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Fan HSL, Ho MY, Ko RWT, Kwok JYY, Chau PH, Wong JYH, Wang MP, Lok KYW. Feasibility and effectiveness of WhatsApp online group on breastfeeding by peer counsellors: a single-blinded, open-label pilot randomized controlled study. Int Breastfeed J 2022; 17:91. [PMID: 36544208 PMCID: PMC9771777 DOI: 10.1186/s13006-022-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION With mobile technologies becoming more advanced and accessible, mobile health (mHealth) has been incorporated in delivering timely and convenient breastfeeding support. However, its feasibility and potential efficacy remain to be examined. Therefore, the primary objective of this study is to assess the feasibility and acceptability of an online instant messaging peer support group for breastfeeding. The secondary objective is to evaluate the effect of the intervention on breastfeeding outcomes. METHODS A pilot randomized controlled trial was conducted. A total of 33 primiparous women were recruited in the antenatal clinic at a public hospital in Hong Kong between March and April 2021. They were randomized to receive either standard care (n = 18) or standard care and receive peer-group support in an online instant messaging app (n = 15). Participants received telephone follow-up for up to six months postpartum or until they stopped breastfeeding. After completing the study, six participants in the intervention group were interviewed to understand their perceptions of the intervention. RESULTS This pilot study shows that online messaging peer support group is feasible and acceptable to women. In total, 54.4% of the eligible women agreed to participate, and 97.0% completed the follow-up. Participants perceived that providing peer support through instant messaging app is appropriate. It serves as a channel for the participants to ask questions and obtain information. Furthermore, meetings of the peer supporters and group members can be held to enhance the effectiveness of the intervention. In addition, no significant differences were found in any and exclusive breastfeeding rates, breastfeeding attitude, and breastfeeding self-efficacy between the two groups. CONCLUSIONS This study shows that online messaging peer support group is feasible and acceptable. A full-scale study should be conducted to understand the effect of the online instant messaging peer support group on breastfeeding outcomes. TRIAL REGISTRATION The study protocol is registered on Clinicaltrial.gov (NCT04826796) on 1 April 2021.
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Affiliation(s)
- Heidi S. L. Fan
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - M. Y. Ho
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Rachel W. T. Ko
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Jojo Y. Y. Kwok
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - P. H. Chau
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Janet Y. H. Wong
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - M. P. Wang
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Kris Y. W. Lok
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
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Lok KY, Ko RW, Fan HS, Chau PH, Wong JY, Wang MP, Tsang V. Feasibility and Acceptability of an Online WhatsApp Support Group on Breastfeeding: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e32338. [PMID: 35262504 PMCID: PMC8943542 DOI: 10.2196/32338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mobile health, the use of mobile technology in delivering health care, has been found to be effective in changing health behaviors, including improving breastfeeding practices in postpartum women. With the widespread use of smartphones and instant messaging apps in Hong Kong, instant messaging groups could be a useful channel for delivering breastfeeding peer support. Objective The aim of this paper is to study the feasibility and acceptability of an online instant messaging peer support group by trained peer counselors on improving breastfeeding outcome in primiparous women in Hong Kong. Methods A two-arm, assessor-blind, randomized controlled feasibility study will be conducted on 40 primiparous women with the intention to breastfeed. Participants are recruited from the antenatal obstetrics and gynecology clinic of a public hospital in Hong Kong and randomly assigned at a 1:1 ratio to either intervention or control group. The intervention group receives peer support in an online instant messaging group with trained peer counselors on top of standard care, whereas the control group receives standard care. Breastfeeding outcome will be assessed for 6 months post partum or until weaned. The breastfeeding status, the proportion and duration of exclusive and any breastfeeding in each group, and the self-efficacy and attitude of participants will be assessed. The feasibility and acceptability of the study would also be assessed in preparation for a full randomized controlled trial. Results This study (protocol version 1 dated January 5, 2021) has been reviewed and approved by the institutional review board of the University of Hong Kong, Hospital Authority Hong Kong West Cluster (reference UW 21-039), on January 26, 2021. Data collection is ongoing and expected to be completed in December 2021. The findings will be updated on clinical trial registry and disseminated in peer-reviewed journals. Conclusions This study aims to assess the feasibility and effectiveness of an online instant messaging peer support group in improving the breastfeeding outcome of primiparous women in Hong Kong. Its findings could inform the feasibility of a full-scale trial with this intervention design. Trial Registration ClinicalTrials.gov NCT04826796; https://clinicaltrials.gov/ct2/show/NCT04826796 International Registered Report Identifier (IRRID) DERR1-10.2196/32338
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Affiliation(s)
- Kris Yw Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Rachel Wt Ko
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Heidi Sl Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - P H Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Janet Yh Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - M P Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Vicky Tsang
- Natural Parenting Network, Hong Kong, Hong Kong
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Kabongo EM, Mukumbang FC, Delobelle P, Nicol E. Understanding the influence of the MomConnect programme on antenatal and postnatal care service utilisation in two South African provinces: a realist evaluation protocol. BMJ Open 2019; 9:e029745. [PMID: 31266842 PMCID: PMC6609052 DOI: 10.1136/bmjopen-2019-029745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Timely antenatal care (ANC) and postnatal care (PNC) attendance decrease maternal and child mortality by improving maternal and child health (MCH) outcomes. Mobile health or mHealth has been identified as an effective way of improving the uptake of MCH services. The MomConnect programme is an mHealth initiative launched by the National Department of Health of South Africa in August 2014 to support MCH. Although widely used, there is a limited understanding of how, why, for whom and under which health system conditions, the implementation of MomConnect improves the health-seeking behaviour of pregnant women and mothers of infants in ANC and PNC facilities. This paper describes the protocol for a realist evaluation of the MomConnect programme, to provide a theory-based understanding of how, why and under what healthcare conditions the MomConnect programme works or not. METHOD AND ANALYSIS We will use the realist evaluation approach through its research cycle conducted in three phases. In phase I, a multimethod elicitation study design will be used, including a document review, key informant interviews and a scoping review to formulate an initial programme theory of the MomConnect intervention. Content and thematic analytic approaches will be used to analyse the data that will be fitted into a realist framework to formulate the initial programme theory. In phase II, a multi-case study design will be applied using a multimethod approach in two South African provinces. In each case, a theory-testing approach underpinned by the hypothetico-deduction analytic model will be used to test the initial programme theory. Surveys, interviews and focus group discussions will be conducted with various programme actors and analysed using appropriate methods. Phase III will entail refining the tested/modified programme theory through cross-case analysis. EXPECTED OUTCOMES An improved understanding of how and why the MomConnect intervention improves the health-seeking behaviour of pregnant women and mothers of infants, and the health system conditions that influence its implementation. ETHICS AND DISSEMINATION Ethics approval was granted by the Stellenbosch University Ethics Committee (S18/09/189). The protocol has been designed and the study will be conducted in line with the principles of the Declaration of Helsinki (1964).
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Affiliation(s)
- Eveline M Kabongo
- Division of Health Systems and Public Health, Stellenbosch University, Cape Town, South Africa
| | | | - Peter Delobelle
- School of Public Health, University of the Western Cape, Cape Town, South Africa
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, Western Cape Province, South Africa
| | - Edward Nicol
- Division of Health Systems and Public Health, Stellenbosch University, Cape Town, South Africa
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
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Jiang H, Li M, Wen LM, Baur L, He G, Ma X, Qian X. A Community-Based Short Message Service Intervention to Improve Mothers' Feeding Practices for Obesity Prevention: Quasi-Experimental Study. JMIR Mhealth Uhealth 2019; 7:e13828. [PMID: 31162133 PMCID: PMC6638993 DOI: 10.2196/13828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prevalence of childhood obesity is increasing in China, and the effect of mobile phone short message service (SMS) interventions to prevent early childhood obesity needs to be evaluated. OBJECTIVE The objective of this study was to assess the effect of an SMS intervention on the prevention of obesity in young children. METHODS A quasi-experimental design SMS intervention was carried out in 4 community health centers (CHCs) in Shanghai, China. A total of 2 CHCs were assigned to the intervention group, and 2 CHCs were assigned to the control group. Mothers in the intervention group received weekly SMS messages on breastfeeding and infant feeding from the third trimester to 12 months postpartum. The primary outcomes were children's body mass index (BMI), BMI z-score, and weight-for-length z-score at 12 and 24 months. Factors associated with higher BMI and weight-for-length z-score at 24 months were also assessed. RESULTS A total of 582 expectant mothers were recruited at the beginning of the third gestational trimester. 477 (82.0%) and 467 (80.2%) mothers and their children were followed up to 12 and 24 months postpartum, respectively. There were no significant differences in children's BMI, BMI z-score, and weight-for-length z-score at 12 and 24 months between the 2 groups. Factors associated with higher BMI, BMI z-score, and weight-for-length z-score at 24 months included higher birth weight, introduction of solid foods before 4 months, and taking a bottle to bed at 12 months. CONCLUSIONS The SMS intervention did not show a significant effect on children's BMI, BMI z-score, or weight-for-length z-score at 12 and 24 months. Introduction of solid foods before 4 months and taking a bottle to bed at 12 months were significantly and positively correlated with a higher BMI, BMI z-score, and weight-for-length z-score at 24 months. Further studies with more rigorous design are needed to evaluate the effect of SMS interventions on preventing early childhood obesity.
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Affiliation(s)
- Hong Jiang
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Mu Li
- School of Public Health, University of Sydney, Sydney, Australia.,China Studies Centre, University of Sydney, Sydney, Australia
| | - Li Ming Wen
- School of Public Health, University of Sydney, Sydney, Australia.,Health Promotion Unit, Sydney Local Health District, Sydney, Australia
| | - Louise Baur
- School of Public Health, University of Sydney, Sydney, Australia.,Discipline of Child & Adolescent Health, University of Sydney, Sydney, Australia
| | - Gengsheng He
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Xiaoying Ma
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Xu Qian
- School of Public Health, Global Health Institute, Fudan University, Shanghai, China.,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
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Mobile applications: effective tools against HIV in Africa. HEALTH AND TECHNOLOGY 2018. [DOI: 10.1007/s12553-017-0200-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lee S, Begley CE, Morgan R, Chan W, Kim SY. m-Health Policy Readiness and Enabling Factors: Comparisons of Sub-Saharan Africa and Organization for Economic Cooperation and Development Countries. Telemed J E Health 2018; 24:908-921. [PMID: 29432073 PMCID: PMC6247984 DOI: 10.1089/tmj.2017.0278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background:As an innovative solution to poor access to care in low- and middle-income countries (LMICs), m-health has gained wide attention in the past decade. Introduction:Despite enthusiasm from the global health community, LMICs have not demonstrated high uptake of m-health promoting policies or public investment. Materials and Methods:To benchmark the current status, this study compared m-health policy readiness scores between sub-Saharan Africa and high-income Organization for Economic Cooperation and Development (OECD) countries using an independent two-sample t test. In addition, the enabling factors associated with m-health policy readiness were investigated using an ordinal logistic regression model. The study was based on the m-health policy readiness scores of 112 countries obtained from the World Health Organization Third Global Survey on e-Health. Results:The mean m-health policy readiness score for sub-Saharan Africa was statistically significantly lower than that for OECD countries (p = 0.02). The enabling factors significantly associated with m-health policy readiness included information and communication technology development index (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.12–2.2), e-health education for health professionals (OR 4.43; 95% CI 1.60–12.27), and the location in sub-Saharan Africa (OR 3.47; 95% CI 1.06–11.34). Discussion:The findings of our study suggest dual policy goals for m-health in sub-Saharan Africa. First, enhance technological and educational support for m-health. Second, pursue global collaboration for building m-health capacity led by sub-Saharan African countries with hands-on experience and knowledge. Conclusion:Globally, countries should take a systematic and collaborative approach in pursuing m-health policy with the focus on technological and educational support.
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Affiliation(s)
- Seohyun Lee
- 1 Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston , Houston, Texas.,2 Institute of Health and Environment, Center for Global Health Research, Graduate School of Public Health, Seoul National University , Seoul, South Korea
| | - Charles E Begley
- 1 Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston , Houston, Texas
| | - Robert Morgan
- 1 Department of Management, Policy and Community Health, School of Public Health, University of Texas Health Science Center at Houston , Houston, Texas
| | - Wenyaw Chan
- 3 Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston , Houston, Texas
| | - Sun-Young Kim
- 2 Institute of Health and Environment, Center for Global Health Research, Graduate School of Public Health, Seoul National University , Seoul, South Korea .,4 Department of Public Health Science, Graduate School of Public Health, Seoul National University , Seoul, South Korea
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