Division for Health Services, Global Health Cluster, Norwegian Institute of Public Health, Oslo, Norway.
Center for Intervention Science in Maternal and Child Health, University of Bergen, Bergen, Norway.
PLoS One. 2021 Apr 23;16(4):e0249713. doi: 10.1371/journal.pone.0249713. eCollection 2021.
The eRegCom cluster randomized controlled trial assesses the effectiveness of targeted client communication (TCC) via short message service (SMS) to pregnant women, from a digital maternal and child health registry (eRegistry) in Palestine, on improving attendance and quality of care. In this paper, we assess whether this TCC intervention could also have unintended consequences on pregnant women's worries, and their satisfaction with antenatal care (ANC).
We interviewed a sub-sample of Arabic-speaking women attending ANC at public primary healthcare clinics, randomized to either the TCC intervention or no TCC (control) in the eRegCom trial, who were in 38 weeks of gestation and had a phone number registered in the eRegistry. Trained female data collectors interviewed women by phone from 67 intervention and 64 control clusters, after securing informed oral consent. The Arabic interview guide, pilot-tested prior to the data collection, included close-ended questions to capture the woman's socio-demographic status, agreement questions about their satisfaction with ANC services, and the 13-item Cambridge Worry Scale (CWS). We employed a non-inferiority study design and an intention-to-treat analysis approach.
A total of 454 women, 239 from the TCC intervention and 215 from the control arm participated in this sub-study. The mean and standard deviation of the CWS were 1.8 (1.9) for the intervention and 2.0 (1.9) for the control arm. The difference in mean between the intervention and control arms was -0.16 (95% CI: -0.31 to -0.01) after adjusting for clustering, which was below the predefined non-inferiority margin of 0.3. Women in both groups were equally satisfied with the ANC services they received.
The TCC intervention via SMS did not increase pregnancy-related worries among recipients. There was no difference in women's satisfaction with the ANC services between intervention and control arms.
eRegCom 整群随机对照试验评估了通过短信服务（SMS）向巴勒斯坦数字母婴健康登记处（eRegistry）中的孕妇进行有针对性的客户沟通（TCC），对改善就诊率和护理质量的有效性。在本文中，我们评估了这种 TCC 干预是否也会对孕妇的担忧以及她们对产前护理（ANC）的满意度产生意外影响。
我们对参加公共初级保健诊所 ANC 的阿拉伯语孕妇进行了一项亚组抽样调查，这些孕妇是在 eRegCom 试验中被随机分配到 TCC 干预组或无 TCC 对照组（对照组），妊娠 38 周，并且在 eRegistry 中注册了电话号码。经过知情口头同意后，由经过培训的女性数据收集员通过电话对来自 67 个干预组和 64 个对照组的女性进行了访谈。在数据收集之前，使用阿拉伯语访谈指南进行了试点测试，该指南包括封闭式问题以获取妇女的社会人口统计学状况，关于对 ANC 服务满意度的同意问题，以及 13 项剑桥担忧量表（CWS）。我们采用非劣效性研究设计和意向治疗分析方法。
共有 454 名妇女参加了这项子研究，其中 239 名来自 TCC 干预组，215 名来自对照组。干预组和对照组的 CWS 均值和标准差分别为 1.8（1.9）和 2.0（1.9）。调整聚类后，干预组和对照组之间的平均差异为-0.16（95%CI：-0.31 至-0.01），低于预设的非劣效性边界 0.3。两组妇女对所接受的 ANC 服务均同样满意。
通过短信的 TCC 干预并未增加接受者的妊娠相关担忧。干预组和对照组妇女对 ANC 服务的满意度没有差异。
