Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluation of an mHealth SMS Dialogue Strategy to Meet Women's and Couples' Postpartum Contraceptive Needs in Kenya
Brief Summary: Meeting women's need for postpartum family planning is has been acknowledged as a global priority in maternal and child health. The prevention of unintended pregnancies in sub-Saharan African countries, which carry the highest global burdens of maternal mortality and HIV infection, is projected to substantially decrease maternal and neonatal morbidity and mortality. Many barriers to contraceptive uptake exist, both within and outside of the postpartum time period, and include socio-cultural, economic, and supply-side factors. Furthermore, while the importance of engaging men in family planning programs has been acknowledged for decades, few interventions have succeeded in increasing male involvement in family planning while maintaining a focus on women's empowerment. Innovative approaches to meeting the family planning needs of women and couples are urgently needed.

Public health interventions are increasingly incorporating mobile health (mHealth) approaches using short message service (SMS) technology in low-income countries, approaches that have demonstrated benefit among various reproductive health outcomes. The investigators hypothesize that personalized, bidirectional SMS dialogue with individual women and couples will increase postpartum contraceptive uptake, thereby decreasing unmet need for family planning in Kenya. The investigators have collaborated with the University of Washington (UW) Department of Computer Science and Engineering (CSE) along with Kenyan telecommunication providers to develop a hybrid messaging system that allows for innovative bidirectional SMS messaging. This system has been used successfully in maternal child health (MCH) clinics in Kenya. In qualitative research, women in Kenya have expressed a strong desire for mHealth support to provide additional education, counseling and reminders to supplement counseling by health workers.

The investigators propose a randomized controlled trial (RCT) comparing the effects of bidirectional SMS dialogue vs. control on highly effective contraceptive use at 6 months postpartum among HIV negative women and couples in Nyanza Province, Kenya. Data from this RCT and accompanying qualitative study will contribute to innovative, scale-able strategies to address unmet need for contraception and increase male involvement in family planning.


Options:
A: Inclusion Criteria:

* Parents of children less than 11 months of age
* Currently enrolled at Kaiser Permanente Colorado at the time of identification
* The child is missing recommended vaccinations

Exclusion Criteria:

* Non-english speaking
* diagnosis code indicating parent vaccine refusal
B: Inclusion Criteria:

* Known or recently diagnosed HIV-positive in ANC or; Tested HIV-negative at ANC
* Plans to deliver in facility catchment area
* 18 years or older
* Able and willing to provide consent

Exclusion Criteria:

-
C: Inclusion Criteria:

* Pregnant; at least 28 weeks gestation
* HIV negative
* Daily access to a mobile phone
* Planning to stay in area for 6 months postpartum
* Able to read/write or has trusted person to help

Exclusion Criteria:

* Does not meet above criteria
D: Inclusion Criteria:

* the mother has access to a cell phone (either her own phone or the phone of a household member)
* the mother lives in the uptake area of the health center.

Exclusion Criteria:

* the mother does not have access to a mobile phone.

Answer: C