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Open Access Highly Accessed Study protocol

MObile Technology for Improved Family Planning Services (MOTIF): study protocol for a randomised controlled trial

Chris Smith13*, Uk Vannak1, Ly Sokhey1, Thoai D Ngo2, Judy Gold2, Khemrin Khut1, Phil Edwards3, Tung Rathavy4 and Caroline Free3

Author Affiliations

1 Marie Stopes International Cambodia (MSIC), Phnom Penh, Cambodia

2 Evidence, Strategy and Innovation, Health Systems Department, Marie Stopes International (MSI), London, UK

3 Department of Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK

4 National Maternal Child Health Center (NMCHC) and Reproductive Health National Programme Manager, Phnom Penh, Cambodia

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Trials 2013, 14:427  doi:10.1186/1745-6215-14-427

Published: 12 December 2013

Abstract

Background

Providing women with contraceptive methods following abortion is important to reduce repeat abortion rates, yet evidence for effective post-abortion family planning interventions are limited. This protocol outlines the evaluation of a mobile phone-based intervention using voice messages to support post-abortion family planning in Cambodia.

Methods/Design

A single blind randomised controlled trial of 500 participants. Clients aged 18 or over, attending for abortion at four Marie Stopes International clinics in Cambodia, owning a mobile phone and not wishing to have a child at the current time are randomised to the mobile phone-based intervention or control (standard care) with a 1:1 allocation ratio.

The intervention comprises a series of six automated voice messages to remind clients about available family planning methods and provide a conduit for additional support. Clients can respond to message prompts to request a phone call from a counsellor, or alternatively to state they have no problems. Clients requesting to talk to a counsellor, or who do not respond to the message prompts, receive a call from a Marie Stopes International Cambodia counsellor who provides individualised advice and support regarding family planning. The duration of the intervention is 3 months. The control group receive existing standard of care without the additional mobile phone-based support.

We hypothesise that the intervention will remind clients about contraceptive methods available, identify problems with side effects early and provide support, and therefore increase use of post-abortion family planning, while reducing discontinuation and unsafe method switching.

Participants are assessed at baseline and at 4 months. The primary outcome measure is use of an effective modern contraceptive method at 4 months post abortion. Secondary outcome measures include contraception use, pregnancy and repeat abortion over the 4-month post-abortion period.

Risk ratios will be used as the measure of effect of the intervention on the outcomes, and these will be estimated with 95% confidence intervals. All analyses will be based on the ‘intention to treat’ principle.

Discussion

This study will provide evidence on the effectiveness of a mobile phone-based intervention using voice messages to support contraception use in a population with limited literacy. Findings could be generalisable to similar populations in different settings.

Trial registration

ClinicalTrials.gov Identifier: NCT01823861

Keywords:
Family planning; Post-abortion family planning; Contraception; mHealth; Cambodia