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

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 Intervention A total of 98 rural pregnant women were enrolled and assigned to intervention or control groups in this two-group experimental design. 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 Results Demographics, health risk data, interaction with platform, medical records, hospital billing charges, Client Satisfaction Questionnaire-8, satisfaction comments, and the Patient Activation Measure. 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.