Mobile Strategies for Women's and Children's Health: Optimizing Adherence and Efficacy of PMTCT/ART

NCT ID: NCT02400671

Last Updated: 2022-11-02

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

825 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2020-02-28

Brief Summary

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The investigators are conducting a 3-arm randomized trial comparing the effects of unidirectional SMS (ie: "push" messaging to participant) vs. bidirectional SMS dialogue between participant and provider vs. control (no SMS) among HIV-infected Kenyan mothers in Kenyan PMTCT-ART for outcomes of ART adherence and retention in care.

Detailed Description

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The investigators will compare trial arms for impact on maternal retention, adherence, virologic failure and resistance and infant HIV or HIV-free survival.

The investigators will determine correlates of maternal loss to follow-up and virologic failure and correlates of infant HIV in the overall study and stratified by trial arm. In the bidirectional SMS arm, the investigators will determine the rate of SMS interactivity, impact of critical time-points on messaging, and characteristics of high and low 'interactors'.

The investigators will determine cost-effectiveness of unidirectional and bidirectional SMS interventions. These data will contribute a potential scale-able strategy to improve PMTCT-ART as programs aspire to 'virtual elimination' of infant HIV.

Conditions

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mHealth PMTCT Adherence, Medication SMS Maternal Health HIV/AIDS

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Two-way SMS

Participants will receive weekly push SMS messaging with a questions and have the ability to text back to the study nurse

Group Type EXPERIMENTAL

SMS messaging

Intervention Type BEHAVIORAL

One-Way SMS

Participants will receive weekly push SMS messaging

Group Type EXPERIMENTAL

SMS messaging

Intervention Type BEHAVIORAL

Control

Participants will receive standard of care (no intervention)

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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SMS messaging

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* pregnant, HIV-infected, access to a mobile phone, remaining in study area for two years

Exclusion Criteria

* enrolled in another research study
Minimum Eligible Age

14 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Nairobi

OTHER

Sponsor Role collaborator

Kenyatta National Hospital

OTHER_GOV

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Grace John-Stewart

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Grace John-Stewart

Role: PRINCIPAL_INVESTIGATOR

UW

Locations

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Ahero District Hospital

Ahero, , Kenya

Site Status

Bondo District Hospital

Bondo, , Kenya

Site Status

Mathare City Council Clinic

Nairobi, , Kenya

Site Status

Riruta Health Centre

Nairobi, , Kenya

Site Status

Rachuonyo sub-County Hospital

Oyugis, , Kenya

Site Status

Siaya County Referral Hospital

Siaya, , Kenya

Site Status

Countries

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Kenya

References

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Drake AL, Unger JA, Ronen K, Matemo D, Perrier T, DeRenzi B, Richardson BA, Kinuthia J, John-Stewart G. Evaluation of mHealth strategies to optimize adherence and efficacy of Option B+ prevention of mother-to-child HIV transmission: Rationale, design and methods of a 3-armed randomized controlled trial. Contemp Clin Trials. 2017 Jun;57:44-50. doi: 10.1016/j.cct.2017.03.007. Epub 2017 Mar 14.

Reference Type BACKGROUND
PMID: 28315480 (View on PubMed)

Ronen K, Unger JA, Drake AL, Perrier T, Akinyi P, Osborn L, Matemo D, O'Malley G, Kinuthia J, John-Stewart G. SMS messaging to improve ART adherence: perspectives of pregnant HIV-infected women in Kenya on HIV-related message content. AIDS Care. 2018 Apr;30(4):500-505. doi: 10.1080/09540121.2017.1417971. Epub 2017 Dec 18.

Reference Type BACKGROUND
PMID: 29254362 (View on PubMed)

Lewis K, Harrington EK, Matemo D, Drake AL, Ronen K, O'Malley G, Kinuthia J, John-Stewart G, Unger JA. Utilizing perspectives from HIV-infected women, male partners and healthcare providers to design family planning SMS in Kenya: a qualitative study. BMC Health Serv Res. 2019 Nov 21;19(1):870. doi: 10.1186/s12913-019-4708-7.

Reference Type BACKGROUND
PMID: 31752872 (View on PubMed)

Fairbanks J, Beima-Sofie K, Akinyi P, Matemo D, Unger JA, Kinuthia J, O'Malley G, Drake AL, John-Stewart G, Ronen K. You Will Know That Despite Being HIV Positive You Are Not Alone: Qualitative Study to Inform Content of a Text Messaging Intervention to Improve Prevention of Mother-to-Child HIV Transmission. JMIR Mhealth Uhealth. 2018 Jul 19;6(7):e10671. doi: 10.2196/10671.

Reference Type BACKGROUND
PMID: 30026177 (View on PubMed)

Osborn L, Ronen K, Larsen AM, Richardson B, Khasimwa B, Chohan B, Matemo D, Unger J, Drake AL, Kinuthia J, John-Stewart G. Antenatal depressive symptoms in Kenyan women living with HIV: contributions of recent HIV diagnosis, stigma, and partner violence. AIDS Care. 2022 Jan;34(1):69-77. doi: 10.1080/09540121.2021.1981216. Epub 2021 Sep 27.

Reference Type DERIVED
PMID: 34579601 (View on PubMed)

Kinuthia J, Ronen K, Unger JA, Jiang W, Matemo D, Perrier T, Osborn L, Chohan BH, Drake AL, Richardson BA, John-Stewart G. SMS messaging to improve retention and viral suppression in prevention of mother-to-child HIV transmission (PMTCT) programs in Kenya: A 3-arm randomized clinical trial. PLoS Med. 2021 May 24;18(5):e1003650. doi: 10.1371/journal.pmed.1003650. eCollection 2021 May.

Reference Type DERIVED
PMID: 34029338 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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STUDY00000916

Identifier Type: -

Identifier Source: org_study_id

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