Chris Smith|Judy Gold|Tho?i D. Ngô|Colin Sumpter|Caroline Free
Mobile phone-based interventions for improving contraception use
London School of Hygiene & Tropical Medicine|Innovations for Poverty Action|Whitney Museum of American Art|London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine
background contraception provides significant benefits womens childrens health yet estimated 225 million women unmet need modern contraceptive methods 2014 interventions delivered mobile phone demonstrated effective health areas effects use contraception established objectives assess effects mobile phonebased interventions improving contraception use search methods searched randomised controlled trials rcts clientprovider interventions delivered mobile phone improve contraception use compared standard care another intervention searched electronic databases cochrane central register controlled trials central medline embase global health psycinfo popline africawide information latin american caribbean health sciences literature lilacs january 1993 october 2014 well clinical trials registries online mhealth resources abstracts key conferences selection criteria randomised controlled trials mobile phonebased interventions improve form contraception use amongst users potential users contraception outcome measures included uptake contraception measures adherence pregnancy abortion data collection analysis two review authors independently screened titles abstracts studies retrieved using search strategy extracted data included studies calculated mantelhaenszel risk ratio rr dichotomous outcomes mean difference md continuous outcomes together 95 confidence intervals cis differences interventions outcome measures permit us undertake metaanalysis main results five rcts met inclusion criteria three trials aimed improve adherence specific method contraception amongst existing new contraception users comparing automated text message interventions versus standard care two trials aimed improve uptake adherence limited one method users nonusers contraception trials low risk bias areas assessed one trial usa reported improved self reported oral contraceptive oc continuation six months intervention comprising range unidirectional interactive text messages rr 119 95 ci 105 135 one trial cambodia reported increased self reported use effective contraception four months post abortion intervention comprising automated interactive voice messages phone counsellor support rr 139 95 ci 117 166 one feasibility trial usa reported lower mean number days scheduled completed attendance first subsequent depoprovera appointments using clinic records intervention comprising reminders healthy self management text messages mean difference md 860 days 95 ci 1674 046 simple text message oc reminders effect missed pills assessed electronic medication monitoring small trial usa md 05 missed pills 95 ci 108 208 effect self reported contraception use noted amongst isotretinoin users intervention provided health information via two unidirectional text messages mail rr 126 95 ci 084 189 one trial assessed potential adverse effects intervention reported evidence road traffic accidents domestic abuse authors conclusions review provides limited evidence interventions delivered mobile phone improve contraception use whilst evidence suggests series interactive voice messages counsellor support improve postabortion contraception mixture unidirectional interactive daily educational text messages improve oc adherence costeffectiveness longterm effects interventions remain unknown highquality trials required robustly establish effects interventions delivered mobile phone improve contraception use