Breastfeeding Self-Efficacy, Newborn Knowledge, Parenting Self Efficacy, Postpartum Anxiety, Postpartum Depression
Conditions
Brief summary
The purpose of this study is to evaluate a text message intervention called Essential Coaching for Every Mother in Tanzania to improve mothers' access to essential newborn care information during the immediate six-week postnatal period.
Detailed description
This is a 2-group parallel arm randomized controlled trial. Participants will be randomized into either the intervention or a control group. No changes to in-person care will occur. This study will be conducted in Dar es Salaam, Tanzania with mothers recruited from a Tanzanian postnatal ward who have recently given birth at four different hospitals. Participants in the intervention group will start receiving the Essential Coaching for Every Mother program based on their delivery date up to six weeks postpartum. Mothers in the control group will not receive any text messages. Both groups will be asked to complete a survey at enrolment and six-weeks postpartum. The investigators aim to recruitment 124 participants in total, 62 per group.
Interventions
BEHAVIORALEssential Coaching for Every Mother
Daily text messages for the first six-weeks postpartum.
Sponsors
IWK Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* have recently given birth within the hospital within 48 hours * have daily access to a mobile phone with text message capabilities * are over 18 years of age * speak and read English or Swahili.
Exclusion criteria
* newborns die or are expected to die prior to leaving the hospital * they have no access to mobile phone, either personal or shared * unwilling to receive text messages * decline to participate * are experiencing major postnatal complications expected to impact learning or ability to consent while in the hospital (e.g., postpartum hemorrhage, seizures) * participated in Phase I of this project.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Newborn Care Knowledge | Baseline (enrolment), and six-weeks postpartum (follow-up) | Knowledge will be assessed using a modified questionnaire developed by McConnell and colleagues. Questions will determine whether mothers can identify danger signs, hand washing practices, cord care, newborn thermal care, and breastfeeding. A summative score will be created with a maximum of five points and a minimum of zero, where each point represents knowledge on the above postnatal health topics. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Breastfeeding Self-Efficacy | Baseline (enrolment), and six-weeks postpartum (follow-up) | Breastfeeding self-efficacy will be measured using the Breastfeeding Self-Efficacy Scale - Short Form. Higher scores indicate higher breastfeeding self-efficacy. |
| Postpartum Depression | Baseline (enrolment), and six-weeks postpartum (follow-up) | Depression will be measured using the Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a self-report screening scale with 10 items that can indicate if a respondent has symptoms related to perinatal depression with a score \>12 considered high symptoms of depression. |
| Postpartum Anxiety | Baseline (enrolment), and six-weeks postpartum (follow-up) | Anxiety will be measured using the Generalized Anxiety Disorder (GAD)-7, which is a 7-item scale used to assess generalized anxiety disorder. The scale ranges between 0 and 21, with scores of 10 or greater indicative of generalized anxiety at a moderate/severe level. |
| Newborn morbidity | Six-weeks postpartum (follow-up) | Data will be collected on number of morbidities (e.g., diarrhea, jaundice, infection) identified per infant enrolled in the study within the 6-weeks. |
| Newborn mortality | Six-weeks postpartum (follow-up) | Data will be collected on newborn mortality (e.g., number of infant deaths during study). |
| Need for readmission | Six-weeks postpartum (follow-up) | Data will be collected on number of readmission to hospital for the infant and mothers during the six weeks and related reason. |
| Postnatal Clinic Attendance | Six-weeks postpartum (follow-up) | Data will be collected on the number and date of postnatal contact. |
| Maternal Self-Efficacy | Baseline (enrolment), and six-weeks postpartum (follow-up) | Parenting self-efficacy will be measured using the Karitane Parenting Confidence Scale (KPCS) tool. This 15-item tool was developed to assess perceived self-efficacy of mothers of newborns birth to twelve months of age. A cut off score of 39 or less (out of a possible 45) was determine to be a clinically low perceived parenting self-efficacy (PPSE). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Implementation Dose | Enrolment and study completion (6 weeks) | Dose delivered - number of text messages sent. Output data available through the Africa's Talking and TextIt platforms will be collected per participant. |
| Implementation Engagement | Enrolment and study completion (6 weeks) | Un-subscription rates/drop out after enrolment. Output data available through the Africa's Talking and TextIt platforms will be collected per participant. |
| Recruitment Effectiveness | Enrolment | Number of participants enrolled versus approached. Number of participants per hospital site. |
| Implementation Quality | Six-weeks postpartum | Mothers in the intervention group will be asked about the number of messages they recall receiving, user experience, perspectives on the frequency and timing of messages, and what did they like and not like about Essential Coaching for Every Mother. |
Countries
Tanzania
Outcome results
None listed