- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04598165
Mobile WACh NEO: Mobile Solutions for Neonatal Health and Maternal Support
Mobile WACh NEO Randomized Clinical Trial: Mobile Phone 2-Way Short Message Service (SMS) Versus Control to Reduce Neonatal Mortality in Kenya
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
High-impact essential newborn care practices and interventions are available to support neonatal survival, but coverage remains a challenge in sub-Saharan Africa, where neonatal mortality is unacceptably high. Many newborns continue to die at home without health care services being sought. The reasons are multifactorial, at the societal, health system, and family levels. Decisions made within the household and the family's ability to reach care play a large part in determining neonatal outcomes. It is estimated that up to 80% of neonatal and child deaths may have delays in recognition of infant illness and decision to seek care. Two-way mobile health (mHealth) communication strategies can enable mothers to remotely interact with a healthcare worker (HCW) and receive real-time education, counseling, encouragement, motivation and decisional guidance to support care-seeking decisions and ultimately neonatal health and survival.
The investigators developed a unique two-way SMS platform (Mobile WACh) that combines automated SMS messaging and dialogue with a HCW. The team adapted this approach for intensive neonatal support and evaluations (Mobile WACh NEO). Mobile WACh NEO (MWN) enhances the benefits of SMS messaging by engaging mothers with SMS communication and bringing timely information and support - asking critical questions at crucial times in order to assess the needs and health of newborns and assist in care seeking decisions.
This is a randomized controlled trial of the MWN intervention among 5,020 participants (2,510 MWN arm, 2,510 control arm) to determine the effect of MWN on neonatal mortality, essential newborn care, care seeking, and maternal mental health in the first 6 weeks postpartum.
Aim 1: To determine the effect of Mobile WACh NEO on neonatal mortality, compared to no SMS control.
Aim 2: To examine the effect of Mobile WACh NEO on maternal implementation of essential newborn care and care seeking behavior.
Aim 3: To examine the effects of Mobile WACh NEO on maternal social support, self-efficacy and depression.
Finally, investigators will explore the associations between maternal mental health, implementation of essential newborn care, neonatal care seeking and participant engagement by SMS.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Bondo, Kenya
- Bondo Sub-County Referral Hospital
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Homa Bay, Kenya
- Rachuonyo County Hospital
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Kisumu, Kenya
- Kisumu County Hospital
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Nairobi, Kenya
- Mathare North Health Centre
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Nairobi, Kenya
- Riruta Health Center
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Kisumu
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Ahero, Kisumu, Kenya
- Ahero Sub-District Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Pregnant
- 28-36 weeks gestation
- Daily access to a mobile phone (own or shared) on the Safaricom network
- Willing to receive SMS
- Able to read and respond to text messages in English, Kiswahili or Luo, or have someone in the household who can help
Exclusion Criteria:
- Currently enrolled in another research study
- Previous participant in the Mobile WACh NEO RCT (i.e. with a new pregnancy)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Interactive two-way SMS dialogue
Participants will receive automated SMS messages with prompts to reply.
They will have the ability to both respond to and initiate SMS dialogue.
Trained Study Nurses will monitor and respond to participant messages.
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We will utilize Mobile WACh, a human-computer hybrid system that enables seamless two-way SMS communication and patient tracking, to provide consistent support to women and their infants during the peripartum period and 6 weeks into the baby's life.
Women will receive automated theoretically grounded SMS messages targeting the appropriate peripartum period and will have the capability to respond and spontaneously message a nurse based at the clinic.
During pregnancy, automated SMS will be delivered weekly.
Two weeks prior to the participant's estimated due date (EDD), daily messaging will begin, and will continue for two weeks after delivery is ascertained.
Thereafter, SMS will be delivered every other day for the remaining four weeks.
Women who experience pregnancy or infant loss will be enrolled into an infant loss track where they will receive messages of support.
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No Intervention: No SMS Control
Control receiving standard of care.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Neonatal mortality
Time Frame: 28 days postpartum
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Death during 1st 28 days of life
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28 days postpartum
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cord care
Time Frame: 2-weeks postpartum
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Number of participants with no application of substances to cord
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2-weeks postpartum
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Early neonatal mortality
Time Frame: 7 days postpartum
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Death during 1st 7 days of life
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7 days postpartum
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Initiation of early breastfeeding
Time Frame: 1 hour postpartum
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Number of participants initiating breastfeeding in 1st hour of life
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1 hour postpartum
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Exclusive breastfeeding
Time Frame: 6-weeks postpartum
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Cessation of exclusive breastfeeding in 1st 6 weeks of life
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6-weeks postpartum
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Thermal care
Time Frame: 24 hours postpartum
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Number of participants giving infant a bath in 1st 24 hours of life
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24 hours postpartum
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Home provision of Kangaroo Mother Care
Time Frame: 14 days at home postpartum
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Number of participants providing any duration of skin-to-skin care on ≥10 of the first 14 days at home, among low birthweight or preterm infants
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14 days at home postpartum
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Maternal knowledge of neonatal danger signs
Time Frame: 6-weeks postpartum
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Number of danger signs or symptoms successfully named
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6-weeks postpartum
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Depression
Time Frame: Enrollment through 6-weeks postpartum
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Score above diagnostic threshold (>=13) for Edinburgh Postnatal Depression Scale.
Possible scores are 0-30, with a higher score indicating a higher likelihood of possible depressive illness.
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Enrollment through 6-weeks postpartum
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Social support
Time Frame: Enrollment through 6-weeks postpartum
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Score using Medical Outcomes Study (MOS) Social Support Survey.
Possible scores are 0-100, with a higher score indicating higher levels of social support.
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Enrollment through 6-weeks postpartum
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Self-efficacy
Time Frame: Enrollment through 6-weeks postpartum
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Score using the Karitane Parenting Confidence Scale.
Possible scores are 0-45, with higher scores indicating higher levels of parenting confidence.
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Enrollment through 6-weeks postpartum
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Appropriate care-seeking
Time Frame: 18 weeks postpartum
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Proportion of illness episodes with danger signs in which the clinic was attended and/or where the infant was hospitalized irrespective of danger signs reported in 1st 18 weeks of life (study follow-up period).
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18 weeks postpartum
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Jennifer A Unger, MD, MPH, Brown University
- Study Director: John Kinuthia, MBChB, MMed, Kenyatta National Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY00006395
- 1R01HD098105-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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