Message Service Research Articles

Intention to use short messaging services for promoting drug adherence among individuals with diabetes in Addis Ababa, Ethiopia

Background Suboptimal medication adherence among individuals with diabetes presents a significant challenge in low-income nations. Growing evidence demonstrates the effectiveness of text messaging interventions to enhance medication adherence. This study assesses the intention to use Short Messaging Service (SMS) based reminder services in promoting drug adherence among diabetic patients and associated factors in Addis Ababa, Ethiopia. Methods An institution-based cross-sectional study was conducted from February 06, 2023, to March 27, 2023, in Addis Ababa, Ethiopia. A sample of 351 patients was selected using systematic random sampling. Structured questionnaires were used for data collection. Binary and multivariable logistic regression models were used to analyze the association between intention to use SMS reminders to promote drug adherence among individuals with diabetes and related factors. Results A total of 333 respondents, with a 94.87% response rate, were interviewed for this study. The majority of respondents, 66.4 % (95% CI [61.9–71.2]), expressed an intention to use SMS-based reminder services to promote their drug adherence. Age < 45 years (AOR = 5.73, 95% CI [2.07–15.73]), higher educational level (AOR = 3.03, 95% CI [1.16–7.90]), type of diabetes (AOR = 3.71, 95% CI [1.16–7.90]), oral medication users (AOR = 2.99, 95% CI [1.42–6.32]), SMS as a preferred medium for communication (AOR = 2.86, 95% CI [1.17–7.00]) were deemed to be important variables linked to intention to use SMS reminders to promote drug adherence among individuals with diabetes. Conclusion The findings suggest the majority of individuals with diabetes have intention to use SMS reminders to enhance adherence. This result indicates the potential for utilization of SMS reminders to enhance adherence to diabetic medications. Furthermore, the findings highlight the importance of tailored interventions that take into account patient characteristics and preferences as factors that influence intention when designing such an intervention.

A Nutritional Strategy Based on Multiple Components for Glycemic Control in Type 2 Diabetes: A Multicenter Randomized Controlled Clinical Trial

Background/Objectives: The optimal dietary approach for managing glycemic and metabolic control in type 2 diabetes (T2D) is still uncertain, though it should be tailored for clinical settings. Therefore, we sought to assess the impact of a multicomponent nutritional strategy on glycemic control in T2D patients within a public health system. Methods: NUGLIC was an open-label, parallel-group, superiority, multicenter randomized controlled trial. Participants aged 30 and older with poorly controlled T2D were randomly assigned to either (1) a personalized dietary prescription (control group, n = 185) or (2) a strategy involving targeted nutritional advising, mindfulness techniques, and short message services (NUGLIC [intervention] group, n = 186). The primary outcomes were glycated hemoglobin (HbA1c, %) measured after 24 weeks and glycemic control, defined as having an HbA1c > 7% at baseline and achieving ≤7% after follow-up, or having HbA1c ≤ 7% at baseline and reducing the use of glucose-lowering medications post-follow-up. The secondary outcomes included cardiometabolic features, self-care practices, diet quality, and quality of life. Results: A total of 371 participants were included in an intention-to-treat analysis for the primary outcomes. At six months, both groups exhibited a reduction in HbA1c levels compared to the baseline (NUGLIC group: −0.6% [95% confidence interval (CI) −0.9; −0.3], p < 0.001; control group: −0.5% [95% CI −0.7; −0.3], p < 0.001). However, no significant differences were observed between the groups in terms of HbA1c after follow-up (intervention group: 8.1%; control group: 8.3%; difference: −0.2% [95% CI −0.5; 0.1], p = 0.30) or glycemic control (NUGLIC group: 19.9%; control group: 18.9%; odds ratio 0.96 [95% CI 0.56; 1.67], p = 0.89). While the control group showed an improvement in overall diet quality, no significant differences emerged between the groups by the end of this study (p = 0.13). There were also no significant differences in other secondary outcomes nor in the use of glucose-lowering medications and adverse events after follow-up. Conclusions: The multicomponent nutritional strategy did not demonstrate superiority over personalized dietary prescriptions in achieving glycemic control for participants with poorly managed T2D. In this sense, both nutritional interventions could be used in clinical practice to improve HbA1c levels, considering the profile and preferences of individuals.

Efficacy of an mHealth intervention to support pain self-management and improve analgesia in patients with rib fractures: protocol for a randomised controlled trial

IntroductionIn light of the risks of over-reliance on opioid analgesia during recovery from rib fractures, there is increased interest in the efficacy of non-pharmacological approaches to pain management. This paper...

Optimizing SMS Spam Detection Using Machine Learning: A Comparative Analysis of Ensemble and Traditional Classifiers

With the rapid rise of mobile communication, Short Message Service (SMS) has become an essential platform for transmitting information. However, the growing volume of unsolicited and harmful spam messages presents significant challenges for both users and mobile network operators. This study explores the effectiveness of various machine learning models, including Random Forest, Gradient Boosting, AdaBoost, Support Vector Machine (SVM), Logistic Regression, and an Ensemble Voting Classifier, in detecting SMS spam. A dataset containing 5,572 SMS messages, labeled as either spam or ham (legitimate), was used to evaluate these models. Hyperparameter tuning was performed on each model to optimize accuracy, and the models were assessed using metrics such as precision, recall, F1-score, and accuracy. The results indicated that the SVM and Ensemble Voting Classifier achieved the highest performance, with accuracies of 0.9857 and 0.9848, respectively. Both models demonstrated superior recall for spam messages, making them highly effective for real-world spam detection systems. While Random Forest, Gradient Boosting, and AdaBoost also performed well, their slightly lower recall for spam suggests that they may misclassify some spam as legitimate messages. The study highlights the effectiveness of machine learning models in addressing the SMS spam problem, particularly when using ensemble methods. Future research should focus on addressing class imbalance and exploring deep learning approaches to further enhance model performance. These findings offer valuable insights for developing more accurate and scalable SMS spam detection systems.

Electronic Health Interventions and Cervical Cancer Screening: Systematic Review and Meta-Analysis.

Cervical cancer is a significant cause of mortality in women. Although screening has reduced cervical cancer mortality, screening rates remain suboptimal. Electronic health interventions emerge as promising strategies to effectively tackle this issue. This systematic review and meta-analysis aimed to determine the effectiveness of electronic health interventions in cervical cancer screening. On December 29, 2023, we performed an extensive search for randomized controlled trials evaluating electronic health interventions to promote cervical cancer screening in adults. The search covered multiple databases, including MEDLINE, the Cochrane Central Registry of Controlled Trials, Embase, PsycINFO, PubMed, Scopus, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature. These studies examined the effectiveness of electronic health interventions on cervical cancer screening. Studies published between 2013 and 2022 were included. Two independent reviewers evaluated the titles, abstracts, and full-text publications, also assessing the risk of bias using the Cochrane Risk of Bias 2 tool. Subgroup analysis was conducted based on subjects, intervention type, and economic level. The Mantel-Haenszel method was used within a random-effects model to pool the relative risk of participation in cervical cancer screening. A screening of 713 records identified 14 articles (15 studies) with 23,102 participants, which were included in the final analysis. The intervention strategies used in these studies included short messaging services (4/14), multimode interventions (4/14), phone calls (2/14), web videos (3/14), and internet-based booking (1/14). The results indicated that electronic health interventions were more effective than control interventions for improving cervical cancer screening rates (relative risk [RR] 1.464, 95% CI 1.285-1.667; P<.001; I2=84%), cervical cancer screening (intention-to-treat) (RR 1.382, 95% CI 1.214-1.574; P<.001; I2=82%), and cervical cancer screening (per-protocol; RR 1.565, 95% CI 1.381-1.772; P<.001; I2=74%). Subgroup analysis revealed that phone calls (RR 1.82, 95% CI 1.40-2.38), multimode (RR 1.62, 95% CI 1.26-2.08), SMS (RR 1.41, 95% CI 1.14-1.73), and video- and internet-based booking (RR 1.25, 95% CI 1.03-1.51) interventions were superior to usual care. In addition, electronic health interventions did not show a statistically significant improvement in cervical cancer screening rates among women with HPV (RR 1.17, 95% CI 0.95-1.45). Electronic health interventions had a greater impact on improving cervical cancer screening rates among women in low- and middle-income areas (RR 1.51, 95% CI 1.27-1.79). There were no indications of small study effects or publication bias. Electronic health interventions are recommended in cervical cancer screening programs due to their potential to increase participation rates. However, significant heterogeneity remained in this meta-analysis. Researchers should conduct large-scale studies focusing on the cost-effectiveness of these interventions. CRD42024502884; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=502884.

Influence of male targeted short message service on knowledge, nature of attitude and male involvement on uptake of family planning among spouses in Marsabit County, Kenya

Background: Family planning services helps the individuals or couples to regulate the number and determine healthy spacing and timing of pregnancies. Globally, contraceptive prevalence stands at 49.0%, Sub-Saharan Africa at 29.0%, Kenya at 56.9% and Marsabit County at 5.6%. Some of the reasons given for low uptake include low knowledge level, negative attitude and lack of male involvement on family planning matters. This study aimed at establishing the influence of male targeted short message service on knowledge, nature of attitude and male involvement on uptake of family planning among spouses in Marsabit County. Methods: A pre-test and post-test quasi experimental study design was adopted involving randomly selected 220 couples from Laisamis (control group) and Moyale (intervention group) sub-counties. Intervention of male targeted short message service was offered weekly to male spouses from Moyale sub-county. A questionnaire was used to collect data. Data analysis was done using SPSS. All the required ethical and logistical considerations were adhered to accordingly. Results: Male targeted short message service increased level of knowledge significantly (OR 4.173, p=0.001), changed nature of attitude (OR 2.7335, p=0.004) and male involvement in family planning (OR 4.4306, p=0.001). Conclusions: The study concluded male targeted SMS intervention increased level of knowledge, attitude changed and males were involved. The County government of Marsabit should engage opinion leaders in family planning to help in educating and changing the attitude of the men towards family planning.

Influence of male targeted short message service on uptake of family planning among spouses in Marsabit County, Kenya

Background: Family planning helps in regulating the number of children and determine healthy spacing and timing of births between pregnancies. The global contraceptive prevalence stands at 49.0%, Sub-Saharan Africa at 29.0%, Kenya at 56.9% while in Marsabit County at 5.6%. Male spouse involvement on matters of family planning deserves attention. This study aimed at establishing the influence of male targeted short message service on uptake of family planning among female spouses in Marsabit County, Kenya. Methods: A pre-test and post-test quasi experimental study design was adopted involving randomly selected 220 couples from Laisamis and Moyale sub-counties. Intervention of male targeted short message service was offered to male spouses from Moyale sub-county for a period of 4 months. A questionnaire was used to collect data. Quantitative data analysis was done using SPSS. All the required ethical and logistical considerations followed. Results: At baseline level of uptake was overall 14.3%, control 13.2% and intervention 15.4% while at endline overall 30.2%, control 20.4% and intervention 39.5%. Further results revealed that uptake of family planning was increased by use of short message service. Conclusions: The study concluded that the level of uptake was low but with SMS intervention uptake significantly increased. The Ministry of Health should consider integrating male targeted short message service intervention in provision of family planning services to increase uptake.

The use of digital technologies to promote sexual health in young adults: a narrative review

Abstract Background New technologies have the potential to play an important role in promoting sexual health, especially among young people, who are the biggest users and those at greatest risk of contracting Sexually Transmitted Infections (STI). The risk behavior assumed by young people today highlights this vulnerability in several contexts, such as individual, social, economic, and family. In this sense, it becomes relevant to approach sex education in schools using digital technologies. Objectives To identify the evidence in the literature on the use of digital technologies to promote the sexual health of young adults. Methods Narrative literature review. Three independent reviewers extracted, analyzed and synthesized the articles and results. Results Through the selection process, four studies were included. The articles show that the use of digital technologies (mobile phones/applications) leads to increased knowledge, improved attitudes and sexual behavior among young adults. The interventions studied in the studies were based on Short Message Service, electronic mail interventions and the MyPEEPS mobile application, with the following main focuses: Increased knowledge, attitudes, and behaviors of young adults. Considering the results of the studies, all interventions proved to be effective as facilitators of sexual health promotion. Conclusions The use of digital technologies allowed an increase in the promotion of the sexual health of the participants, since there was an increase in the level of knowledge with the use of digital technologies such as SMS, emails and mobile applications when comparing the experimental and control groups. The use of these digital technologies also allowed for a change in attitudes and behaviors, such as a significant increase in serological testing for STIs and an increase in health care seeking. Key messages • The use of digital technology promotes the sexual health of young adults, so these strategies should be implemented by health professionals. • The dissemination of these digital strategies will have an impact on Public Health, specifically regarding the sexual health of young adults.

Patient-reported outcomes, postoperative pain and pain relief after day case surgery (POPPY): methodology for a prospective, multicentre observational study.

In the UK, approximately 70% of surgical procedures are undertaken as day-cases. Little information exists about recovery from day-case surgery, yet international data highlights patients are at risk of developing significant longer-term health problems including chronic post-surgical pain and persistent postoperative opioid use. The Patient-reported Outcomes, Postoperative Pain and pain relief after daY case surgery (POPPY) study was a national prospective multicentre observational study, measuring short- and longer-term patient-reported outcomes, postoperative pain and pain relief after day-case surgery. This was a collaborative project led by resident anaesthetists under the Research and Audit Federation of Trainees umbrella. Adult day-case surgical patients were recruited on the day of surgery. Baseline data including patient characteristics; procedure details; pre-operative analgesic use; pre-existing pain; and quality of life scores were recorded. Patients were followed up through automated short message service messages. Short-term (postoperative days 1, 3 and 7) outcomes included: quality of recovery; pain severity; impact of pain on function; and analgesic use. Longer-term outcomes (postoperative day 97) included: quality of life; analgesic use; incidence of chronic post-surgical pain; and incidence persistent postoperative opioid use. Additional outcomes were completed by those patients with chronic post-surgical pain and persistent postoperative opioid use, with 30 patients recruited to a qualitative semi-structured interview study exploring postoperative expectations, recovery, postoperative pain and opioid use. An embedded pilot study at four sites recruited 129 patients. Responses to the automated short message service were gained from 129 patients (100%) at day 1; 116 (89.9%) at day 3; 108 (83.7%) at day 7; and 77 (59.7%) at day 97 postoperatively. The pilot enabled refinement of the methods and processes before the national roll out. This paper outlines the methods for the POPPY study, the largest UK multicentre prospective observational study considering short- and longer-term outcomes following day-case surgery.

Utilizing Citizen Generated Data to enhance Women's Access to Sexual and Reproductive Health Services in Somalia: Insights, Barriers, and Pathways Forward

Purpose: This study was undertaken to capture citizen’s insights on practical steps that individuals, families, communities, and institutions could take to support the improvement of Sexual and Reproductive Health (SRH) services in Somalia. This includes raising awareness of issues affecting women's access to SRH, such as Gender-Based Violence (GBV) and Female Genital Mutilation (FGM). Methodology: This research employed a qualitative research design, utilizing semi-structured radio questions distributed through various channels such as radio promos, mini-dramas, interactive radio shows, and Short Messaging Service (SMS) on mobile phones. To enhance and validate the findings from the radio series, thirty Focus Group Discussions (FGD) involving 270 'hard-to-reach' participants were conducted across all Federal Member States (FMS) of Somalia, excluding Somaliland. Collaborating with 20 radio stations, a total of 4,268 participants from across Somalia were involved in this study. The qualitative data obtained was categorized into themes, and the subsequent information was analyzed using content analysis methodology for qualitative data, as well as descriptive statistics and inferential analysis through statistical package for social science (SPSS) version 25 and excel for quantitative data. The presentation of the data included the use of tables and figures. Findings: This study outlined key challenges in accessing quality SRH services for women in Somalia. Priorities included enhancing healthcare infrastructure and availability of SRH professionals, along with emphasizing health education on reproductive health and family planning. Food insecurity's impact, especially among displaced populations, was noted. GBV and FGM were highlighted, calling for comprehensive survivor care and male involvement in prevention. Collaboration between schools and the private sector was proposed for menstrual hygiene. Men's support for SRH access was deemed crucial. Addressing stigma around SRH access, GBV, and FGM was stressed, urging comprehensive awareness campaigns and improved healthcare provision for survivors. Unique Contribution to Theory, Practice and Policy: Addressing women's SRH in Somalia involves investing in healthcare infrastructure, expanding health education programs, ensuring access to nutritious food, and engaging men as allies in promoting women's SRH rights. Moreover, efforts to combat stigma, GBV, and FGM must be culturally sensitive and inclusive, involving religious and community leaders, and addressing underlying socio-economic factors contributing to these issues.

Terminology of medicines used to control seizure disorders: 2024 ILAE Recommendations and profile of real-world term use

Background. The International League Against Epilepsy (ILAE) has provided recommendations on the terminology of medicines for control of seizure disorders, which should be adapted into different languages.Objective: to evaluate the usage profile of terms describing the effects of medicines used in patients with epilepsy.Material and methods. The search query analysis systems Google Trends and Yandex Wordstat as well as PubMed/MEDLINE, Google Scholar and eLibrary databases were used to evaluate the general public and professional usage profile, respectively.The following terms in Russian and English were studied: “antiepileptic”, “antiepileptic drug”, “antiseizure”, “antiseizure drug”. In order to ascertain a prevailing opinion within professional and patient communities, a questionnaire survey was conducted on the public online resources of the non-profit partnership “The Association of Epileptologists and Patients” carried out via the cloud-based cross-platform social media as well as instant messaging service Telegram and the social media platform VK.Results. In the English-speaking internet segment, the term “antiepileptic” is used more than 5 times frequently than “antiseizure” by the general public. Conversely, in the Russian-language segment, the term “antiseizure” is almost 2.5 times more common. The term “antiepileptic” is more prevalent in scientific community in both segments. This finding aligns with the profile of terminology usage observed among epileptologists and epilepsy patients. The questionnaire survey results revealed that 56.42% of 179 respondents were in favor of the terms “antiepileptic drug”, “AED” and “antiepileptic therapy”, whereas as few as 17.32% of those endorsed the ILAE-proposed terminology.Conclusion. In light of the established practice of terminology use in both professional scientific community and among practicing epileptologists and epileptic patients, as well as the differences in the semantics of English- and Russian-language terms and the identified lack of precision in the ILAE definition of epilepsy, it can be concluded that for the Russian-speaking population, the terms “antiepileptic drug”, “AED” are more preferable rather than the terms “antiseizure medication”, “ASM”. Additionally, it is preferable to use the terms “convulsive ictus” and “epileptic ictus” due to negative connotation with term “seizure” in Russian. The terms “antiseizure” and “antiepileptic” should not be regarded as mutually exclusive in the context of treatment that has a direct impact on epilepsy course. Finally, it is necessary to further refine epilepsy definition and classification.

AniBalloons: Animated chat balloons as affective augmentation for social messaging and chatbot interaction

Despite being prominent and ubiquitous, message-based communication is limited in nonverbally conveying emotions. Besides emoticons or stickers, messaging users continue seeking richer options for affective communication. Recent research explored using chat-balloons’ shape and color to communicate emotional states. However, little work explored whether and how chat-balloon animations could be designed to convey emotions. We present the design of AniBalloons, 30 chat-balloon animations conveying Joy, Anger, Sadness, Surprise, Fear, and Calmness. Using AniBalloons as a research means, we conducted three studies to assess the animations’ affect recognizability and emotional properties (N=40), and probe how animated chat-balloons would influence communication experience in typical scenarios including instant messaging (N=72) and chatbot service (N=70). Our exploration contributes a set of chat-balloon animations to complement nonverbal affective communication for a range of text-message interfaces, and empirical insights into how animated chat-balloons might mediate particular conversation experiences (e.g., perceived interpersonal closeness, or chatbot personality).

Impact of text message reminders on immunosuppressive medication adherence among kidney transplant recipients: A randomized controlled study.

One of the most common problems encountered in transplant patients is nonadherence with immunosuppressive drugs, one of the most important reasons for graft rejection. The study aimed to assess the impact of text message reminders on medication adherence among kidney transplant recipients. A randomized controlled trial. The study was conducted from January to October 2021. This study included a total of 100 patients receiving a kidney transplant, 50 in the intervention group and 50 in the control group. Patients in the intervention group were sent text message reminders four times a day during the 6th-9th months after transplantation. Control patients received no such intervention. Tacrolimus concentrations in the bloodstream were monitored for all participants through measurements taken at Months 7, 8 and 9. Data collection tools included Sociodemographic Form and Immunosuppressive Medication Adherence Scale. Patients were homogeneously distributed among the groups. Sending daily text message reminders to transplant recipients caused an independent positive effect on medication adherence scale scores at the end of the study. Mean pretest medication adherence score of all patients was 45.18 ± 4.22 and posttest score was 47.4 ± 3.6. The intervention group exhibited a significantly higher mean posttest adherence score compared to controls, with values of 48.68 ± 2.58 and 45.62 ± 4.42, respectively (p < 0.001). Findings demonstrated a substantial improvement in the final medication adherence scores of transplant patients when they received daily Short Message Service reminders, acting as an independent factor (β = 0.356, p < 0.001). Sending text message reminders to kidney transplant recipients is a statistically and clinically effective intervention to improve immunosuppressive medication adherence.

Indigenous knowledge and sugar sweetened beverages: Qualitative adaptations towards chronic disease prevention and intervention

Sugar sweetened beverages (SSB) are a concern for Indigenous populations and are associated with multiple chronic diseases. To address this concern, we culturally tailored and tested the feasibility of an evidence-based SSB-reducing curriculum. The modified curriculum was designed for Indigenous men and is thematically based on traditional values, ancestral teachings, and community strengths while promoting healthy lifestyles. A community-based participatory research (CBPR) approach was used to develop an interview guide using an Indigenous-centered theoretical framework. Two Indigenous content experts conducted both individual and focus group interviews (n = 14) with urban community leaders and athletes. Two Indigenous qualitative scientists analyzed the data with the support of an inter-tribal community advisory board. Results included imagery utilization, the importance of water, marketing, taste, and building routine. These findings guided the development of 6-month Indigenous focused SSB intervention consisting of 12 in-person intervention sessions and 27 short messaging service (SMS) messages.

Diagnosing skin neglected tropical diseases with the aid of digital health tools: A scoping review.

Delays in diagnosis and detection of skin neglected tropical diseases (NTDs) pose obstacles to prompt treatment, which is crucial in preventing disability. Recent developments in digital health have given rise to approaches that could increase access to diagnosis in resource-poor areas affected by skin NTDs. This scoping review provides an overview of current digital health approaches that aim to aid in the diagnosis of skin NTDs and provides an insight into the diverse functionalities of current digital health tools, their feasibility, usability, and the current gaps in research around these digital health approaches. This scoping review included a comprehensive literature search on PubMed, EMBASE and SCOPUS, following the PRISMA guidelines. Eleven studies were included in the review and were analysed using a descriptive thematic approach. Most digital tools were found to be mobile-phone based, such as mobile Health (mHealth) apps, store-and-forward tele-dermatology, and Short Messaging Service (SMS) text-messaging. Other digital approaches were based on computer software, such as tele-dermatopathology, computer-based telemedicine, and real-time tele-dermatology. Digital health tools commonly facilitated provider-provider interactions, which helped support diagnoses of skin NTDs at the community level. Articles which focused on end-user user experience reported that users appreciated the usefulness and convenience of these digital tools. However, the results emphasized the existing lack of data regarding the diagnostic precision of these tools, and highlighted various hurdles to their effective implementation, including insufficient infrastructure, data security issues and low adherence to the routine use of digital health tools. Digital health tools can help ascertain diagnosis of skin NTDs through remote review or consultations with patients, and support health providers in the diagnostic process. However, further research is required to address the data security issues associated with digital health tools. Developers should consider adapting digital health tools to diverse socio-cultural and technical environments, where skin NTDs are endemic. Researchers are encouraged to assess the diagnostic accuracy of digital health tools and conduct further qualitative studies to inform end-user experience. Overall, future studies should consider expanding the geographical and disease scope of research on digital health tools which aid the diagnosis of skin NTDs.

Digital communication between mothers and community health workers to support neonatal health (CHV-NEO): study protocol for a randomized controlled trial

BackgroundProvision of essential newborn care at home, rapid identification of illness, and care-seeking by caregivers can prevent neonatal mortality. Mobile technology can connect caregivers with information and healthcare worker advice more rapidly and frequently than healthcare visits. Community health workers (CHWs) are well-suited to deliver such interventions. We developed an interactive short message service (SMS) intervention for neonatal health in Kenya, named CHV-NEO. CHV-NEO sends automated, theory-based, actionable, messages throughout the peripartum period that guide mothers to evaluate maternal and neonatal danger signs and facilitate real-time dialogue with a CHW via SMS. We integrated this intervention into Kenya’s national electronic community health information system (eCHIS), which is currently used at scale to support CHW workflow.MethodsThe effect of CHV-NEO on clinical and implementation outcomes will be evaluated through a non-blinded cluster randomized controlled trial. Twenty sites across Kisumu County in Western Kenya were randomized 1:1 to provide either the national eCHIS with integrated CHV-NEO messaging (intervention) or standard of care using eCHIS without CHV-NEO (control). We will compare neonatal mortality between arms based on abstracted eCHIS data from 7200 pregnant women. Secondary outcomes include self-reported provision of essential newborn care (appropriate cord care, thermal care, and timely initiation of breastfeeding), knowledge of neonatal danger signs, and care-seeking for neonatal illness, compared between arms based on questionnaires with a subgroup of 2000 women attending study visits at enrollment in pregnancy and 6 weeks postpartum. We will also determine CHV-NEO’s effect on CHW workflows and evaluate determinants of intervention acceptability, adoption, and fidelity of use through questionnaires, individual interviews, and messaging data.DiscussionWe hypothesize that the CHV-NEO direct-to-client communication strategy can be successfully integrated within existing CHW workflows and infrastructure, improve the provision of at-home essential newborn care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. The intervention’s integration into the national eCHIS tool will facilitate rapid scale-up if it is clinically effective and successfully implemented.Trial registrationClinicalTrials.gov, NCT05187897. The CHV-NEO study was registered on January 12, 2022.

The Medium is the Message: How Secure Messaging Apps Leak Sensitive Data to Push Notification Services

Like most modern software, secure messaging apps rely on thirdparty components to implement important app functionality. Although this practice reduces engineering costs, it also introduces the risk of inadvertent privacy breaches due to misconfiguration errors or incomplete documentation. Our research investigated secure messaging apps' usage of Google's Firebase Cloud Messaging (FCM) service to send push notifications to Android devices. We analyzed 21 popular secure messaging apps from the Google Play Store to determine what personal information these apps leak in the payload of push notifications sent via FCM. Of these apps, 11 leaked metadata, including user identifiers (10 apps), sender or recipient names (7 apps), and phone numbers (2 apps), while 4 apps leaked the actual message content. Furthermore, none of the data we observed being leaked to FCM was specifically disclosed in those apps' privacy disclosures. We also found several apps employing strategies to mitigate this privacy leakage to FCM, with varying levels of success. Of the strategies we identified, none appeared to be common, shared, or well-supported. We argue that this is fundamentally an economics problem: incentives need to be correctly aligned to motivate platforms and SDK providers to make their systems secure and private by default.

Feasibility and Acceptability of a REDCap-Embedded HIPAA-Compliant Text Messaging Application to Track Medication Adherence in Adolescents With Lupus.

Despite advances in clinical care and treatment options, adolescents with lupus continue to experience adverse health outcomes. Poor adherence to medication regimens is a major contributor to these negative outcomes. The utility of short message service (SMS) in tracking barriers to adherence prospectively remains untested for adolescents with lupus. Our objectives were (1) feasibility of incorporating a Health Insurance Portability and Accountability Act (HIPAA)-compliant SMS text messaging application into REDCap and (2) acceptability of using SMS text messaging to track barriers to medication adherence in adolescents with lupus. This study is a 12-week pilot cohort study of adolescents with SLE per the 1997 revised American College of Rheumatology. A REDCap-embedded HIPAA-compliant text messaging application was used to send biweekly messages with survey link to track medication adherence. Measures were completed. Descriptive statistics were used to summarize demographics, medical, and acceptability data. Response to text messages and survey completion rates were reported as a measure of feasibility. Most eligible adolescents approached agreed to participate (n = 17, 71% enrollment rate). The cellphone ownership rate among adolescents eligible for participation was 92%. Nine subjects responded to all text messages sent (53% response and completion rate). Eleven subjects (65%) responded to two thirds of the text messages. Overall, 77% of enrolled subjects completed at least half of the surveys sent. Reminders to complete surveys were sent to 30% of enrolled adolescents. This study shows that embedding a HIPAA-compliant SMS text message application in REDCap is feasible and can be used to engage adolescents with chronic conditions in monitoring between clinic visits.

SMS-SOS: a randomised trial of the efficacy of a short message service (SMS) brief contact intervention in reducing repetition of hospital-treated self-harm: commentary, Prakash

SMS-SOS: a randomised trial of the efficacy of a short message service (SMS) brief contact intervention in reducing repetition of hospital-treated self-harm: commentary, Prakash

Mount SMB.pcap: Reconstructing file systems and file operations from network traffic

File system and network forensics are fundamental in forensic investigations, but are often treated as distinct disciplines. This work seeks to unify these fields by introducing a novel framework capable of mounting network captures, enabling investigators to seamlessly browse data using conventional tools. Although our implementation supports various protocols such as HTTP, TLS, and FTP, this work will particularly focus on the complexities of the Server Message Block (SMB) protocol, which is fundamental for shared file system access, especially within local networks.For this, we present a detailed methodology to extract essential file system data from SMB network traffic, aiming to reconstruct the share's file system as accurately as the original. Our approach goes beyond traditional tools like Wireshark, which typically only extract individual files from SMB transmissions. Instead, we reconstruct the entire file system hierarchy, retrieve all associated metadata, and handle multiple versions of files captured within the same network traffic. In addition, we also investigate how file operations impact SMB commands and show how these can be used to accurately recreate user activities on an SMB share based solely on network traffic. Although both methodologies and implementations can be applied independently, their combination provides investigators with a comprehensive view of the reconstructed file system along with the corresponding user activities extracted from network traffic.