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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2020

01-12-2020 | Care | Research article

Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study

Authors: Binyam Bogale, Kjersti Mørkrid, Brian O’Donnell, Buthaina Ghanem, Itimad Abu Ward, Khadija Abu Khader, Mervett Isbeih, Michael Frost, Mohammad Baniode, Taghreed Hijaz, Tamara Awwad, Yousef Rabah, J. Frederik Frøen

Published in: BMC Medical Informatics and Decision Making | Issue 1/2020

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Abstract

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.
Appendix
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Metadata
Title
Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study
Authors
Binyam Bogale
Kjersti Mørkrid
Brian O’Donnell
Buthaina Ghanem
Itimad Abu Ward
Khadija Abu Khader
Mervett Isbeih
Michael Frost
Mohammad Baniode
Taghreed Hijaz
Tamara Awwad
Yousef Rabah
J. Frederik Frøen
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
BMC Medical Informatics and Decision Making / Issue 1/2020
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-019-1002-x

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