The feasibility and promise of mobile technology with community health worker reinforcement to reduce rural preterm birth

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Objectives: (1) Assess feasibility of a smartphone platform intervention combined with Community Health Worker (CHW) reinforcement in rural pregnant women; (2) Obtain data on the promise of the intervention on birth outcomes, patient activation, and medical care adherence; and (3) Explore financial implications of the intervention using return on investment (ROI). Sample: A total of 98 rural pregnant women were enrolled and assigned to intervention or control groups in this two-group experimental design. Intervention: The intervention group received usual prenatal care plus a smartphone preloaded with a tailored prenatal platform with automated texting, chat function, and hyperlinks and weekly contact from the CHW. The control group received usual prenatal care and printed educational materials. Measurements: Demographics, health risk data, interaction with platform, medical records, hospital billing charges, Client Satisfaction Questionnaire-8, satisfaction comments, and the Patient Activation Measure. Results: A total of 77 women completed the study. The intervention was well-received, showed promise for improving birth outcomes, patient activation, and medical care adherence. Financial analysis showed a positive ROI under two scenarios. Conclusions: Despite several practical issues, the study appears feasible. The intervention shows promise for extending prenatal care and improving birth outcomes in rural communities. Further research is needed with a larger and more at-risk population to appreciate the impact of the intervention.

Original languageEnglish (US)
Pages (from-to)508-516
Number of pages9
JournalPublic Health Nursing
Issue number6
Publication statusPublished - Nov 1 2018



  • community health workers
  • community-based participatory research
  • implementation science
  • mobile technology
  • premature birth
  • prenatal care
  • rural health
  • smartphone
  • text messaging

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health

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