Abstract
BackgroundMaternal attendance at postnatal clinic visits and timely diagnosis of infant HIV infection are important steps for prevention of mother-to-child transmission (PMTCT) of HIV. We aimed to use theory-informed methods to develop text messages targeted at facilitating these steps.MethodsWe conducted five focus group discussions with health workers and women attending antenatal, postnatal, and PMTCT clinics to explore aspects of women's engagement in postnatal HIV care and infant testing. Discussion topics were informed by constructs of the Health Belief Model (HBM) and prior empirical research. Qualitative data were coded and analyzed according to the construct of the HBM to which they related. Themes were extracted and used to draft intervention messages. We carried out two stages of further messaging development: messages were presented in a follow-up focus group in order to develop optimal phrasing in local languages. We then further refined the messages, pretested them in individual cognitive interviews with selected health workers, and finalized the messages for the intervention.ResultsFindings indicated that brief, personalized, caring, polite, encouraging, and educational text messages would facilitate women bringing their children to clinic after delivery, suggesting that text messages may serve as an important “cue to action.” Participants emphasized that messages should not mention HIV due to fear of HIV testing and disclosure. Participants also noted that text messages could capitalize on women's motivation to attend clinic for childhood immunizations.ConclusionsApplying a multi-stage content development approach to crafting text messages – informed by behavioral theory – resulted in message content that was consistent across different focus groups. This approach could help answer “why” and “how” text messaging may be a useful tool to support maternal and child health. We are evaluating the effect of these messages on improving postpartum PMTCT retention and infant HIV testing in a randomized trial.
Highlights
Diagnosis of HIV among infants born to HIV-positive mothers is a critical component of prevention of mother-to-child transmission of HIV (PMTCT) [1]
One potential solution for improving maternal retention in PMTCT programs and increasing the rates of early infant HIV diagnosis is the use of mobile phone technology for health
Between eight and ten participants each were recruited for four different focus groups: health workers from maternal and child health clinics; women attending antenatal clinics; women attending postnatal clinics; women enrolled in PMTCT programs
Summary
Diagnosis of HIV among infants born to HIV-positive mothers is a critical component of prevention of mother-to-child transmission of HIV (PMTCT) [1]. One potential solution for improving maternal retention in PMTCT programs and increasing the rates of early infant HIV diagnosis is the use of mobile phone technology for health (mHealth). We have previously used text messaging to improve clinic return rates for other HIV prevention interventions [6]. Despite strong evidence of efficacy, to our knowledge the theoretical foundations for these interventions have not been reported in the literature. Our aim was to develop a set of individually tailored, culturally appropriate text messages targeted at improving uptake of infant HIV testing rates and maternal retention in PMTCT programs. Maternal attendance at postnatal clinic visits and timely diagnosis of infant HIV infection are important steps for prevention of mother-to-child transmission (PMTCT) of HIV. We aimed to use theory-informed methods to develop text messages targeted at facilitating these steps
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
