Background
Adolescents are at increased risk for adverse pregnancy outcomes. mHealth for behaviour change involves delivering targeted timely health education content aimed to improve the users’ knowledge, attitudes, and ultimately influence their health behaviours. This study developed and evaluated the ‘Teen MomConnect’ intervention to improve antenatal appointment attendance and its determinants among pregnant adolescent girls and young women (AGYW) in South Africa. It demonstrates how theory-based tailored mHealth content can developed for pregnant AGYW.
Methods
Teen MomConnect sent fixed and two-way tailored SMS behavioural reinforcement and motivational text messages to pregnant AGYW aged 13-20 years. The intervention functionality was adapted from MomConnect, a South African national mHealth program that sends fixed SMS’s to pregnant women. The study was conducted among 412 AGYW in Cape Town in 2016-2019. In a pilot randomised controlled trial, participants were allocated to the control group that received MomConnect messages or the intervention group that received Teen MomConnect.
Results
Formative research and self-determination theory informed message development. 84% and 72% rated the intervention messages highly for content value and motivational nature respectively. The low engagement (20% average response rate to the interactive messages) impacted intervention fidelity. While appointment attendance did not differ significantly between Teen MomConnect and MomConnect, it was higher in Teen MomConnect participants who engaged with the message content more frequently. It was also higher in the intervention group who received motivational counseling, suggesting that more interpersonal approaches are needed to complement mHealth in AGYW. Teen MomConnect significantly improved knowledge scores among those with higher message engagement.
Conclusions
As mHealth moves to more advanced technologies, the study still holds relevance by providing an evidence-base to inform tailoring, targeting and implementing of future interventions for vulnerable populations. These interventions need to explore approaches to increase message interactivity and engagement for young audiences.
Keywords: mHealth; pregnancy; adolescent girls and young women; South Africa; tailoring
