Mobile Phone Text Messaging Plus Motivational Interviewing: Effects on Breastfeeding, Child Health Outcomes

Summary

Background

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 has been beneficial across many health problems, including HIV viral load suppression, body weight loss, and alcohol and tobacco use. Combining a number of intervention approaches is more likely to influence behaviour change than an individual approach. Investigators assume that continued breastfeeding is sustained among women living with HIV receiving weekly text messages combined with motivational interviewing and that this contributes to improved infant health outcomes.

Objectives:

1. To determine the effects of mobile phone text messaging combined with motivational interviewing versus standard of care on: (a) Continued exclusive breastfeeding to six month of child age, (b) Continued any form of breastfeeding to 6 month of child age.
2. To determine the contribution of the combined intervention on improved infant health outcomes: (a) Infant morbidity (all -cause hospitalization) and death (all -causes, (b) Infant growth.

Methods

Investigators propose a group sequential clinical trial to determine whether text messaging combined with motivational interviewing will prolong breastfeeding and the contribution of the combined intervention on improved infant health outcomes. The study will recruit 275 women living with HIV and HIV exposed infants at birth and randomly assign study interventions for 6 months.

Conditions

• Breastfeeding, Exclusive
• HIV Infections

Interventions

BEHAVIORAL

Mobile phone text messaging plus prospective motivational interviewing

Interactive weekly mobile phone text messaging plus prospective motivational interviewing at study follow up visits

BEHAVIORAL

Standard infant feeding counselling

Standard infant feeding counselling as part of routine practice at primary healthcare facility

Sponsors & Collaborators

• McMaster University

  collaborator OTHER

• Columbia University

  collaborator OTHER

• University of Stellenbosch

  lead OTHER

Principal Investigators

• Moleen Dzikiti · University of Stellenbosch

• Taryn Young · University of Stellenbosch

• Mark Cotton · University of Stellenbosch

• Lehana Thabane · McMaster University

• Louise Kuhn · Columbia University

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-07-22

Primary Completion

2024-09-30

Completion

2024-09-30

Countries

• South Africa

Study Locations