title: Impact of Text Message Reminders on Caregivers' Adherence to a Home Fortification Program Against Child Anemia in Rural Western China: A Cluster-Randomized Controlled Trial.
abstract: To test whether text message reminders sent to caregivers improve the effectiveness of a home micronutrient fortification program in western China.
  
  
  
  We carried out a cluster-randomized controlled trial in 351 villages (clusters) in Shaanxi Province in 2013 and 2014, enrolling children aged 6 to 12 months. We randomly assigned each village to 1 of 3 groups: free delivery group, text messaging group, or control group. We collected information on compliance with treatments and hemoglobin concentrations from all children at baseline and 6-month follow-up. We estimated the intent-to-treat effects on compliance and child anemia using a logistic regression model.
  
  
  
  There were 1393 eligible children. We found that assignment to the text messaging group led to an increase in full compliance (marginal effect = 0.10; 95% confidence interval [CI] = 0.03, 0.16) compared with the free delivery group and decrease in the rate of anemia at end line relative to the control group (marginal effect = -0.07; 95% CI = -0.12, -0.01), but not relative to the free delivery group (marginal effect = -0.03; 95% CI = -0.09, 0.03).
  
  
  
  Text messages improved compliance of caregivers to a home fortification program and children's nutrition.
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Huan
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Sun
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Renfu
authors.initials: R
authors.lastname: Luo
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Sean
authors.initials: S
authors.lastname: Sylvia
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Ai
authors.initials: A
authors.lastname: Yue
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Yaojiang
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Linxiu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Alexis
authors.initials: A
authors.lastname: Medina
authors.affiliation: Huan Zhou and Shuai Sun are with the Department of Health and Social Behavior, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China. Renfu Luo is with the Center for Chinese Agricultural Policy, School of Advanced Agricultural Sciences, Peking University, Beijing, China. Sean Sylvia is with the School of Economics, Renmin University of China, Beijing. Ai Yue and Yaojiang Shi are with the Center for Experimental Economics in Education (CEEE), Shaanxi Normal University, Shaanxi, China. Linxiu Zhang is with the Center for Chinese Agricultural Policy, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing. Alexis Medina and Scott Rozelle are with the Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA.
authors.forename: Scott
authors.initials: S
authors.lastname: Rozelle
mesh_terms: D000740:Anemia / Q000188:drug therapy*; D017028:Caregivers; D040421:Cell Phone; D002681:China; D019587:Dietary Supplements; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007501:Iron / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data; D017010:Reminder Systems / Q000706:statistics & numerical data*; D012424:Rural Population; D060145:Text Messaging / Q000706:statistics & numerical data*
chemical_list: D006454:Hemoglobins; D007501:Iron