Mobile Link - a theory-based messaging intervention for improving sexual and reproductive health of female entertainment workers in Cambodia: study protocol of a randomized controlled trial.

Publisher: BioMed Central Country of Publication: England NLM ID: 101263253 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-6215 (Electronic) Linking ISSN: 17456215 NLM ISO Abbreviation: Trials Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2006-

Reproductive Health* ; Sexual Health* ; Text Messaging*/instrumentation ; Women's Health*; Health Promotion/*methods ; Sex Workers/*education ; Telemedicine/*methods ; Women, Working/*education; Cambodia ; Cell Phone ; Contraception Behavior ; Female ; Gender-Based Violence/prevention & control ; HIV Infections/prevention & control ; HIV Infections/transmission ; HIV Infections/virology ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Multicenter Studies as Topic ; Randomized Controlled Trials as Topic ; Sex Workers/psychology ; Single-Blind Method ; Telemedicine/instrumentation ; Time Factors ; Women, Working/psychology

Background: In Cambodia, HIV prevalence is concentrated in key populations including among female entertainment workers (FEWs) who may engage in direct or indirect sex work. Reaching FEWs with sexual and reproductive health (SRH) services has been difficult because of their hidden and stigmatized nature. Mobile-phone-based interventions may be an effective way to reach this population and connect them with the existing services. This article describes study design and implementation of a randomized controlled trial (RCT) of a mobile health intervention (the Mobile Link) aiming to improve SRH and related outcomes among FEWs in Cambodia.
Methods: A two-arm RCT will be used to determine the effectiveness of a mobile-phone-based text/voice messaging intervention. The intervention will be developed through a participatory process. Focus group discussions and in-depth interviews have been conducted to inform and tailor behavior change theory-based text and voice messages. During the implementation phase, 600 FEWs will be recruited and randomly assigned into one of the two arms: (1) a control group and (2) a mobile phone message group (either text messages [SMS] or voice messages [VM], a delivery method chosen by participants). Participants in the control group will also receive a weekly monitoring survey, which will provide real-time information to implementing partners to streamline outreach efforts and be able to quickly identify geographic trends. The primary outcome measures will include self-reported HIV and sexually transmitted infections (STI) testing and treatment, condom use, contraceptive use, and gender-based violence (GBV).
Discussion: If the Mobile Link trial is successful, participants will report an increase in condom use, linkages to screening and treatment for HIV and STI, and contraception use as well as a reduction in GBV. This trial is unique in a number of ways. First, the option of participation mode (SMS or VM) allows participants to choose the message medium that best links them to services. Second, this is the first RCT of a mobile-phone-based behavior change intervention using SMS/VMs to support linkage to SRH services in Cambodia. Lastly, we are working with a hidden, hard-to-reach, and dynamic population with which existing methods of outreach have not been fully successful.
Trial Registration: Clinical trials.gov, NCT03117842 . Registered on 31 March 2017.

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P30 MH058107 United States MH NIMH NIH HHS; 16SANIN210 International 5% Initiative

Keywords: Cambodia; Female entertainment workers; HIV; Mobile Link; Randomized controlled trial; Sexual and reproductive health; Study protocol; mHealth

ClinicalTrials.gov NCT03117842

Date Created: 20180421 Date Completed: 20190314 Latest Revision: 20231112

20240105

PMC5907699

10.1186/s13063-018-2614-7

29673381