Abstract
BackgroundAlthough mobile health (mHealth) has been widely applied in health care services, few studies have reported the detailed process of the development and implementation of text messaging (short message service, SMS) interventions.ObjectiveOur study aims to demonstrate the process and lessons learned from a community-based text messaging (SMS) intervention for improving infant feeding in Shanghai, China.MethodsThe intervention included planning and development, implementation, and process evaluation. A 3-phase process was adopted during planning and development: (1) a formative study with expectant and new mothers to explore the barriers of appropriate infant feeding practices; (2) a baseline questionnaire survey to understand potential intervention approaches; and (3) development of the text message bank. The text messaging intervention was delivered via a computer-based platform. A message bank was established before the start of the intervention containing information on the benefits of breastfeeding, preparing for breastfeeding, early initiation of breastfeeding, timely introduction of complementary foods, and establishing appropriate feeding practices, etc. An expert advisory committee oversaw the content and quality of the message bank. Process evaluation was conducted through field records and qualitative interviews with participating mothers.ResultsWe found that the text messaging intervention was feasible and well received by mothers because of its easy and flexible access. The weekly based message frequency was thought to be appropriate, and the contents were anticipatory and trustworthy. Some mothers had high expectations for timely response to inquiries. Occasionally, the text messages were not delivered due to unstable telecommunication transmission. Mothers suggested that the messages could be more personalized.ConclusionsThis study demonstrates the feasibility and value of text messaging intervention in filling gaps in delivering health care services and promoting healthy infant feeding practices in settings where personal contact is limited.
Highlights
The Life Course Health Development Model suggests that health interventions should focus on early childhood to build a solid basis for long-term health [1]
The aim of this paper is to present the planning and development, implementation, and process evaluation of a community-based short message service (SMS) text messaging intervention targeted at improved infant feeding practices in Shanghai, China
We report the process of the planning and development, implementation, and process evaluation of the intervention using documentation such as researchers’ diaries, field records, project meeting minutes, and qualitative interviews with participants
Summary
The Life Course Health Development Model suggests that health interventions should focus on early childhood to build a solid basis for long-term health [1]. Infant feeding practices may have long-term effects by influencing eating behaviors and obesity risk in later life [2,3,4,5,6]. Inappropriate infant feeding knowledge and practices have been widespread among new parents or caregivers. Parents are the “gatekeepers” of children’s eating environments Their feeding practices strongly influence children’s eating patterns, which lay the foundation of future eating habits and children’s weight [11,12]. Research has shown that rapid early weight gain before 2 years of age is associated with the increased risk of later overweight or obesity, and infant feeding practices have a high potential for long-term health effects [13,14,15]. Mobile health (mHealth) has been widely applied in health care services, few studies have reported the detailed process of the development and implementation of text messaging (short message service, SMS) interventions
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