Impact of a text-messaging programon adolescent reproductive health: A cluster-randomized trial in Ghana

Slawa Rokicki, J. Cohen, J.A. Salomon and Günther Fink

American Journal of Public Health, 2017, vol. 107, issue 2, 298-305

Abstract: Objectives. To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. Methods. We conducted a cluster-randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. Results. From baseline to 3months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI]= 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR= 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Conclusions. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

Date: 2017
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http://hdl.handle.net/10.2105/AJPH.2016.303562

Related works:
Working Paper: Impact of a Text Messaging Program on Adolescent Reproductive Health: A Cluster–Randomized Trial in Ghana (2017)
Working Paper: Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster?Randomized Trial in Ghana (2016)
Working Paper: Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster?Randomized Trial in Ghana
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2016.303562_6

DOI: 10.2105/AJPH.2016.303562

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