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ORIGINAL ARTICLE
Open Access

Efficacy of a Digital Health Tool on Contraceptive Ideation and Use in Nigeria: Results of a Cluster-Randomized Control Trial

Stella Babalola, Caitlin Loehr, Olamide Oyenubi, Akinsewa Akiode and Allison Mobley
Global Health: Science and Practice June 2019, 7(2):273-288; https://doi.org/10.9745/GHSP-D-19-00066
Stella Babalola
aJohns Hopkins Center for Communication Programs, Baltimore, MD, USA.
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  • For correspondence: stellababalola@jhu.edu
Caitlin Loehr
bIntraHealth International, Washington, DC, USA.
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Olamide Oyenubi
aJohns Hopkins Center for Communication Programs, Baltimore, MD, USA.
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Akinsewa Akiode
cNigeria Urban Reproductive Health Initiative, Abuja, Nigeria.
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Allison Mobley
dConsultant, Baltimore, MD, USA.
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Figures & Tables

Tables

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    TABLE 1.

    Sociodemographic Characteristics of Study Participants Before the Intervention, by Study Group, Kaduna, Nigeria, 2017

    Sociodemographic IndicatorBoth Groups (N=565)Intervention Group (n=221)Control Group (n=344)Z (or t)/P for Difference Between Groups
    Mean age, years26.826.427.01.380/.17
    Currently married, %55.953.457.50.973/.33
    Tertiary education, %32.033.031.40.407/.68
    Muslim, %60.565.657.21.980/.048
    Mean parity2.362.222.441.109/.27
    • View popup
    TABLE 2.

    Mean Number of Smart Client Drama Episodes Completed, by Sociodemographic Characteristics, Intervention Group, Kaduna, Nigeria, 2017 (n=221)

    Sociodemographic CharacteristicsMean No. of Drama Episodes CompletedMean No. of Personal Stories CompletedMean No. of Sample Dialogues Completed
    Age group, years
    18–246.892.331.81
    25+7.452.752.01
    Education level
    Secondary or less7.282.602.13*
    Tertiary7.172.581.53
    Marital status
    Never married6.63*2.13*1.25***
    Ever married7.692.932.44
    Religion
    Muslim7.83***2.95**2.40***
    Christian6.111.891.04
    Parity
    0–16.65*2.11*1.25***
    ≥27.652.922.40
    All7.242.591.15
    • ↵* P<.05;

    • ↵** P<.01;

    • ↵*** P<.001.

    • View popup
    TABLE 3.

    Change in Selected Ideational and Behavioral Outcomes and Results of Differences-in-Differences (DID), per-Protocol Analyses, Kaduna, Nigeria, 2017a

    Intervention ConditionPercent Reporting OutcomeDID Results
    Pre-StudyPost-StudyEstimate in Percentage PointsStd. ErrorP
    Already thought of the number of children to have
    Intervention group33.077.543.2.087<.001
    Control group42.543.8
    Confident discussing family planning with provider
    Intervention group35.573.661.5.089<.001
    Control group59.536.1
    Discussed family size with spouse in last 6 months (currently married women only)
    Intervention group65.298.541.2.118.001
    Control group74.666.7
    Discussed contraceptive methods with spouse in last 6 months (currently married women only)
    Intervention group46.475.822.7.119.06
    Control group43.049.7
    Rejected the myth that contraceptive methods can hurt a woman's womb
    Intervention group50.678.848.4.089<.001
    Control group64.143.9
    Using modern contraceptive method
    Intervention group28.863.634.8.084<.001
    Control group32.732.7
    • ↵a Total sample size (per protocol): intervention (n=92); control (n=158). All estimated models controlled for age, education, number of children ever born, and education.

    • View popup
    TABLE 4.

    Change in Selected Ideational and Behavioral Outcomes and Results of Differences-in-Differences (DID), Intention-to-Treat Analyses, Kaduna, Nigeria, 2017a

    Intervention ConditionPercent Reporting OutcomeDID Results
    Pre-StudyPost-StudyEstimate in Percentage PointsStd. ErrorP
    Already thought of the number of children to have
    Intervention group24.843.517.8.052<.001
    Control group24.525.4
    Confident discussing family planning with provider
    Intervention group20.436.327.7.054<.001
    Control group30.018.2
    Discussed family size with spouse in last 6 months (currently married women only)
    Intervention group23.632.915.4.073.03
    Control group32.126.0
    Discussed contraceptive methods with spouse in last 6 months (currently married women only)
    Intervention group17.330.09.6.074.18
    Control group16.519.6
    Rejected the myth that contraceptive methods can hurt a woman's womb
    Intervention group25.237.022.7.057<.001
    Control group30.419.5
    Using modern contraceptive method
    Intervention group22.937.414.8.050.003
    Control group20.920.6
    • ↵a Total sample size (intention to treat): intervention (n=220); control (n=339). All estimated models controlled for age, education, number of children ever born, and education.

    • View popup
    TABLE 5.

    Pre-Study Sociodemographic Characteristics of Study Participants, by Whether They Participated in the Post-Study Survey, Kaduna, Nigeria, 2017

    Sociodemographic IndicatorParticipated in Post-Study Survey (n=92)Lost to Follow-Up: Did Not Participate in Post-Study Survey (n=129)Z (or t)/P for Difference Between Groups
    Intervention group
    Mean age, years26.626.20.653/.51
    Currently married, %55.452.30.453/.56
    Tertiary education, %39.128.11.716/.09
    Muslim, %73.960.12.123/.03
    Mean parity2.432.081.145/.25
    Control group
    Mean age, years27.226.80.777/.44
    Currently married, %57.357.00.063/.95
    Tertiary education, %35.427.91.470/.14
    Muslim, %59.754.11.052/.29
    Mean parity2.442.430.011/.99
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Global Health: Science and Practice: 7 (2)
Global Health: Science and Practice
Vol. 7, No. 2
June 24, 2019
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Efficacy of a Digital Health Tool on Contraceptive Ideation and Use in Nigeria: Results of a Cluster-Randomized Control Trial
Stella Babalola, Caitlin Loehr, Olamide Oyenubi, Akinsewa Akiode, Allison Mobley
Global Health: Science and Practice Jun 2019, 7 (2) 273-288; DOI: 10.9745/GHSP-D-19-00066

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Efficacy of a Digital Health Tool on Contraceptive Ideation and Use in Nigeria: Results of a Cluster-Randomized Control Trial
Stella Babalola, Caitlin Loehr, Olamide Oyenubi, Akinsewa Akiode, Allison Mobley
Global Health: Science and Practice Jun 2019, 7 (2) 273-288; DOI: 10.9745/GHSP-D-19-00066
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