基于手机短信的信息框架干预对提高埃塞俄比亚吉马地区农村产妇卫生服务利用率和新生儿护理实践效果的研究：一项集群随机对照试验方案。

Effectiveness of a Mobile Phone Messaging-Based Message Framing Intervention for Improving Maternal Health Service Uptake and Newborn Care Practice in Rural Jimma Zone, Ethiopia: Protocol for a Cluster Randomized Controlled Trial.

机构信息

Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, Jimma, Ethiopia.

Department of Technology Systems, University of Oslo, Oslo, Norway.

出版信息

JMIR Res Protoc. 2024 Jul 23;13:e52395. doi: 10.2196/52395.

DOI:10.2196/52395

PMID:39042451

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11303884/

Abstract

BACKGROUND

Ethiopia has high rates of maternal and neonatal mortality. In 2019 and 2020, the maternal and newborn mortality rates were estimated at 412 per 1,000,000 births and 30 per 10,000 births, respectively. While mobile health interventions to improve maternal and neonatal health management have shown promising results, there are still insufficient scientific studies to assess the effectiveness of mobile phone messaging-based message framing for maternal and newborn health.

OBJECTIVE

This research aims to examine the effectiveness of mobile phone messaging-based message framing for improving the use of maternal and newborn health services in the Jimma Zone, Ethiopia.

METHODS

A 3-arm cluster-randomized trial design was used to evaluate the effects of mobile phone-based intervention on maternal and newborn health service usage. The trial arms were (1) gain-framed messages (2) loss-framed messages, and (3) usual care. A total of 21 health posts were randomized, and 588 pregnant women who had a gestational age of 16-20 weeks, irrespective of their antenatal care status, were randomly assigned to the trial arms. The intervention consisted of a series of messages dispatched from the date of enrolment until 6-8 months. The control group received existing care without messages. The primary outcomes were maternal health service usage and newborn care practice, while knowledge, attitude, self-efficacy, iron supplementation, and neonatal and maternal morbidity were secondary outcomes. The outcomes will be analyzed using a generalized linear mixed model and the findings will be reported according to the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth) statement for randomized controlled trials.

RESULTS

Recruitment of participants was conducted and the baseline survey was administered in March 2023. The intervention was rolled out from May 2023 till December 2023. The end-line assessment was conducted in February 2024.

CONCLUSIONS

This trial was carried out to understand how mobile phone-based messaging can improve maternal and newborn health service usage. It provides evidence for policy guidelines around mobile health strategies to improve maternal and newborn health.

TRIAL REGISTRATION

Pan African Clinical Trials Registry PACTR202201753436676; https://tinyurl.com/ykhnpc49.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52395.

摘要

背景

埃塞俄比亚的母婴死亡率很高。2019 年和 2020 年，母婴死亡率估计分别为每 100 万活产儿 412 例和每 10000 例活产儿 30 例。虽然移动医疗干预措施在改善母婴健康管理方面显示出了良好的效果，但仍缺乏科学研究来评估基于手机短信的消息框架对母婴健康的有效性。

目的

本研究旨在评估基于手机短信的消息框架对改善埃塞俄比亚吉马地区母婴健康服务使用的效果。

方法

采用 3 臂整群随机试验设计评估基于手机的干预对母婴健康服务使用的影响。试验组分别为（1）增益框架消息组，（2）损失框架消息组和（3）常规护理组。共有 21 个卫生所被随机分组，随机分配给试验组的 588 名孕妇的妊娠年龄为 16-20 周，不论其产前保健状况如何。干预措施包括从入组日期至 6-8 个月发送的一系列消息。对照组接受现有的护理而不发送消息。主要结局是母婴健康服务的使用和新生儿护理实践，知识、态度、自我效能、铁补充剂以及新生儿和产妇发病率是次要结局。使用广义线性混合模型分析结果，并根据 CONSORT-EHEALTH（电子和移动健康应用及在线远程医疗试验的报告标准）声明报告随机对照试验的结果。