{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T14:24:24Z","timestamp":1774362264501,"version":"3.50.1"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2016,12,11]],"date-time":"2016-12-11T00:00:00Z","timestamp":1481414400000},"content-version":"vor","delay-in-days":135,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"SHM Foundation"},{"name":"Innovation and Regulation in Digital Services Chair, France"},{"name":"Ethics Board of the School of Medicine of Universidad Francisco Marroqu\u00edn","award":["CE\/FM UFM0062-13"],"award-info":[{"award-number":["CE\/FM UFM0062-13"]}]},{"name":"Ethics Board of the School of Medicine of Universidad Francisco Marroqu\u00edn","award":["NCT02263118"],"award-info":[{"award-number":["NCT02263118"]}]},{"name":"School of Medicine of Universidad Francisco Marroqu\u00edn"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:p>Objective: To develop a descriptive model of structural characteristics of mHealth in the context of newborn nutrition, and to assess the effects of illustrative interventions through a mixed-methods study consisting of an impact evaluation and a qualitative assessment.<\/jats:p><jats:p>Materials and Methods: We conducted a 23-week intervention with 100 mothers in rural Guatemala in 2013 and 2014. In group 1 (n\u2009=\u200924), participants received health-promoting text messages. In group 2 (n\u2009=\u200932), peer-to-peer groups were formed. In group 3 (n\u2009=\u200930), peer-to-peer groups were formed, a health professional participated in the discussions, and participants received health-promoting messages. In the control group (n\u2009=\u200914), participants were simply given a mobile phone. We measured changes in knowledge and self-reported behavior. Four focus groups in 2015 showed the perceptions of 44 additional women and the potential of the previously tested interventions in other marginalized areas.<\/jats:p><jats:p>Results: Significant relationships were found between group membership and changes in knowledge (P\u2009&amp;lt;\u2009.001), and between changes in knowledge and self-reported behavior (P\u2009=\u2009.010). Within peer-to-peer groups, 3665 text messages were shared; discussions covered topics such as breastfeeding practices, health concerns, and emotional issues. Focus groups revealed a deficit of support for mothers, a precariousness of public services, different cultural barriers affecting access to care, and the potential for scaling up.<\/jats:p><jats:p>Discussion: The complementarity of structural arrangements of mHealth interventions can play an important role in helping to encourage recommended breastfeeding attitudes along with providing rich information about challenges in rural areas.<\/jats:p><jats:p>Conclusion: A mixed-methods study was appropriate to compare the effects and assess the potential of mHealth strategies in a complex rural setting.<\/jats:p>","DOI":"10.1093\/jamia\/ocw102","type":"journal-article","created":{"date-parts":[[2016,7,30]],"date-time":"2016-07-30T02:43:55Z","timestamp":1469846635000},"page":"352-360","source":"Crossref","is-referenced-by-count":29,"title":["Modeling and testing maternal and newborn care mHealth interventions: a pilot impact evaluation and follow-up qualitative study in Guatemala"],"prefix":"10.1093","volume":"24","author":[{"given":"Jos\u00e9 Tom\u00e1s","family":"Prieto","sequence":"first","affiliation":[{"name":"Center for Health Studies, Universidad del Valle de Guatemala"},{"name":"Centre de Recherche en Gestion, Ecole Polytechnique, France"}]},{"given":"Clara","family":"Zuleta","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad Francisco Marroqu\u00edn, Guatemala"}]},{"given":"Jorge Tulio","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad Francisco Marroqu\u00edn, Guatemala"}]}],"member":"286","published-online":{"date-parts":[[2016,7,29]]},"reference":[{"issue":"1","key":"2020110612373189400_ocw102-B1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/10810730.2013.864735","article-title":"mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries","volume":"20","author":"Chib","year":"2015","journal-title":"J Health Commun"},{"issue":"3","key":"2020110612373189400_ocw102-B2","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1002\/msj.20256","article-title":"Mobile phone tools for field-based health care workers in low-income countries","volume":"78","author":"Derenzi","year":"2011","journal-title":"Mt Sinai J Med"},{"key":"2020110612373189400_ocw102-B3","first-page":"CD007458","article-title":"Mobile phone messaging reminders for attendance at healthcare appointments","volume":"12","author":"Gurol-Urganci","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"2020110612373189400_ocw102-B4","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/j.1475-6773.2011.01342.x","article-title":"How effective are short message service reminders at increasing clinic attendance? 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