title: Effects of postpartum mobile phone-based education on maternal and infant health in Ecuador.
abstract: OBJECTIVE
  To evaluate the effects of a mobile phone-based intervention on postnatal maternal health behavior and maternal and infant health in a middle-income country.
  
  
  METHODS
  A prospective evaluation enrolled consecutive postpartum women at two public hospitals in Quito, Ecuador, between June and August 2012. Inclusion criteria were live birth, no neonatal intensive care admission, and Spanish speaking. Intervention and control groups were assigned via random number generation. The intervention included a telephone-delivered educational session and phone/text access to a nurse for 30days after delivery. Maternal and infant health indicators were recorded at delivery and 3months after delivery via chart review and written/telephone-administered survey.
  
  
  RESULTS
  Overall, 102 women were assigned to the intervention group and 76 to the control group. At 3months, intervention participants were more likely to attend the infant's postnatal check-up (P=0.022) and to breastfeed exclusively (P=0.005), and less likely to feed formula (P=0.016). They used more effective forms of contraception (more implants P=0.023; fewer condoms P=0.036) and reported fewer infant illnesses (P=0.010). There were no differences in maternal acute illness or check-up attendance.
  
  
  CONCLUSIONS
  Mobile phone-based postnatal patient education is a promising strategy for improving breastfeeding, contraceptive use, and infant health in low-resource settings; different strategies are needed to influence postpartum maternal health behavior.
authors.affiliation: Department of Kinesiology and Health Education and Population Research Center, University of Texas, Austin, TX, USA. Electronic address: maslowsky@austin.utexas.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Maslowsky
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Frost
authors.affiliation: Department of Kinesiology and Health Education and Population Research Center, University of Texas, Austin, TX, USA.
authors.forename: C Emily
authors.initials: CE
authors.lastname: Hendrick
authors.affiliation: Department of Epidemiology, Universidad Técnica Equinoccial and Hospital General Enrique Garcés, Quito, Ecuador.
authors.forename: Freddy O
authors.initials: FO
authors.lastname: Trujillo Cruz
authors.affiliation: Departments of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Sofia D
authors.initials: SD
authors.lastname: Merajver
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D040421:Cell Phone / Q000706:statistics & numerical data*; D002648:Child; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D004484:Ecuador; D005260:Female; D006801:Humans; D000068104:Infant Health / Q000592:standards*; D007231:Infant, Newborn; D000068097:Maternal Health / Q000592:standards*; D049590:Postpartum Period; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Breastfeeding; Maternal health; Mobile phone; Newborn health