Text Messages Validation and Adaptation for Breastfeeding Promotion / Validación y adaptación de mensajes de texto para el fomento de la lactancia materna / Validação e adaptação de mensagens de texto para o fomento da lactância materna

Abstract Objective: to design and validate a text messages database to promote breastfeeding. Materials and methods: quantitative research, instruments validation type done in three phases: (1) creation of text messages from documental analysis, (2) validation of content with experts, (3) comprehension tests with pregnant and maternal women. The analyzed information was done with SPSS version 22. Results: the final database had 96 text messages, submitted to the content validation phase with the participation of 13 experts. The internal consistency was "very high" with Cronbach Alfa of 0.93. The results of comprehension tests showed an adequate understanding of messages by pregnant and maternal women. Conclusions: the quantitative results showed through Cronbach Alfa, and comprehension tests administered to pregnant and maternal women, allowed to keep all the messages elaborated in phase 0 of the research and justify their adequate use for the promotion of breastfeeding.

Resumen Objetivo: diseñar y validar una base de datos de mensajes de texto para el fomento de la lactancia materna. Materiales y métodos: investigación cuantitativa del tipo validación de instrumentos, realizada en tres fases, la primera, permitió elaborar los mensajes de texto a partir de indagación documental; en la segunda se llevó a cabo la validación de contenido con expertos en la temática y en la tercera se realizaron las pruebas de comprensión con gestantes y lactantes. La información fue analizada en el software SPSS versión 22. Resultados: la base de datos de mensajes de texto final estuvo conformada por 96 mensajes, los cuales fueron sometidos a la fase de validación de contenido donde participaron 13 expertos. La consistencia interna se ubicó como "muy alto" con el Alfa de Cronbach de 0,93. Los resultados de las pruebas de comprensión evidenciaron un adecuado entendimiento de los mensajes por parte de las gestantes y lactantes. Conclusiones: los resultados cuantitativos evidenciados a través del Alfa de Cronbach, junto con las pruebas de comprensión realizadas con madres gestantes y lactantes, permitieron conservar el total de mensajes elaborados en la fase 0 de la investigación y soportan su adecuada utilización para el fomento de la lactancia materna.

Resumo Objetivo: esenhar e validar uma base de dados de mensagens de texto para o fomento da lactância materna. Materiais e métodos: pesquisa quantitativa o tipo validação de instrumentos, feita em três fases, a primeira, permitiu elaborar as mensagens de texto a partir de indagação documental; na segunda se levou a cabo a validação de conteúdo com expertos na temática e na terceira se realizaram as provas de compreensão com gestantes e lactantes. A informação foi analisada no software SPSS versão 22. Resultados: a base de dados de mensagens de texto final esteve conformada por 96 mensagens, os quais foram submetidos à fase de validação de conteúdo onde participaram 13 expertos. A consistência interna se ubicou como "muito alto" com l Alfa de Cronbach de 0,93. Os resultados das provas de compreensão evidenciaram um adequado entendimento das mensagens por parte das gestantes e lactantes. Conclusões: os resultados quantitativos evidenciados a través do Alfa de Cronbach, junto com as provas de compressão feitas com mães gestantes e lactantes, permitiram conservar o total de mensagens elaborados na fase 0 da pesquisa e suportam sua adequada utilização para o fomento da lactância materna.

Text Messages to Promote Secondary Prevention after Acute Coronary Syndrome (IMPACS trial)

Abstract Background Short message service (SMS) to promote healthcare improves the control of cardiovascular risk factors, but there is a lack of evidence in low and middle-income countries, particularly after acute coronary syndromes (ACS). Objective This study aims to evaluate whether the use of SMS increases risk factor control after hospital discharge for ACS. Methods IMPACS is a 2-arm randomized trial with 180 patients hospitalized due to ACS at a tertiary hospital in Brazil. Eligible patients were randomized (1:1) to an SMS intervention (G1) or standard care (G2) upon hospital discharge. The primary endpoint was set to achieve 4 or 5 points in a risk factor control score, consisting of a cluster of 5 modifiable risk factors: LDL-C <70mg/dL, blood pressure (BP) <140/90mmHg, regular exercise (≥5 days/week, 30 minutes/session), nonsmoker status, and body mass index (BMI) <25 kg/m2] at 6 months. Secondary outcomes were components of the primary outcome plus rehospitalization, cardiovascular death, and death from any cause. Results are designated as significant if p<0.05. Results From randomized patients, 147 were included in the final analysis. Mean age was 58 (51-64) years, 74% males. The primary outcome was achieved by 12 (16.2%) patients in G1 and 15 (20.8%) in G2 (OR=0.73, 95%CI 0.32-1.70, p=0.47). Secondary outcomes were also similar: LDL-C<70 mg/dl (p=0.33), BP<140/90 mmHg (p=0.32), non-smoker (p=0.74), regular exercise (p=0.97), BMI (p=0.71), and rehospitalization (p=0.06). Death from any cause occurred in three participants (2%), including one cardiovascular death in each group. Conclusion SMS intervention did not significantly improve cardiovascular risk factor control when compared to standard care in patients discharged after ACS in Brazil.

Atividade física na gravidez e seu efeito sobre os parâmetros relacionados ao peso: um estudo piloto randomizado e controlado / Physical activity in pregnancy and its effect on weight-related parameters: a pilot randomized controlled trial

INTRODUÇÃO: O declínio no nível de atividade física durante a gravidez está relacionado a várias complicações relacionadas à gravidez. Portanto, a atividade física regular durante a gravidez tem um papel importante na manutenção da boa saúde reprodutiva e de um estilo de vida saudável. OBJETIVOS: Avaliar o efeito de exercícios supervisionados, mensagens de texto e intervenções de atividade física baseadas em pedômetros durante a gravidez sobre os níveis de atividade física e parâmetros relacionados ao peso. MATERIAIS E MÉTODOS: Estudo piloto de grupo paralelo controlado e aleatório. Sessenta mulheres grávidas foram aleatorizadas em cinco grupos (N=12 em cada grupo): Grupo A: Exercício supervisionado; Grupo B: Pedômetro; Grupo C: Pedômetro mais mensagem de texto; Grupo D: Mensagem de texto e Grupo E: Controle. Mulheres grávidas de 20 a 30 anos de idade com uma gravidez de um botão e idade gestacional inferior a 16 semanas na inclusão, um IMC ≥ 18,5 kg /m2, uma disponibilidade de telefone celular e capacidade de falar e ler hindi e inglês foram selecionadas para participação no estudo. Mulheres com gestações gêmeas ou múltiplas, IMC >30kg/m2, gravidez de alto risco conforme decisão do ginecologista, quaisquer complicações relacionadas à gravidez, tais como hipertensão pré-gestacional, diabetes pré-gestacional e outras condições de saúde importantes que restringem sua atividade física no momento do recrutamento e mulheres grávidas analfabetas foram excluídas do estudo. O Grupo A recebeu um exercício supervisionado de luz a moderada intensidade de 45-60 minutos uma vez por semana a partir da 15ª semana até o parto. Os grupos B e C foram encorajados a melhorar o nível de atividade física, concentrando-se em uma contagem de passos de pelo menos 5000-7500 passos por dia avaliados por pedômetro em sete dias consecutivos por mês. O grupo C, além do pedômetro e o grupo D receberam SMS padrão relacionados aos cuidados da gravidez (atividade física, dieta, motivacional e educacional específica). Foi utilizada a ANOVA de uma via para estimar as diferenças entre os grupos e foi utilizado o teste t pareado para estimar a diferença dentro do grupo nas variáveis de resultado (p=0,05). RESULTADOS: O resultado do estudo mostrou estatisticamente significativo entre as diferenças de peso dos grupos no 9º mês (p=0,029) e a retenção de peso nos 2 meses pós-parto (p=0,005). O grupo de exercício supervisionado reteve menos peso durante o período pós-parto em comparação com o grupo de controle (Exercício supervisionado vs Controle, MD = 2,79kg, p=0,002). Entretanto, não houve melhora estatística significativa no ganho de peso gestacional, IMC, circunferência da cintura, circunferência do quadril e relação cintura/quadril em comparação com os grupos. CONCLUSÃO: Pode-se concluir que os exercícios supervisionados são eficazes para aumentar a atividade física, reduzir os parâmetros relacionados ao peso e ajudar na adoção de um estilo de vida saudável durante a gravidez.

INTRODUCTION: The decline in the level of physical activity during pregnancy is related to various pregnancy related complications. Therefore, regular physical activity during pregnancy plays an important role in maintaining good reproductive health and healthy lifestyle. OBJECTIVES: was to assess the effect of supervised exercises, text messages, and pedometer-based physical activity interventions during pregnancy on physical activity levels and weight-related parameters. MATERIALS AND METHODS: Controlled, randomized, parallel-group pilot study. Sixty pregnant women were randomized into five groups (N= 12 in each group): Group A: Supervised exercise; Group B: Pedometer; Group C: Pedometer plus text message; Group D: Text message and Group E: Control. Pregnant women aged 20-30 years with a singleton pregnancy and gestational age of less than 16 weeks at inclusion, a BMI ≥ 18.5 kg /m2, an availability of mobile phone and ability to speak and read Hindi and English languages were selected for participation in the study. Women with twin or multiple pregnancies, BMI >30kg/m2, high-risk pregnancy as decided by the gynecologist, any pregnancy related complications such as pre-gestational hypertension, pre-gestational diabetes, and other major health conditions restricting their physical activity at the time of recruitment and illiterate pregnant women were excluded from the study. Group A received supervised light to moderate intensity exercise of 45-60 minutes once weekly from the 15th week till delivery. Groups B and C were encouraged to improve physical activity level, focusing at a steps count of at least 5000-7500 steps per day assessed by pedometer on seven consecutive days per month. Group C in addition to pedometer and group D received standard SMS related to pregnancy care (physical activity, diet, motivational, and educational specific. One-way ANOVA was used to estimate the between-group differences and Paired t-test was used to estimate the within-group difference in the outcome variables (p=0.05). RESULTS: The result of the study showed statistically significant between groups differences in the weight at 9th month (p=0.029) and weight retention at 2months post-partum (p=0.005). The supervised exercise group retained less weight during post-partum period as compared to control group (Supervised exercise vs Control, MD = 2.79kg, p=0.002). However, there was no statistical significant improvement in gestational weight gain, BMI, waist circumference, hip circumference and waist to hip ratio as compared to groups. CONCLUSIONS: It can be concluded that supervised exercises are effective in increasing physical activity, reducing weight-related parameters, and help in adopting a healthy lifestyle during pregnancy.

Efecto del uso de mensajes de texto en dispositivos de telefonía móvil en la adherencia al tratamiento de hipertensión arterial / Effect of mobile phone text messaging on adherence to hypertension treatment

La hipertensión arterial es una de las enfermedades crónicas de mayor incidencia a nivel mundial, produce una importante mortalidad y discapacidad. Este trabajo tuvo por objetivo evaluar el efecto del uso de mensajes de texto en dispositivos de telefonía móvil en la adherencia al tratamiento de hipertensión arterial. Se efectuó un estudio de intervención cuasiexperimental, de antes y después, en el cual se entrevistó a pacientes que pertenecían a un programa ambulatorio de enfermedades crónicas. Se formaron 4 grupos, uno de ellos, el grupo control. A los grupos intervenidos se les remitieron mensajes de texto (educativos/motivadores), con diferentes frecuencias de envío, por un período de 2 meses. Al término de la intervención, se pidió llenar el cuestionario Martín-Bayarre-Grau para determinar su adherencia al tratamiento antihipertensivo antes y después de la intervención. Se realizó un análisis bivariado, en el cual se comparó la variable adherencia al tratamiento, antes y después de la intervención, de los cuatro grupos del estudio. Se encontró solo una diferencia significativa en el grupo 3 (p = 0,011), al cual se le enviaron 8 mensajes al mes (2 por semana). También se comparó, después de los 2 meses, a los grupos sometidos a intervención versus el grupo control; se halló una diferencia significativa en el grupo 3 (p = 0,022). La intervención ha demostrado ser útil para mejorar la adherencia en esta población de estudio. Se obtuvo una respuesta positiva en el grupo 3, que recibió 8 mensajes al mes(AU)

Hypertension is one of the chronic diseases with the highest incidence worldwide and a cause of considerable mortality and disability. This paper aims to evaluate the effect of mobile phone text messaging on adherence to hypertension treatment. A quasi-experimental before-after intervention was conducted based on interviews with patients from a chronic disease outpatient program. Four groups were formed, one of which was the control group. The groups intervened were sent encouraging educational text messages at varying frequencies for a period of two months. At the close of the intervention, participants were asked to fill in the Martín Bayarre Grau questionnaire to determine their adherence to antihypertensive treatment before and after the intervention. A bivariate analysis was performed comparing the variable adherence to treatment before and after the intervention in the four study groups. A significant difference was only found in Group 3 (p = 0.011). This group was sent eight messages per month (two messages per week). Additionally, a comparison between the intervention groups and the control group conducted at two months found a significant difference in Group 3 (p = 0.022). The intervention proved was useful to improve adherence in the study population. A positive response was obtained in Group 3, who received eight messages per month(AU)

The effect of different mouth washes and text messages reminder in the oral health of orthodontic patients

Aim: The aim of this study was to investigate the effect of different mouth washes and to study the effect of text message reminder on the oral health status of orthodontic patients treated with fixed appliances. Methods: This study was a clinical trial with pre-test and post-test control group design, conducted on 24 patients undergoing fixed orthodontic treatment aged 15-30 years. The patients randomly divided into two groups; one received a weekly telephone text massage reminder for the instructions of brushing and rinsing while the second group did not receive any messages. Ortho-plaque index and gingival index were used to evaluate the patient's oral hygiene status. The reading indices after brushing only were regarded as a control, then the patients were instructed to use two mouth washes, one containing sodium fluoride with cetylpyridinium chloride, the second containing chlorhexidine digluconate with cetylpyridinium chloride and Aloe Vera. Each one was used routinely for 4 weeks with the same amount and method. The washout period between the two types mouth washes was 4 weeks with a standardized toothbrush and paste. Results: Ortho-plaque index values decreased over the time between first, second and third visits. However, this index raised up at the fourth visit and again dropdown at the fifth visit. Similar results were detected for gingival index. Also, significant interaction between messages and the assessments was recorded for gingival index with a significant difference between the group of text messages and without text messages group (p<0.05). Conclusions: The results of this study showed that the combination of sodium fluoride with cetylpyridinium chloride was more potent for plaque control, while chlorhexidine digluconate with cetylpyridinium chloride and Aloe Vera combination showed a better gingival improvement. Moreover, the text messages reminder could enhance, but not replace direct oral hygiene instruction in orthodontic patients

Mensajes de Texto en el Entrenamiento a Padres sobre Prácticas de Crianza / Text Messages in the Parent Training for Raising Practices

Resumen El entrenamiento conductual a padres promueve la adquisición de habilidades de crianza para la reducción de problemas de conducta infantil. El objetivo de este estudio fue evaluar el aprendizaje y mantenimiento de las habilidades de crianza y reducción de la conducta infantil, reportada por los padres, en función del entrenamiento conductual y el uso de sus mensajes de texto. Se trabajó con 62 padres de familia con un promedio de 40 años de edad. El promedio de edad de los niños fue de 9 años. Se trabajó con un diseño cuasi experimental con un grupo de comparación: presencial contra presencial con mensajes de texto, donde se llevaron a cabo cuatro fases: evaluación al inicio, al final del entrenamiento, al seguimiento (sesiones de 60 minutos) y entrenamiento conductual (cuatro sesiones de 120 minutos cada una). Se utilizaron el Inventario de Prácticas de Crianza, el Cuestionario de Habilidades de Manejo Conductual Infantil y el Inventario de Conducta Infantil. En la condición de comparación se agregaron 84 mensajes de texto sobre: análisis funcional de la conducta, elogio, ganancias, interacción social positiva, instrucciones claras, corrección del comportamiento, ignorar conducta inadecuada, actividades planeadas, establecimiento de reglas y solución de problemas. Los resultados mostraron problemas moderados de conducta, que se redujeron y mantuvieron 11% en promedio por debajo de la evaluación inicial, durante el seguimiento, en función del entrenamiento conductual con y sin mensajes; Pero el uso de mensajes de texto es una herramienta eficaz para promover un mayor cambio mantenido y reportado de la conducta oposicionista (9.57%) y del uso del castigo (22.05%, respecto a la primera evaluación). Estudios adicionales deberán indicar el papel mediador de los mensajes de texto entre las prácticas de crianza y la reducción de problemas de conducta infantil.

Abstract Parent behavioral training promotes raising skills acquisition for the children behavior problems reduction. The goal of this work was to assess learning and maintenance of the raising skills and the reduction of the children behavior, reported by the parents, because of behavioral training and the use of texting messages. We worked with 62 family´ parents of 40 years old. The mean age of the children was 9 years old. We worked with a quasiexperimental design with a comparison group: presence based modality against and presence plus text messages modality, where we run four phases: beginning, final and following assessments (60 minutes' sessions) and behavioral training (four 120 minutes sessions). We used the Raising Practices Inventory, Managing Skills for Children Behavior Questionnaire and Children Behavior Inventory. On the comparison condition we added 84 texting messages about: behavior functional analysis, praise, gains, positive social interaction, alpha commands, behavioral correction, inadequate behavior ignoring, planned activities, rules establishment, and problem solution. Results showed moderated behavior problems that were reduced and maintained 11%, on average, underneath of the beginning assessment, throughout following assessment, because of behavioral training with or without messages; But, the use of texting messages appears to be an efficient tool to promote a reported maintained mayor changing of the oppositional behavior (9.57%) and of the punishment using (22.05%, with regard to beginning assessment). Additional studies should indicate the mediator role of the texting messages between raising practices and the children behavior problems reduction.

Efectividad de seguimiento telefónico- mensajes de texto: agencia de autocuidado en pacientes con Hipertensión arterial / Efectividad de seguimiento telefónico- mensajes de texto: agencia de autocuidado en pacientes con Hipertensión arterial

Propósito:El objetivo de esta investigación fue determinar la efectividad de una estrategia de seguimiento telefónico asociado a mensajes de texto en la capacidad de agencia de autocuidado en pacientes con hipertensión arterial. Metodología:Se desarrolló un estudio clínico aleatorizado en 119 usuarios de la Fundación Oftalmológica de Santander-FOSCAL. En el diseño se conformaron dos grupos, un grupo intervención y un grupo control que fueron equivalentes en los procedimientos durante el estudio y se realizó la clasificación de manera aleatoria mediante Excel realizado por una persona externa al staff del estudio, con el siguiente esquema:Grupo intervención y Grupo control, en el cual se le aplicó la pre y post prueba (medición de la capacidad de agencia de autocuidado mediante el instrumento antes y después del seguimiento y el contacto telefónico y mensajería de texto al grupo intervenidocon un periodo de 2 meses. El instrumento que se utilizó fue Capacidad de agencia de autocuidado en pacientes hipertensos. Los datos fueron analizados Por el Software Stata Versión 11.0, para su respectivo análisis. Resultados:La capacidad de agencia de autocuidado de los pacientes hipertensos en el estudio posterior a la intervención de contacto telefónico y mensajería de texto demostró significancia con cambios importantes en las variables clínicas, cambios en los estadios de la hipertensión, mayor conocimiento de la enfermedad, actividad física, búsqueda en la orientación por el profesional de salud, alimentación saludable, mayor apoyo familiar.

Purpose: The objective of this research is to compare the effectiveness of followup telephone and text messages strategy against the conventional self-care in hypertension patients over self-care agency. Methodology: We conducted a randomized clinical study at the FundaciónOftalmológica de Santander-FOSCAL. 119 patients were randomly assigned in two equivalent groups to receive intervention of follow-up telephone and text messages strategy group against conventional care (control group). A pre and posttest of self-care agency were assessed (Using a descriptive instrument at the baseline and two months after). The instrument was used in hypertensive patients. The data were analyzed in Stata Software Version 11.0. Results: An intervention of follow-up telephone and text messages strategy in hypertensive patients showed significance with changes in clinical variables, changes in the stages of hypertension, increased knowledge of the disease, physical activity, guidance from the health professional, healthy eating, increased family support.

Effect of Counselling and Reminder Text Messages Follow-Up on Adherence to Antiretroviral Therapy in Hajiya Gambo Sawaba General Hospital, Zaria, Nigeria.

Poor adherence is a major challenge to antiretroviral therapy. It is now recommended that patients have 95% adherence in order to maintain sufficient suppression of viral replication and prevent the emergence of resistance. It is therefore of paramount importance device methods to improve patient adherence. The use of mobile phone calls and text messages are being explored in improving adherence. In this study, the effect of counselling plus reminder text messages were determined. A total of 132 patients was allocated into an intervention and control groups. Both groups were given additional adherence counselling at the beginning of the study and at every clinic visit. The intervention group was also sent reminder text messages for a period of 24 weeks. The CD4 count of all patients was recorded at the start of the study, then the final reading after the follow-up period. The difference in the increase in the CD4 counts between the two groups was compared to find out the difference. Additionally, patients’ self-report of adherence was compared between the two groups. Patients with 95% and above adherence were classified as adherent, while those with less than 95% non-adherent. It was found that the patients who received reminder text messages in addition to counselling had significantly higher mean percentage increase in CD4 count (36.7%) compared to the control group (19.12%), which received counselling only (p=0.007) However, using self-report form, there was no statistical significant difference in the level of adherence between intervention group and control group. It was therefore concluded that regular counselling and reminder text messages have improved adherence to antiretroviral therapy.