Nkabane-Nkholongo Elizabeth, Mpata Mokgatle Mathildah, Bickmore Timothy, Julce Clevanne, Thompson David, Jack Brian W
School of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA.
BMC Glob Public Health. 2024 Sep 5;2(1):60. doi: 10.1186/s44263-024-00091-0.
Young women worldwide face problems like unwanted pregnancy and sexually transmitted infections. Providing sexual and reproductive health education to young women in low- and middle-income countries is a priority. It is unknown if using digital health interventions to deliver health education is effective in resource-constrained settings.
We conducted an interventional trial among young women in the low-middle-income country of Lesotho to test the impact of the conversational agent system ("Nthabi") designed to deliver sexual and reproductive health information on either a smartphone or tablet for up to 6 weeks. We measured participant's knowledge before and after the discussion of family planning, folic acid use, and healthy eating. The main outcome measure was a change in knowledge among participants in these three topic areas. The number of correct pre- and post-test responses was compared using generalized linear models that directly estimated the proportions and percentages of correct responses.
We recruited 172 young women (mean age 22.5 years, 91% unmarried, 69% completed high school, 23% unemployed, 66% students) to use Nthabi on a mobile phone (11.6%) or loaned tablet device (88.4%). The mean number of interactions with Nthabi was 8.6. Family planning was chosen to be discussed by 82 of the 172 participants (52.2%), and of those, 49 (31.2%) completed the content on this topic, and 26 (16.6) completed the post-test. For the 11 questions about family planning, the total percent of correct responses increased from 85.5% (796 total responses) on the pre-test to 89.9% (320 responses) on the post-test (p = 0.0233). Folic acid use was chosen to be discussed by 74 (47.1%) of 172 participants, and of those, 27 (17.7%) completed the content on this topic, and all 27 (17.7%) completed the post-test. For the 5 questions about folic acid use, the total percent of correct responses was 45.3% (181 total responses) on the pre-test and 71.6% (111 responses) on the post-test (p < 0.0001).
The Nthabi conversational agent system increased knowledge of family planning methods and folic acid use among young women in Lesotho. Digital health interventions like Nthabi have the potential to offer new ways to deliver reproductive health information.
ClinicalTrials.gov registration April 20, 2020; ID: NCT04354168 .
世界各地的年轻女性面临意外怀孕和性传播感染等问题。为低收入和中等收入国家的年轻女性提供性与生殖健康教育是一项优先事项。在资源有限的环境中，利用数字健康干预措施提供健康教育是否有效尚不清楚。
我们在低收入和中等收入国家莱索托的年轻女性中进行了一项干预试验，以测试旨在通过智能手机或平板电脑提供长达6周性与生殖健康信息的对话代理系统（“恩塔比”）的影响。我们在讨论计划生育、叶酸使用和健康饮食之前和之后测量了参与者的知识水平。主要结局指标是这三个主题领域参与者知识的变化。使用直接估计正确回答比例和百分比的广义线性模型比较测试前后正确回答的数量。
我们招募了172名年轻女性（平均年龄22.5岁，91%未婚，69%完成高中学业，23%失业，66%是学生），让她们在手机（11.6%）或借用的平板电脑设备（88.4%）上使用恩塔比。与恩塔比的平均互动次数为8.6次。172名参与者中有82人（52.2%）选择讨论计划生育，其中49人（31.2%）完成了该主题的内容，26人（16.6%）完成了测试后评估。对于11个关于计划生育的问题，正确回答的总百分比从测试前的85.5%（共796个回答）增加到测试后的89.9%（320个回答）（p = 0.0233）。172名参与者中有74人（47.1%）选择讨论叶酸使用，其中27人（17.7%）完成了该主题的内容，所有27人（17.7%）完成了测试后评估。对于5个关于叶酸使用的问题，正确回答的总百分比在测试前为45.3%（共181个回答），在测试后为71.6%（111个回答）（p < 0.0001）。
恩塔比对话代理系统增加了莱索托年轻女性对计划生育方法和叶酸使用的知识。像恩塔比这样的数字健康干预措施有可能提供传递生殖健康信息的新方式。
ClinicalTrials.gov于2020年4月20日注册；标识符：NCT04354168 。
