title: MObile Technology for Improved Family Planning Services (MOTIF): study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Providing women with contraceptive methods following abortion is important to reduce repeat abortion rates, yet evidence for effective post-abortion family planning interventions are limited. This protocol outlines the evaluation of a mobile phone-based intervention using voice messages to support post-abortion family planning in Cambodia.
  
  
  METHODS
  A single blind randomised controlled trial of 500 participants. Clients aged 18 or over, attending for abortion at four Marie Stopes International clinics in Cambodia, owning a mobile phone and not wishing to have a child at the current time are randomised to the mobile phone-based intervention or control (standard care) with a 1:1 allocation ratio.The intervention comprises a series of six automated voice messages to remind clients about available family planning methods and provide a conduit for additional support. Clients can respond to message prompts to request a phone call from a counsellor, or alternatively to state they have no problems. Clients requesting to talk to a counsellor, or who do not respond to the message prompts, receive a call from a Marie Stopes International Cambodia counsellor who provides individualised advice and support regarding family planning. The duration of the intervention is 3 months. The control group receive existing standard of care without the additional mobile phone-based support.We hypothesise that the intervention will remind clients about contraceptive methods available, identify problems with side effects early and provide support, and therefore increase use of post-abortion family planning, while reducing discontinuation and unsafe method switching.Participants are assessed at baseline and at 4 months. The primary outcome measure is use of an effective modern contraceptive method at 4 months post abortion. Secondary outcome measures include contraception use, pregnancy and repeat abortion over the 4-month post-abortion period.Risk ratios will be used as the measure of effect of the intervention on the outcomes, and these will be estimated with 95% confidence intervals. All analyses will be based on the 'intention to treat' principle.
  
  
  CONCLUSIONS
  This study will provide evidence on the effectiveness of a mobile phone-based intervention using voice messages to support contraception use in a population with limited literacy. Findings could be generalisable to similar populations in different settings.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01823861.
authors: Marie Stopes International Cambodia (MSIC), Phnom Penh, Cambodia. christopher.smith@lshtm.ac.uk.
authors: Chris
authors: C
authors: Smith
authors: Uk
authors: U
authors: Vannak
authors: Ly
authors: L
authors: Sokhey
authors: Thoai D
authors: TD
authors: Ngo
authors: Judy
authors: J
authors: Gold
authors: Khemrin
authors: K
authors: Khut
authors: Phil
authors: P
authors: Edwards
authors: Tung
authors: T
authors: Rathavy
authors: Caroline
authors: C
authors: Free
mesh_terms: D040421:Cell Phone; D002985:Clinical Protocols; D003625:Data Collection; D004992:Ethics, Medical; D005193:Family Planning Services; D006801:Humans; D017063:Outcome Assessment, Health Care; D018401:Sample Size; D016037:Single-Blind Method