Title
The ARMADILLO text message intervention to improve the sexual and reproductive health knowledge of adolescents in Peru: Results of a randomized controlled trial
Date Issued
01 February 2022
Access level
open access
Resource Type
journal article
Publisher(s)
Public Library of Science
Abstract
Background The ARMADILLO Study determined whether adolescents able to access SRH information on-demand via SMS were better able to reject contraception-related myths and misconceptions as compared with adolescents receiving pushed SMS or no intervention. Trial design This trial was an unblinded, three-arm, parallel-group, individual RCT with a 1:1:1 allocation. Trial registration: ISRCTN85156148. Methods This study was conducted in Lima, Peru among participants ages 13–17 years. Eligible participants were randomized into one of three arms: Arm 1: access to ARMADILLO’s SMS information on-demand; Arm 2 access to ARMADILLO SMS information pushed to their phone; Arm 3 control (no SMS). The intervention period lasted seven weeks. At baseline, endline, and follow-up (eight weeks following endline), participants were assessed on a variety of contraception-related myths and misconceptions. An index of myths-believed was generated. The primary outcome assessed the subject-specific change in the mean score between baseline and endline. Knowledge retention from endline to follow-up was also assessed, as was a ‘content exposure’ outcome, which assessed change in participants’ knowledge based on relevant SMS received. Results In total, 712 participants were randomized to the three arms: 659 completed an endline assessment and were included in the primary analysis. Arm 2 participants believed fewer myths at endline compared with control arm participants (estimated subject-specific mean difference of -3.69% [-6.17%, -1.21%], p = 0.004). There was no significant difference between participants in Arm 1 vs. the control Arm, or between participants in Arm 1 vs. Arm 2. A further decrease in myths believed between endline and follow-up (knowledge retention) was observed in all arms; however, there was no difference between arms. The content exposure analysis saw significant reductions in myths believed for Arm 1 (estimated subject-specific mean difference of -9.47% [-14.83%, -4.11%], p = .001) and Arm 2 (-5.93% [-8.57%, -3.29%], p < .001) as compared with the control arm; however Arm 1’s reduced sample size (n = 28) is a severe limitation. Discussion The ARMADILLO SMS content has a significant (but small) effect on participants’ contraception-related knowledge. Standalone, adolescent SRH digital health interventions may affect only modest change. Instead, digital is probably best used a complementary channel to expand the reach of existing validated SRH information and service programs.
Volume
17
Issue
2 February
Language
English
OCDE Knowledge area
Ciencias socio biomédicas (planificación familiar, salud sexual, efectos políticos y sociales de la investigación biomédica)
Scopus EID
2-s2.0-85124382049
PubMed ID
Source
PLoS ONE
ISSN of the container
19326203
Sources of information: Directorio de Producción Científica Scopus