Project Title

Mobile phone text messaging plus motivational interviewing: effects on breastfeeding , child health and survival outcomes, a group sequential randomised standard of care controlled trial (MTM-MI)

EDCTP Project Call

Career Development Fellowship (CDF)

Project Objectives

1. To compare the effects of interactive weekly mobile phone text messaging combined with motivational interviewing versus standard of care on infant breastfeeding practice, specifically with respect to: (a) Continued exclusive breastfeeding to six month of child age, (b) Continued any form of breastfeeding to 6 month of child age. 2. To compare the contribution of interactive weekly mobile phone text messaging combined with motivational interviewing versus standard of care on improved infant health outcomes, specifically with respect to: (a) Infant morbidity (all –cause hospitalization) and all –cause death, (b) Infant growth (anthropometric measurements)

Study Design

Two arm randomized study

Project Summary

Lack of breastfeeding, at a minimum, doubles the risk of infant death in the first six months of life. Many infants in low resourced settings at high risk of infectious disease morbidity and death are deprived of the immunological and nutritional benefits of breast milk, through an attenuated duration of breast milk exposure. South Africa has one of the lowest exclusive breastfeeding rates in Africa, 8% in infants under 6 months of age. Mobile phone text messaging as a simple, low-cost intervention improves medication adherence among patients with HIV, diabetes, and tuberculosis. Motivational interviewing is a patient-centered non-coercive approach that explores the patient’s readiness to change behaviour and supports the person’s commitment to do so in the preferred direction. Motivational interviewing has been beneficial across many health problems, including HIV viral load suppression, body weight loss, and alcohol and tobacco use. Improving breastfeeding practices in low-resource setting is key to achieving the Sustainable Development targets for under-five child survival. The need for effective intervention to support breastfeeding in resource-limited settings is increasingly pertinent in view of increased disease burden on an already stressed public healthcare system. Combining several intervention approaches is more likely to influence behaviour change than an individual approach. We conducted a group sequential clinical trial to determine whether text messaging combined with motivational interviewing compared to standard infant feeding counselling prolong breastfeeding and improve infant health outcomes. Study recruitment started on the 22nd of July 2022. We screened 1145 and enrolled 276 women living with HIV and their infants at birth and randomly assigned study interventions for 6 months. We completed study follow up on the 15th of May 2024. A study intervention facilitator not involved in administering the study questionnaires at follow up visits administered the study interventions. Research assistants administered a baseline questionnaire and follow up study questionnaires.

Host Organisation

Results & Outcomes

Current Organisation

Stellenbosch University

Current Job Title

Senior Lecturer

Biography

Publications