mHealth Cross-Cutting Methodology
The Challenge
Health outcomes for women, adolescents and children still lag behind targets in many countries, particularly neonatal mortality, family planning uptake, childhood wasting and areas related to HIV treatment and prevention. At the same time, mobile phone coverage in low- and middle-income countries has dramatically increased. Mobile technologies offer opportunities to engage community members with their health directly in the palm of their hands.
Our Response
We work closely with researchers, clinicians, epidemiologists, local and national health decisionmakers, on-the-ground leaders and technology partners to design mobile health interventions to reach those most at risk, and for whom connections to health workers and facilities can make a transformation in their health. We carefully design studies to bring evidence about the ways that digital interventions can – and cannot – support health systems.
Research Studies
Ongoing
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 Child Health and Human Development (R01HD103581)
Award Years: 04/15/2021 – 02/28/2026
Principal Investigator: Keshet Ronen, UW
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 (R01NR019220)
Award Years: 09/18/2020 – 06/30/2026 (extended)
Principal Investigator: Jillian Pintye, UW; John Kinuthia, Kenyatta National Hospital, UW
Mobile solutions to empower reproductive life planning for women living with HIV (Mobile WACh Empower)
We will evaluate an SMS platform and reproductive health counseling intervention designed to provide reproductive life counseling and integrated reproductive health/HIV services 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 and Human Development (R01HD104551)
Award Years: 06/01/2021 – 05/31/2026
Principal Investigator: Alison Drake, UW
Mechanisms of Action for mobile SMS PrEP adherence intervention (PrEP Mechanisms)
Mobile health innovations to support adherence could fill an important gap in HIV prevention care delivery. Within this project, we propose to test how and why a specific mobile health intervention works to improve adherence to pre-exposure prophylaxis by examining pregnant and postpartum women’s experiences, their mobile message content, and their responses to study questions about information, motivation, and gaining behavioral skills.
Sponsor: National Institute of Nursing Research (R21NR021354)
Award Years: 07/25/2025 – 06/30/2026
Principal Investigators: Anjuli Wagner, UW; John Kinuthia, Kenyatta National Hospital, UW
Developing a Two-Way SMS Platform to Prevent and Treat Wasting Among HIV-infected and HIV-exposed Uninfected Children (MAMMS IYCF)
This proposal will develop a novel two-way short message service (SMS) platform that targets key barriers to improving nutritional care for HEU and HIV-infected children. This intervention will combine a maternally administered malnutrition monitoring system (MAMMS) with infant and young child education (IYCF) delivered by SMS. After developing the intervention using participatory design methods, we will complete a proof-of-concept quasi-experimental trial of MAMMS-IYCF in the R21. If the R21 milestones are meet, we will use the R33 to conduct a randomized trial testing the effectiveness of MAMMS-IYCF at reduced the incidence wasting, and the duration of wasting treatment. During this trial we will also assess the cost and cost-effectiveness of MAMMS-IYCF, and to better understand which barriers are being successfully addressed by intervention we will measure its effect on key attitudinal and behavioral outcomes including trust in the healthcare system, intention to seek if a child becomes wasted, and IYCF knowledge.
Sponsor: National Institutes of Health (R21HD110150, R33HD110150)
Award Years: 08/17/2022 – 07/01/2027
Principal Investigators: Arianna Means, Kirk Tickell, UW
Improving fathers mental health, parenting, and familial engagement through an mHealth intervention in Kenya (BABAText)
One in ten fathers experience severe mental health challenges due to the stressors of parenting and fathers’ mental health plays a pivotal role in early child social-emotional development with impact throughout a child’s lifespan. Parenting interventions that support effective parenting knowledge, skills, and behaviors improve parent-child mental health outcomes, including in low- and middle-income settings, yet in-person mental health services for men are scarce and are stigmatizing and logistically challenging for fathers to attend. We propose to develop and pilot test a novel mHealth parenting intervention specifically designed for fathers which incorporates fathers’ needs and preferences from a mixed methods needs assessment, interactive input from a stakeholder advisory group, and elements from evidence-based mental health and parenting interventions through a user-centered co-design approach with fathers in Kenya.
Sponsor: National Institute of Mental Health (K01MH137324)
Award Years: 09/09/2025 – 08/31/2030
Principal Investigator: Anna Larsen, UW
Completed
Mobile Phone Messaging to Improve Women's and Children's Health (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 Institute of Child Health and Human Development (K12HD001264)
Award Years: 07/01/2013 – 07/01/2015
Principal Investigator: Jennifer Unger, Brown University
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
Award Years: 07/01/2016 – 06/30/2019
Principal Investigator: Jennifer Unger, Brown University
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 of Child Health and Human Development (R01HD098105)
Award Years: 06/01/2019 – 03/31/2024
Principal Investigator: Jennifer Unger, Brown University
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 of Child Health and Human Development (R01HD090460)
Award Years: 05/01/2014 – 04/30/2021
Principal Investigator: Grace John-Stewart, UW
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: Society of Family Planning; National Institute of Allergy and Infectious Diseases (K01 AI116298)
Award Years: 2016 – 2021
Principal Investigator: Elizabeth Harrington, UW
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
Award Years: 05/01/2017 – 10/31/2018
Principal Investigator: Alison Drake, UW
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. Visit the study website to learn more.
Sponsor: University of Wisconsin Technology and Adolescent Mental Wellness (TAM) Program
Award Period: 06/01/2019 – 06/01/2021
Principal Investigator: Keshet Ronen, UW
PrIYA mWACh-PrEP Pilot
This study evaluated a two-way short message service (SMS) communication platform to improve continuation of pre-exposure prophylaxis (PrEP) for HIV prevention among Kenyan women who initiated PrEP within routine maternal child health (MCH) and family planning clinics.
Sponsor:
Award Period:
Principal Investigator: Jillian Pintye, UW
Leveraging interactive SMS messaging to monitor and support maternal mental health in Kenya (SMS INTERACTION)
Depression is the most common complication of pregnancy, but it is undertreated due to lack of mental healthcare resources and barriers to in-person care. Short message service (SMS) text messaging is a promising tool to support mental health in the high-risk peripartum period. This project aims to use natural language processing and machine learning to develop an adaptive SMS intervention that supports healthcare workers to deliver effective SMS messages to support perinatal depression.
Sponsor: National Institute of Mental Health (K18MH122978)
Award Period: 01/06/2020 – 08/31/2022
Principal Investigator: Keshet Ronen, UW
Maternal Administered Malnutrition Monitoring System (Mama Aweza)
Mama Aweza is a randomized controlled trial that aims to establish the efficacy and feasibility of a novel malnutrition screening approach, in which caregivers are taught to use MUAC tapes. The caregivers are enrolled in a semi-automated mHealth SMS system that provides health education and MUAC monitoring support to improve early identification and linkage to care for malnourished Kenyan children aged 6-12 months. This scalable childhood growth monitoring system could enable nutrition programs in low and middle-income countries to optimize screening coverage, leading to early identification of malnutrition, lower costs, and a reduction in global under-five mortality.
Sponsor: Thrasher Research Fund
Award Years: 02/01/2019 – 03/31/2022
Principal Investigator: Christine McGrath, UW
Click here to read the study protocol.