El Ayadi Alison M, Diamond-Smith Nadia G, Duggal Mona, Singh Pushpendra, Sharma Preetika, Kaur Jasmeet, Gopalakrishnan Lakshmi, Gill Navneet, Verma Garima Singh, Ahuja Alka, Kumar Vijay, Weil Laura, Bagga Rashmi
University of California, San Francisco, San Francisco, USA.
Postgraduate Institute of Medical Education & Research, Chandigarh, India.
BMC Pregnancy Childbirth. 2025 Mar 5;25(1):239. doi: 10.1186/s12884-025-07310-y.
Significant disruptions in the perinatal continuum of care occur postpartum in India, despite it being a critical time to optimize maternal health and wellbeing. Group-oriented mHealth approaches may help mitigate the impact of limited access to care and the lack of social support that characterize this period. Our team developed and pilot tested a provider-moderated group intervention to increase education, communication with providers, to refer participants to in-person care, and to connect them with a virtual social support group of other mothers with similarly aged infants through weekly calls and text chat.
We analyzed the preliminary effectiveness of the pilot intervention on maternal health knowledge through 6 months postpartum among 135 participants in Punjab, India who responded to baseline and endline surveys. We described change in knowledge of maternal danger signs, birth preparedness, postpartum care use, postpartum physical and mental health, and family planning use over time between individuals in group call (synchronous), other intervention (asynchronous), and control groups.
Participant knowledge regarding danger signs was low overall regarding pregnancy, childbirth and the postpartum period (mean range of 1.13 to 2.05 at baseline and 0.79 to 2.10 at endline). Synchronous participants had a significantly higher increase over time in knowledge of danger signs than asynchronous and control group participants. Birth preparedness knowledge ranged from mean 0.89-1.20 at baseline to 1.31-2.07 at follow-up, with synchronous participants having significantly greater increases in comparison to the control group. Synchronous participants had nearly three-fold increased odds of postpartum health check with a clinical provider than asynchronous participants (OR 2.88, 95% CI 1.07-7.74). No differences were noted in postpartum depressive and anxiety symptoms.
Preliminary effectiveness results are promising, yet further robust testing of the MeSSSSage intervention effectiveness is needed. Further development of strategies to support health knowledge and behaviors and overcoming barriers to postpartum care access can improve maternal health among this population.
在印度，围产期连续护理在产后出现了严重中断，尽管这是优化孕产妇健康和福祉的关键时期。以群体为导向的移动健康方法可能有助于减轻获得护理机会有限以及这一时期缺乏社会支持所带来的影响。我们的团队开发并进行了试点测试，开展了一项由提供者主持的群体干预措施，以增加教育、与提供者的沟通、将参与者转介至面对面护理，并通过每周通话和文本聊天将她们与其他有同龄婴儿的母亲组成的虚拟社会支持群体联系起来。
我们分析了印度旁遮普邦135名参与基线和终线调查的参与者在产后6个月内，该试点干预措施对孕产妇健康知识的初步有效性。我们描述了群体通话（同步）、其他干预（异步）和对照组个体之间，孕产妇危险信号、分娩准备、产后护理使用、产后身心健康以及计划生育使用等方面的知识随时间的变化情况。
参与者对妊娠、分娩和产后时期危险信号的总体了解程度较低（基线时平均范围为1.13至2.05，终线时为0.79至2.10）。随着时间的推移，同步参与的参与者在危险信号知识方面的增加幅度明显高于异步和对照组参与者。分娩准备知识从基线时的平均0.89 - 1.20增加到随访时的1.31 - 2.07，与对照组相比，同步参与的参与者增加幅度显著更大。与异步参与者相比，同步参与的参与者产后接受临床提供者健康检查的几率增加了近三倍（比值比2.88，95%置信区间1.07 - 7.74）。产后抑郁和焦虑症状方面未发现差异。
初步有效性结果令人鼓舞，但仍需要对MeSSSSage干预措施的有效性进行更有力的测试。进一步制定支持健康知识和行为的策略以及克服产后护理获取障碍，可以改善这一人群的孕产妇健康状况。
