坦计划生育与保护协会合作，开发并评估一种通过手机为巴勒斯坦年轻女性提供的避孕行为干预措施。该干预措施是在行为科学的指导下开发的，由简短的手机短信组成，其中包含有关避孕和行为改变方法的信息，为期4个月。
我们将通过进行一项随机对照试验来评估该干预措施。570名年龄在18至24岁之间、未报告使用有效避孕方法的女性将按1:1的比例分配，以接收关于试验参与的干预短信或对照短信。主要结局是在4个月时自我报告的至少一种有效避孕方法的可接受性。次要结局包括有效避孕方法的使用、个别方法的可接受性、停用、服务利用、意外怀孕和堕胎。过程结局包括知识、感知规范、个人能动性和收到的干预剂量。将使用逻辑回归比较两组在4个月时的结局。
这项试验将确定该干预措施对年轻女性对最有效避孕方法态度的影响。如果发现该干预措施有效，将在巴勒斯坦广泛实施。研究结果还可用于设计一项更大规模的试验，以确定其对意外怀孕的影响。
ClinicalTrials.gov，标识符：NCT02905461。于2016年9月14日注册。
