Global WACh

Family Planning Decision Support Scientific Priority Area

 

The Challenge

Many women face significant barriers in accessing family planning services to meet their reproductive health needs. As a result, unintended pregnancy rates remain high and more than 220 million women worldwide continue to face an unmet need for contraception and family planning support.

Our Response

We develop and test innovative strategies using an implementation science framework to achieve sustainable progress in family planning.  We strive to evaluate novel counseling tools and the success of transferable patient-centered care delivery models.  These changes will support women and their families make informed reproductive health decisions, and provide access to respectful and dignified family planning care.

 

Areas of Focus

Novel Family Planning Support Methods

Health support technologies and novel data collection tools will bring the health care system closer to women and their families, bring their health concerns to the attention of decision-makers, and reduce the unmet need for family planning.

Collaboration and Leadership Training

By establishing and growing collaborations, we will responsibly scale and integrate these solutions to help women and their families, expand to other regions and populations and cultivate young innovators to ensure the sustainability of this work.  Our passion for encouraging young Family Planning (FP) and Maternal-Child Health (MCH) researchers has led to the development of projects that bring family planning and contraceptive information and support to women and their partners, provide daily support to women and newborns during the critical postpartum period, and understand adolescent needs for contraception.

Implementation Science

Our implementation science framework for family planning and maternal health focuses on person-centered, novel approaches to reaching women.  We design tools and improve health systems to empower and support women through family planning, pregnancy, and the postpartum period.

 

 

Collaborators

Faculty Directors

Alison Drake
MPH, PhD
Assistant Professor
Global Health and Epidemiology [Adjunct]

SEARCH IN PROGRESS

Faculty Leads and Technical Advisors

Lisa Callegari
MD, MPH
Associate Professor
Obstetrics & Gynecology

Elizabeth Harrington
MD, MPH
Acting Assistant Professor
Obstetrics & Gynecology

Renee Heffron
MPH, PhD
Associate Professor
Global Health and Epidemiology

John Kinuthia
MBChB, MMed, MPH
Head of Research and Programs
Kenyatta National Hospital;
Affiliate Associate Professor
Global Health

Keshet Ronen
PhD
Acting Assistant Professor
Global Health

Alison Roxby
MD, MSc
Associate Professor
Global Health and Epidemiology

Staff and Trainees

Jenna Udren
MPH
Research Coordinator

Claire Rothschild
MSc
Predoctoral Fellow

Lucy Yates
Public Health Major

 

 

Research Studies

Our projects often provide opportunities for University of Washington graduate students to assist in data analysis. Please contact the Principal Investigator to inquire about currently available opportunities or anticipated needs in the near future.

Leveraging the Mobile WACh Hybrid-Computer Platform to Increase Uptake of MCH and FP Strategies

Solutions for Women and Children's Health in Kenya (Mobile WACh)

This randomized trial was designed to determine the effect of a systematic provision of tailored one-way SMS or two-way SMS dialogue on uptake of maternal-child health (MCH) strategies including facility delivery, antenatal care attendance, infant immunizations, exclusive breastfeeding, and postpartum family planning uptake. We utilized a novel human-computer hybrid approach to deliver messaging to women targeted at increasing uptake of MCH and FP strategies.

Sponsor:  National Institutes for Health (K12HD001264)

Award Years:  07/01/2013 – 07/01/2015

Principal Investigator:  Jennifer Unger

Co-Investigators:  Elizabeth Harrington, John Kinuthia

Communication Empowering Mothers and Newborns (Mobile WACh NEO)

This randomized trial was designed to determine the effect of a systematic provision of tailored one-way SMS or two-way SMS dialogue on uptake of MCH strategies including facility delivery, antenatal care attendance, infant immunizations, exclusive breastfeeding, and postpartum family planning uptake.  We utilized a novel human-computer hybrid approach to deliver messaging to women targeted at increasing uptake of MCH and FP strategies.

Sponsor:  United States Agency for International Development (AID-OAA-F-16-00026)

Award Years:  07/01/2016 – 06/30/2019

Principal Investigators:  Jennifer Unger,  John Kinuthia

Co-Investigators:  Maneesh Batra, Alison Drake, Grace John-Stewart, Keshet Ronen

Mobile Solutions for Neonatal Health and Maternal Support (Mobile WACh NEO RCT)

This randomized control trial will evaluate the novel Mobile WACh NEO intervention to address a crucial gap in supporting mothers to care for their neonates and seek care when needed and has the potential to make a significant contribution to the World Health Organization’s Every Newborn Action Plan to end preventable neonatal death and stillbirth.

Sponsor:  National Institute for Health Child Health & Human Development (5R01HD098105)

Award Years:  06/01/2019 – 03/31/2024

Principal Investigators:  Jennifer Unger, John Kinuthia

Co-Investigators:  Maneesh Batra, Grace John-Stewart, Barbra Richardson, Keshet Ronen, Manasi Kumar (University of Nairobi), Dalton Wamalwa (University of Nairobi)

Evaluation of mHealth Strategies to Optimize Adherence and Efficacy of PMTCT/ART (Mobile WACh X)

This randomized trial was designed to determine the effect of a systematic provision of tailored one-way SMS or two-way SMS dialogue to control virologic suppression in HIV-infected peripartum women in Kenya.

Sponsor:  National Institute for Health Child Health & Human Development (5R01HD090460)

Award Years:  05/01/2014 – 04/30/2021

Principal Investigators:  Grace John-Stewart, John Kinuthia

Co-Investigators:  Keshet Ronen, Jennifer Unger

Evaluation of an mHealth SMS Dialogue Strategy to Meet Women's and Couples' Postpartum Contraceptive Needs in Kenya (Mobile WACh XY)

Mobile WACh XY is a two-arm randomized controlled trial (RCT) comparing the effect of bidirectional SMS dialogue vs. control on highly effective contraceptive use at 6 months postpartum among individual 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.  Mobile WACh XY differentiates itself in the family planning arena by including an emphasis on male partner involvement and couple communication.

Sponsor:  National Institutes of Health

Award Years:  2016 – 2021

Principal Investigators:  Elizabeth Harrington

Co-Investigators:  John Kinuthia, Jennifer Unger

A SMS-based Support Intervention to Enhance PrEP Adherence during Pregnancy and Breastfeeding (mWACh-PrEP)

We propose a randomized trial to determine the effect of the mWACh-PrEP tool on PrEP adherence during pregnancy through the postpartum period. We will also gather data on cost and delivery using the Proctor Implementation Outcomes Framework to expedite translation into routine practice. Our overarching hypothesis is that mWACh-PrEP will improve PrEP adherence among mothers at-risk for HIV, be acceptable to patients and providers, and be cost-effective.

Sponsor:  National Institute of Nursing Research (5R05NR019220)

Award Years:  09/18/2020 – 06/30/2025

Principal Investigators:  John-Kinuthia, Jillian Pintye

Mobile solutions to empower reproductive life planning for women living with HIV (mWACh-Empower)

Use of a mobile health (mHealth) intervention to provide reproductive life counseling to women living with HIV may improve delivery of integrated reproductive health/HIV services and prevent adverse reproductive health outcomes. The proposed study will evaluate SMS platform and reproductive health counseling intervention in a cluster randomized controlled trial among women receiving routine HIV care, and plan for future implementation with qualitative and health economic analyses.

Sponsor:  National Institute of Child Health & Human Development (1R01HD104551)

Award Years:  06/01/2021 – 05/30/2026

Principal Investigator:  Alison Drake

Community-based digital communication to support neonatal health (CHV-NEO)

This study will develop an interactive SMS text messaging intervention that remotely connects mothers with community health volunteers (CHVs), and evaluate the intervention’s effect on clinical outcomes (neonatal mortality, facility visits, and essential newborn care), service outcomes (CHV and supervisor workflow), and implementation outcomes (acceptability, uptake, and fidelity of implementation) when implemented as part of routine CHV workflow in Kenya.

Sponsor:  National Institute of Health (5R05NR019220)

Award Years:  04/15/2021 – 02/28/2026

Principal Investigator:  Keshet Ronen

Co-Investigators:  John Kinuthia, Isaac Holeman

 

Utilizing mHealth Tools to Develop New Interventions

Mobile Collection of Contraceptive Use, Behaviors, and Experiences in Western Region, Kenya (mCUBE)

The goal of this study is to develop a deeper understanding of contraceptive behavior, including adherence, experiences of side effects, continuation, and satisfaction, among a cohort of adult women and adolescent girls using modern contraception in western Kenya.  We test the feasibility and acceptability of a novel, tailored mobile messaging platform for collecting real-time, ongoing information from women on their family planning experiences.

Sponsor:  Gates Grand Challenges Award (OPP1172004)

Award Years:  05/01/2017 – 10/31/2018

Principal Investigator:  Alison Drake

Trainee:  Claire Rothschild

Social Media Support for Peripartum Adolescents in Seattle (IMAGINE)

We propose to develop a social media-based group counseling intervention to prevent perinatal depression in adolescents, based on core elements of the MBP curriculum. Leveraging our interdisciplinary collaborative team’s experiences designing and evaluating social media interventions, and providing mental health care to peripartum women and adolescents.

Sponsor:  University of Wisconsin Technology and Adolescent Mental Wellness (TAM)

Award Period:  06/01/2019 – 06/01/2021

Principal Investigator:  Keshet Ronen

Co-Investigators:  Amritha Bhat, Jennifer Unger

Trainee:  Anupa Gewali