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Effectiveness of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda: a randomized controlled trial.

作者信息

Nuwamanya Elly, Nalwanga Robinah, Nuwasiima Afra, Babigumira Janet U, Asiimwe Francis T, Babigumira Joseph B, Ngambouk Vitalis P

机构信息

GHE Consulting, P.O Box 27011, Kampala, Uganda.

Department of Community Medicine and Public Health, Sahlgrenska Academy, University of Gothenburg, P. O Box 414, 40530, Gothenburg, Sweden.

出版信息

Contracept Reprod Med. 2020 Oct 31;5(1):31. doi: 10.1186/s40834-020-00134-5.


DOI:10.1186/s40834-020-00134-5
PMID:33292724
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7603751/
Abstract

BACKGROUND: University students are one of the most vulnerable groups to sexual reproductive health [SRH] threats like sexually transmitted infections [STIs], unwanted pregnancies, and unsafe abortions and often have limited access to SRH information, goods, and services. This study assessed the effectiveness of using a mobile phone application (APP) to increase access to SRH information, goods, and services among university students in Uganda. METHODS: Using data from a double-blinded randomized controlled trial, participants were randomly assigned to both the intervention (APP) and control (standard of care) arms. We executed descriptive analyses for baseline demographic characteristics by intervention, difference in difference (DID), and quantile regression analyses for both primary and secondary outcomes. RESULTS: The median age of participants was 21 years of age, and the majority were female (over 60%), unemployed (over 85%) and Christian (90%). Over 50% were resident in off-campus hostels and in a relationship. Between baseline and end-line, there was a significant increase in SRH knowledge score (DID = 2, P < 0.001), contraceptive use (DID = 6.6%, P < 0.001), HIV Voluntary testing and counselling (DID = 17.2%, P < 0.001), STI diagnosis and treatment (DID = 12.9%, P < 0.001), and condom use at last sex (DID = 4%,P = 0.02) among students who used the APP. There was a significant 0.98 unit increase in knowledge score (adjusted coefficient = 0.98, P < 0.001), a significant 1.6-fold increase in odds of contraceptive use (adjusted coefficient = 1.6, P = 0.04), a significant 3.5-fold increase in HIV VCT (adjusted coefficient = 3.5, P < 0.001), and a significant 2-fold increase in odds of STI testing and treatment (adjusted coefficient = 1.9, P < 0.001) after adjusting for demographic characteristics among APP users compared to the control group. CONCLUSION: A mobile phone application increased sexual and reproductive health information (knowledge score), access to goods (contraceptives), and services (HIV voluntary testing and counseling and sexually transmitted infection diagnosis and management) among sexually active university students in Uganda. Further technical development, including the refinement of youth-friendly attributes, extending access to the app with other platforms besides android which was pilot tested, as well as further research into potential economic impact and paths to sustainability, is needed before the app is deployed to the general youth population in Uganda and other low-income settings. TRIAL REGISTRATION: MUREC1/7 No. 07/05-18. Registered on June 29, 2018.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7677/7603751/7dda1a35e4ed/40834_2020_134_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7677/7603751/7dda1a35e4ed/40834_2020_134_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7677/7603751/7dda1a35e4ed/40834_2020_134_Fig1_HTML.jpg

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Effectiveness of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda: a randomized controlled trial.

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[5]
Mobile phone-based interventions for improving contraception use.

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[7]
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本文引用的文献

[1]
Prevalence and predictors of contraceptive use among women of reproductive age in 17 sub-Saharan African countries: A large population-based study.

Sex Reprod Healthc. 2019-6-10

[2]
Health workers' experiences with the Safe Delivery App in West Wollega Zone, Ethiopia: a qualitative study.

Reprod Health. 2019-5-9

[3]
Mobile Technology for Community Health in Ghana: Is Maternal Messaging and Provider Use of Technology Cost-Effective in Improving Maternal and Child Health Outcomes at Scale?

J Med Internet Res. 2019-2-13

[4]
Study protocol: using a mobile phone-based application to increase awareness and uptake of sexual and reproductive health services among the youth in Uganda. A randomized controlled trial.

Reprod Health. 2018-12-22

[5]
Prevalence and determinants of adolescent pregnancy in Africa: a systematic review and Meta-analysis.

Reprod Health. 2018-11-29

[6]
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BMC Med Inform Decis Mak. 2018-11-12

[7]
Impact of smartphone-assisted prenatal home visits on women's use of facility delivery: Results from a cluster-randomized trial in rural Tanzania.

PLoS One. 2018-6-18

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Int Perspect Sex Reprod Health. 2017-9-1

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Methods Inf Med. 2017-8-8

[10]
Barriers and opportunities to implementation of sustainable e-Health programmes in Uganda: A literature review.

Afr J Prim Health Care Fam Med. 2017-5-29

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