Evaluating the Feasibility, Acceptability, and Preliminary Efficacy of SupportMoms-Uganda, an mHealth-Based Patient-Centered Social Support Intervention to Improve the Use of Maternity Services Among Pregnant Women in Rural Southwestern Uganda: Randomized Controlled Trial

• DOI: 10.2196/36619
• Publication Date: 2022-09-30T11:51:41Z
• Authors: Esther C Atukunda; Mark J Siedner; Celestino Obua; Angella Musiimenta; Norma C Ware; Samuel Mugisha; Josephine N Najjuma; Godfrey R Mugyenyi; Lynn T Matthews
• Keywords: mHealth; Short Message Service; Attendance; Text message

SMS text messaging and other mobile health (mHealth) interventions may improve knowledge transfer, strengthen access to social support (SS), promote positive behaviors among women in the perinatal period. However, few mHealth apps have been taken scale sub-Saharan Africa.We evaluated feasibility, acceptability, preliminary efficacy of a novel, mHealth-based, patient-centered app designed using behavioral science frameworks maternity service use pregnant Uganda.We performed pilot randomized controlled trial between August 2020 May 2021 at referral hospital Southwestern Uganda. We included 120 adult enrolled 1:1:1 ratio receive routine antenatal care (ANC; control), scheduled or audio messages from novel prototype (scheduled [SM]), SM plus reminders 2 participant-identified supporters (SS). Participants completed face-to-face surveys enrollment postpartum The primary outcomes were feasibility acceptability prototype. Other ANC attendance, skilled delivery, SS. conducted qualitative exit interviews with 15 each intervention arm explore mechanisms. Quantitative data analyzed STATA NVivo, respectively.More than 85% 75% participants received ≥85% intended voice calls, respectively. More within 1 hour expected time; 18% (7/40) experienced network issues for both groups. Over 90% (36/40) found this useful, easy use, engaging, compatible strongly recommended it others; 70% (28/40), 78% (31/40), 98% (39/40; P=.04) control, SM, SS arms, respectively, had delivery. Half (20/40), 83% (33/40), all (40/40; P=.001) arms attended ≥4 visits, Women reported highest (median 3.4, IQR 2.8-3.6; P=.02); <20% (8/40; P=.002) missed any visit owing lack transportation. Qualitative showed that liked app; they able comprehend delivery benefits easily share discuss tailored information their significant others, who turn committed providing them needed prepare seek help.We demonstrated developing leverages networks relationships is feasible, acceptable, useful approach communicate important targeted health-related rural Uganda available services. Further evaluation maternal-fetal integration into needed.ClinicalTrials.gov NCT04313348; https://clinicaltrials.gov/ct2/show/NCT04313348.