Effectiveness of mHealth-based educational interventions to improve self-care during pregnancy: A pragmatic randomized controlled trial from northern India.

ABSTRACT

OBJECTIVES: To assess and compare the effectiveness of mHealth-based educational interventions on improving pregnancy self-care knowledge, attitude, and practice (KAP) and the satisfaction in using the interventions. METHODS: We conducted a three-group, pragmatic, randomized controlled trial (July 2019-June 2020) among pregnant women (aged 20-45 years, gestation <20 weeks, and no pre-existing diseases) attending the prenatal clinic of a tertiary care hospital in northern India. Participants were randomly assigned to three arms (Group 1, specially developed mobile application; Group 2, Whatsapp, and Group 3, Control-Standard of care) using block randomization. Blinding was not performed. The educational intervention (for Groups 1 and 2) included general details about pregnancy, self-care preventive practices, and self-management of minor illnesses during pregnancy. The control group received routine instructions delivered by the doctors as part of the standard of care. After 3 months, the post-intervention KAP assessment and satisfaction with interventions/care received were carried out. RESULTS: Of the 150 pregnant women who participated (50 per group), 70 (46.6%) were graduates and 66 (44.0%) were primigravidas. Mean age was 28 years. Pregnant women in Groups 1 and 2 showed a statistically significant (P < 0.001) improvement in KAP on pregnancy self-care compared with the control group post-intervention. However, the same was insignificant (P > 0.05) between Groups 1 and 2. Participant satisfaction with the intervention was significantly high among Group 2 compared with the control group (P < 0.001). CONCLUSION: mHealth-based delivery of self-care education effectively improved KAP among pregnant women. The effectiveness of mHealth-based intervention must be assessed in primary healthcare settings before scaling up. DETAILS OF TRIAL REGISTRATION Registered with Clinical Trial Registry India-CTRI/2019/10/021794 registered on October 29, 2019 (http//ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=37444&EncHid=&userName=CTRI/2019/10/021794).