Smith Chris, Ly Sokhey, Uk Vannak, Warnock Ruby, Edwards Phil, Free Caroline
Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK.
Room 150, Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK.
Contracept Reprod Med. 2017 May 1;2:16. doi: 10.1186/s40834-017-0043-8. eCollection 2017.
The MObile Technology for Improved Family Planning (MOTIF) trial assessed a mobile phone-based intervention comprising voice messages and counsellor support to increase post-abortion contraception at four Marie Stopes International clinics in Cambodia. The aim of this process evaluation was to assess participants' interaction with the intervention from a service provider perspective.
(1) We conducted a descriptive analysis to assess participants' interaction with the intervention. (2) In order to explore how the intervention might work, we assessed associations between interaction with the intervention and contraception use using logistic regression analysis. (3) We undertook a logistic regression analysis to assess associations between baseline socio-demographic factors and requesting to speak to a counsellor (pressing '1'), a variable found to be associated with contraception use.
Amongst 249 women that received six interactive voice messages +/- counsellor support for contraception, around half actively requested to speak to a counsellor (pressed '1') and over 90% spoke to a counsellor at some stage. Women who spoke to the counsellor having requested to (by pressing '1') were more than four times as likely to be using effective contraception at four months compared to women who didn't request or speak to the counsellor (Odds Ratio 4.39; 95% CI: 1.15-16.71). There was a small, non-statistically significant increase in contraception use amongst women that spoke to the counsellor without requesting a call. Increased parity, a history of >2 previous induced abortions, lower socio-economic status, and medical abortion (after adjusting for age, socio-economic status and residence) were associated with requesting to speak to a counsellor.
The interactive message can identify a subgroup of women in whom counselling will be more effective and appears to be equitable in terms of engaging those most in-need. The intervention could be adapted based on the findings of this study.
改善计划生育的移动技术（MOTIF）试验评估了一种基于手机的干预措施，该措施包括语音信息和咨询员支持，以提高柬埔寨四家玛丽斯特普国际诊所的流产后避孕率。本过程评估的目的是从服务提供者的角度评估参与者与干预措施的互动情况。
（1）我们进行了描述性分析，以评估参与者与干预措施的互动情况。（2）为了探究干预措施可能的作用方式，我们使用逻辑回归分析评估了与干预措施的互动和避孕措施使用之间的关联。（3）我们进行了逻辑回归分析，以评估基线社会人口学因素与要求与咨询员通话（按“1”）之间的关联，该变量被发现与避孕措施的使用有关。
在249名收到六条避孕互动语音信息及咨询员支持的女性中，约一半的人主动要求与咨询员通话（按“1”），超过90%的人在某个阶段与咨询员进行了交谈。与未要求或未与咨询员交谈的女性相比，主动要求（按“1”）并与咨询员交谈的女性在四个月时使用有效避孕措施的可能性高出四倍多（优势比4.39；95%置信区间：1.15 - 16.71）。在未要求通话但与咨询员交谈的女性中，避孕措施的使用有小幅增加，但无统计学意义。经调整年龄。社会经济地位和居住地后，多胎、既往人工流产>2次、社会经济地位较低以及药物流产与要求与咨询员通话有关。
互动信息可以识别出咨询效果更佳的女性亚组，并且在吸引最有需求的人群方面似乎是公平的。可根据本研究结果对干预措施进行调整。
