Text Messaging Program for Pregnancy Health

Overseen By Patti Janssen, PhD

Age: Any Age

Sex: Female

Trial Phase: Academic

Sponsor: University of British Columbia

Disqualifiers: Hypertension, Cardiac disease, Diabetes, others

Compensation: Varies

Number of Visits: Unknown

3078 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this randomized clinical trial is to evaluate the effectiveness of SmartMom, a text messaging-based mobile health program for prenatal education. The main questions are to determine if healthy pregnant people receiving SmartMom messages that promote health behaviours in pregnancy versus messages that don't provoke behaviour change have improvement in: 1. knowledge about healthy pregnancy and birth 2. standardized measures of depression, anxiety, and fear of childbirth 3. adoption of positive health behaviours in pregnancy 4. maternal, fetal, and newborn outcomes Participants in the intervention group will receive three evidence-based text messages per week, plus optional supplemental messages on topics relevant to them, throughout pregnancy. The control group will receive general interest messages on pregnancy-related topics that are not promoting behaviour change.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. However, if you have health conditions that require individualized care, you may not be eligible to participate.

What data supports the effectiveness of the text messaging treatment for pregnancy health?

Research shows that text messaging can effectively promote various health behaviors, such as smoking cessation and medication adherence, which suggests it could be beneficial for pregnancy health. Additionally, the SmartMom program is endorsed by the Society of Obstetricians and Gynaecologists of Canada, indicating its credibility as a prenatal education tool. ^{1 2 3 4 5}

Is the SmartMom text messaging program safe for pregnant women?

The SmartMom text messaging program is a prenatal education tool that has been peer-reviewed and endorsed by the Society of Obstetricians and Gynaecologists of Canada, suggesting it is considered safe for use during pregnancy. ^{1 2 3 4 6}

How is the Text Messaging Program for Pregnancy Health different from other treatments for pregnancy health?

The Text Messaging Program for Pregnancy Health is unique because it uses mobile health (mHealth) technology to deliver prenatal education through text messages, making it accessible and cost-effective, especially for those in rural or remote areas. Unlike traditional prenatal classes, this program can overcome barriers such as location, cost, and availability of instructors, and it is endorsed by the Society of Obstetricians and Gynaecologists of Canada. ^{1 2 4 5 6}

Research Team

Patti Janssen, PhD

Principal Investigator

University of British Columbia

Eligibility Criteria

This trial is for pregnant individuals in Canada (except British Columbia) who are at or before 15 weeks gestation with a single pregnancy. They must be able to read and understand English at an 8th-grade level and be comfortable completing online surveys.

Inclusion Criteria

Singleton pregnancy

Can read and understand English at grade 8 level and comfortable completing online surveys

Live in Canada (excluding British Columbia where SmartMom has been piloted)

Exclusion Criteria

Previously had a baby with the SmartMom program

I have a pre-existing health condition like hypertension or diabetes.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive text messages promoting healthy behaviours during pregnancy

Throughout pregnancy (up to 42 weeks)

Weekly text messages

Control

Participants receive general interest messages on pregnancy-related topics

Throughout pregnancy (up to 42 weeks)

Weekly text messages

Follow-up

Participants are monitored for maternal, fetal, and newborn outcomes post-birth

1 month post birth

Treatment Details

Interventions

• Control text messaging
• SmartMom text messaging

Trial Overview The SmartMom clinical trial tests if receiving text messages designed to promote healthy behaviors during pregnancy can improve knowledge, reduce depression/anxiety/fear of childbirth, encourage positive health habits, and better maternal/fetal/newborn outcomes compared to general interest texts.

Participant Groups

Group I: Intervention: SmartMom messaging Active Control 1 Intervention

Participants receive three text messages per week with evidence-based information to promote healthy behaviours during pregnancy.

Group II: Control messaging Placebo Group 1 Intervention

Participants receive one text message per week with general information about pregnancy but not about making healthy choices.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Findings from Research

A cluster randomized trial involving 13,937 pregnant women in Hunan, China, tested a maternal education program delivered via text messaging, but the results showed no statistically significant differences in maternal and perinatal mortality rates between the intervention and control groups.

While the intervention arm had slightly lower rates of maternal (0.04% vs. 0.09%) and perinatal deaths (1.24% vs. 1.45%), the study suggests that larger trials with more intensive implementation are needed to confirm any potential benefits of SMS-based maternal education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of a Maternal Education Program Through Text Messaging in Rural China: Cluster Randomized Controlled Trial. Xie, RH., Tan, H., Taljaard, M., et al.[2020]

In a study involving 83 overweight/obese pregnant women, sending educational SMS about nutrition and physical activity did not significantly reduce excessive gestational weight gain (GWG) compared to a control group receiving general health messages.

Both groups had similar rates of exceeding the Institute of Medicine guidelines for GWG, suggesting that the timing and duration of the intervention may need to be adjusted for more effective outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a Short Message Service Intervention on Excessive Gestational Weight Gain in a Low-Income Population: A Randomized Controlled Trial. Holmes, H., Palacios, C., Wu, Y., et al.[2023]

A review of 48 studies, including 30 randomized controlled trials, found that text messaging can effectively promote various maternal and infant health behaviors, such as smoking cessation and vaccine uptake.

Interventions that are based on established behavior change theories and use motivational language tend to be more successful, highlighting the importance of thoughtful design in text messaging health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of text messaging for maternal and infant health: a systematic review of the literature. Poorman, E., Gazmararian, J., Parker, RM., et al.[2022]

The SmartMom program, a prenatal education initiative delivered via text messaging, was found to be highly acceptable and relevant among 40 Canadian women, reflecting their preferences for receiving pregnancy-related information.

Participants suggested enhancements to the program, such as personalized message streams for specific needs, indicating a strong interest in tailored health information that could promote positive health behaviors during pregnancy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SmartMom Text Messaging for Prenatal Education: A Qualitative Focus Group Study to Explore Canadian Women's Perceptions. Munro, S., Hui, A., Salmons, V., et al.[2019]

The Text4baby program significantly improved pregnant women's beliefs about the importance of taking prenatal vitamins and visiting healthcare providers, with odds ratios indicating a strong positive effect on these attitudes.

Despite the positive changes in beliefs, the study did not find any significant behavioral changes among participants, suggesting that while Text4baby influences health attitudes, further research is needed to assess its impact on actual health behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Initial outcomes from a 4-week follow-up study of the Text4baby program in the military women's population: randomized controlled trial. Evans, WD., Wallace Bihm, J., Szekely, D., et al.[2022]

The SmartMom SMS text messaging program is an effective prenatal education tool that provides reliable and tailored information, meeting the needs of pregnant individuals better than traditional apps, as reported by participants in focus groups.

Participants emphasized the importance of inclusive and comprehensive prenatal education, highlighting that current programs often fail to address the needs of diverse populations, such as Indigenous and LGBTQIA2S+ communities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Expectant Parents' Preferences for Teaching by Texting: Development and Usability Study of SmartMom. Murray, JB., Sharp, A., Munro, S., et al.[2023]

References

1. Canada pubmed.ncbi.nlm.nih.gov

The Impact of a Maternal Education Program Through Text Messaging in Rural China: Cluster Randomized Controlled Trial. [2020]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Effect of a Short Message Service Intervention on Excessive Gestational Weight Gain in a Low-Income Population: A Randomized Controlled Trial. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Use of text messaging for maternal and infant health: a systematic review of the literature. [2022]

4. Canada pubmed.ncbi.nlm.nih.gov

SmartMom Text Messaging for Prenatal Education: A Qualitative Focus Group Study to Explore Canadian Women's Perceptions. [2019]

5. Canada pubmed.ncbi.nlm.nih.gov

Initial outcomes from a 4-week follow-up study of the Text4baby program in the military women's population: randomized controlled trial. [2022]

6. Canada pubmed.ncbi.nlm.nih.gov

Expectant Parents' Preferences for Teaching by Texting: Development and Usability Study of SmartMom. [2023]