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Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study.
BMC Medical Informatics and Decision Making ( IF 3.5 ) Pub Date : 2020-01-06 , DOI: 10.1186/s12911-019-1002-x
Binyam Bogale 1, 2 , Kjersti Mørkrid 1 , Brian O'Donnell 1 , Buthaina Ghanem 3 , Itimad Abu Ward 3 , Khadija Abu Khader 3 , Mervett Isbeih 3 , Michael Frost 4 , Mohammad Baniode 3 , Taghreed Hijaz 5 , Tamara Awwad 3 , Yousef Rabah 3 , J Frederik Frøen 1, 2
Affiliation  

BACKGROUND Targeted client communication (TCC) using text messages can inform, motivate and remind pregnant and postpartum women of timely utilization of care. The mixed results of the effectiveness of TCC interventions points to the importance of theory based interventions that are co-design with users. The aim of this paper is to describe the planning, development, and evaluation of a theory led TCC intervention, tailored to pregnant and postpartum women and automated from the Palestinian electronic maternal and child health registry. METHODS We used the Health Belief Model to develop interview guides to explore women's perceptions of antenatal care (ANC), with a focus on high-risk pregnancy conditions (anemia, hypertensive disorders in pregnancy, gestational diabetes mellitus, and fetal growth restriction), and untimely ANC attendance, issues predefined by a national expert panel as being of high interest. We performed 18 in-depth interviews with women, and eight with healthcare providers in public primary healthcare clinics in the West Bank and Gaza. Grounding on the results of the in-depth interviews, we used concepts from the Model of Actionable Feedback, social nudging and Enhanced Active Choice to compose the TCC content to be sent as text messages. We assessed the acceptability and understandability of the draft text messages through unstructured interviews with local health promotion experts, healthcare providers, and pregnant women. RESULTS We found low awareness of the importance of timely attendance to ANC, and the benefits of ANC for pregnancy outcomes. We identified knowledge gaps and beliefs in the domains of low awareness of susceptibility to, and severity of, anemia, hypertension, and diabetes complications in pregnancy. To increase the utilization of ANC and bridge the identified gaps, we iteratively composed actionable text messages with users, using recommended message framing models. We developed algorithms to trigger tailored text messages with higher intensity for women with a higher risk profile documented in the electronic health registry. CONCLUSIONS We developed an optimized TCC intervention underpinned by behavior change theory and concepts, and co-designed with users following an iterative process. The electronic maternal and child health registry can serve as a unique platform for TCC interventions using text messages.

中文翻译:

使用电子孕产妇和儿童健康登记册为妇女开发有针对性的客户沟通干预措施:定性研究。

背景技术使用文本消息的目标客户通信(TCC)可以通知,激励和提醒孕妇和产后妇女及时利用护理。TCC干预效果的好坏参半表明与用户共同设计基于理论的干预的重要性。本文的目的是描述针对孕妇和产后妇女量身定制的,由巴勒斯坦电子母婴健康登记系统自动完成的,由理论主导的TCC干预的规划,开发和评估。方法我们使用健康信念模型来开发访谈指南,以探讨妇女对产前保健(ANC)的看法,重点是高危妊娠状况(贫血,妊娠高血压疾病,妊娠糖尿病和胎儿生长受限),以及ANC出席不及时,由国家专家小组预定义为引起高度关注的问题。我们对妇女进行了18次深度访谈,对约旦河西岸和加沙地带的公共初级卫生保健诊所的卫生保健提供者进行了八次采访。基于深入访谈的结果,我们使用了可行反馈模型,社交活动和增强型主动选择模型中的概念来构成将TCC内容作为文本消息发送的内容。我们通过与当地健康促进专家,医疗保健提供者和孕妇进行的非结构化访谈,评估了文本消息草案的可接受性和可理解性。结果我们发现对及时参加ANC的重要性以及ANC对妊娠结局的益处的认识不足。我们在对易感性和严重性的了解不足的领域中确定了知识差距和信念 贫血,高血压和糖尿病合并症。为了提高ANC的利用率并弥合已发现的差距,我们使用建议的消息框架模型与用户迭代地组成了可操作的文本消息。我们开发了算法,以针对电子健康注册表中记录的具有较高风险特征的女性触发定制强度更高的短信。结论我们以行为改变理论和概念为基础,开发了一种优化的TCC干预措施,并根据迭代过程与用户进行了共同设计。母婴健康电子注册表可以用作使用文本消息进行TCC干预的独特平台。我们使用推荐的消息框架模型与用户迭代地组成了可操作的文本消息。我们开发了算法,以针对电子健康注册表中记录的具有较高风险特征的女性触发定制强度更高的短信。结论我们以行为改变理论和概念为基础,开发了一种优化的TCC干预措施,并根据迭代过程与用户进行了共同设计。母婴健康电子注册表可以用作使用文本消息进行TCC干预的独特平台。我们使用推荐的消息框架模型与用户迭代地组成了可操作的文本消息。我们开发了算法,以针对电子健康注册表中记录的具有较高风险特征的女性触发定制强度更高的短信。结论我们以行为改变理论和概念为基础,开发了一种优化的TCC干预措施,并根据迭代过程与用户进行了共同设计。母婴健康电子注册表可以用作使用文本消息进行TCC干预的独特平台。结论我们以行为改变理论和概念为基础,开发了一种优化的TCC干预措施,并根据迭代过程与用户进行了共同设计。母婴健康电子注册表可以用作使用文本消息进行TCC干预的独特平台。结论我们以行为改变理论和概念为基础,开发了一种优化的TCC干预措施,并根据迭代过程与用户进行了共同设计。母婴健康电子注册表可以用作使用文本消息进行TCC干预的独特平台。
更新日期:2020-01-06
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