The Impact of Prenatal Short Messages (SMS) on Maternal and Newborn Health (SMS)

April 6, 2016 updated by: Yanfang Su, Harvard School of Public Health (HSPH)

The Impact of Prenatal Short Messages on Maternal and Newborn Health

It is hypothesized that delivering short messages (SMS) to pregnant women can improve maternal and newborn health outcomes. This pilot offers mothers-to-be in rural China free daily short messages (SMS) via cell phone. The aim is to advise them on (a) good household prenatal practices (GHPP) and (b) care seeking (CS) in order to improve the quality of life for mothers and newborns.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Factorial quasi-randomization is utilized to compare two groups of interventions (i.e., GHPP and CS) as well as to compare these individual interventions with a combination of the interventions. It is also possible that distinct treatments have interaction effects, and we plan to test for this. Policymakers are interested in using different strategies to enhance neonatal health. For example, the bank of SMS developed by our team is a combination of several components: reminders for regular checkups, information on GHPP, and information on CS. From a policy perspective, the evaluation of the full bank of SMS may be sufficient for the government to decide whether or not to scale up the full bank of SMS. However, to understand maternal behavior and, for policy purposes, to understand which components in the bank of SMS should be scaled up, it is important to disentangle which component contributes most to final neonatal health. Taken together, are all the components of the bank of SMS effective in changing maternal behavior and enhancing neonatal health? Which mechanisms are at play, good household prenatal care, care seeking in pregnancy, or both?

Study Type

Interventional

Enrollment (Actual)

4467

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Shaanxi
      • Xi'an, Shaanxi, China, 710049
        • Xi'an Jiaotong University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

There were two inclusion criteria: Local pregnant women must 1) own a cell phone in the household, and 2) visit a MCHC for antenatal care during pregnancy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Good household prenatal practice (GHPP)
The GHPP arm receives SMS messages regarding knowledge on nutrition, labor, non-medical pain management, breastfeeding, and depression. This arm also receives messages delivered to the control group.
Behavioral: Good household prenatal practice
Knowledge on nutrition, labor, non-medical pain management, breastfeeding and depression
Experimental: Care seeking (CS)
The CS arm receives SMS messages which include danger-sign recognition and reminders for government-subsidized projects. This arm also receives messages delivered to the control group.
Behavioral: Care seeking
  • Danger-sign recognition
  • Reminders for government projects
Experimental: Full bank of SMS
This arm receives the SMS messages delivered to the GHPP, CS and control group.
Behavioral: Full bank of SMS
  • Danger-sign recognition
  • Reminders for government projects
  • Knowledge on nutrition, labor, non-medical pain management, breastfeeding and depression
No Intervention: Control

Control group receives SMS messages regarding:

  • Reminders of prenatal visits and certified skilled attendance of labor (status quo);
  • Fetal development in different gestational stages.

The three experimental groups receive the control messages as well.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Newborn health
Time Frame: the first month after birth
Newborn health is measured by appropriateness of weight for gestational age.
the first month after birth

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Neonatal Adverse Outcome Indicator (NAOI)
Time Frame: the first month after birth
The NAOI focuses on measuring severe neonatal morbidity.
the first month after birth
Actual number of prenatal visits over expected visits
Time Frame: In the duration of pregnancy, an expected average of 9 months
In the duration of pregnancy, an expected average of 9 months
Uptake of government-subsidized programs
Time Frame: In the duration of pregnancy, an expected average of 9 months, and 1 month after birth

This outcome is measured by the following metrics:

  1. Duration of folic acid
  2. Uptake of infant vaccinations
In the duration of pregnancy, an expected average of 9 months, and 1 month after birth
C-section rate
Time Frame: child birth
child birth
Maternal health
Time Frame: Child birth and 1 year after birth
Maternal health is measured by change of perception in general health and postpartum depression.
Child birth and 1 year after birth
Near-miss
Time Frame: In the duration of pregnancy, an expected average of 9 months, and childbirth
The near-miss focuses on measuring severe maternal morbidity.
In the duration of pregnancy, an expected average of 9 months, and childbirth
Psychological outcomes
Time Frame: In the duration of pregnancy, an expected average of 9 months
Attitudes, personal norms, self-efficacy, social desirability, intentions, plans, susceptibility, expectations, and severity
In the duration of pregnancy, an expected average of 9 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Harvard School of Public Health (HSPH)

Collaborators

Health Science Center of Xi'an Jiaotong University

Investigators

  • Principal Investigator: Yanfang Su, MA, Harvard School of Public Health (HSPH)
  • Principal Investigator: Zhongliang Zhou, PhD, Health Science Center of Xi'an Jiaotong University
  • Principal Investigator: Changzheng Yuan, MS, Harvard School of Public Health (HSPH)
  • Principal Investigator: Jesse Heitner, MPP, Harvard School of Public Health (HSPH)
  • Principal Investigator: Benjamin Campbell, BA, Dartmouth College

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2013

Primary Completion (Actual)

October 1, 2015

Study Completion (Actual)

March 1, 2016

Study Registration Dates

First Submitted

January 14, 2014

First Submitted That Met QC Criteria

January 14, 2014

First Posted (Estimate)

January 15, 2014

Study Record Updates

Last Update Posted (Estimate)

April 7, 2016

Last Update Submitted That Met QC Criteria

April 6, 2016

Last Verified

April 1, 2016

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • newborn2013

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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