{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:55:32Z","timestamp":1791395732725,"version":"4.3.3"},"reference-count":30,"publisher":"BMJ","funder":[{"name":"Dalhousie Obstetrics and Gynecology Clinical Research Award","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2026,9,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In Canada, medication abortion accounts for approximately 30% of the 100\u2009000 annual abortions. Despite the advantages of privacy and autonomy, many individuals report feeling unprepared and uninformed about the medication abortion process. Mobile health (mHealth) tools offer a promising avenue for delivering discreet evidence-based support, yet remain underused in abortion care. This study aimed to develop and refine AbortionCareTXT, a text message-based programme providing timely evidence-based information and emotional support for individuals undergoing medication abortion in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Guided by user-centred intervention development principles, four rounds of semi-structured interviews were conducted with abortion providers and pregnancy-capable people. Participants reviewed and provided feedback on message content, tone, timing and usability, which informed revisions to the programme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve abortion providers and 13 pregnancy-capable people (46.2% with abortion experience) participated. Key modifications across all rounds included simplified language, added reassurance and enhanced privacy and symptom guidance. The final programme consists of 28 messages delivered over 6\u2009weeks, covering information, support, frequently asked questions, emergency care and reminder content aligned with the usual clinical course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results suggest that a structured text-based intervention may be acceptable to both pregnancy-capable people and abortion providers and can address information, emotional and practical needs. AbortionCareTXT may enhance users\u2019 sense of being informed and enhance the patient experience. Future research will evaluate the programme\u2019s feasibility and real-world impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsrh-2026-203281","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:20:29Z","timestamp":1791393629000},"page":"bmjsrh-2026-203281","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Design and development of AbortionCareTXT, a text message programme for individuals undergoing medication abortion"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8361-5291","authenticated-orcid":false,"given":"Melissa","family":"Brooks","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, IWK Health Centre, Halifax, Nova Scotia, Canada"},{"name":"Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7357-1861","authenticated-orcid":false,"given":"Hannah","family":"Richardson","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, IWK Health Centre, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9395-8642","authenticated-orcid":false,"given":"Abdul-Fatawu","family":"Abdulai","sequence":"additional","affiliation":[{"name":"School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Janssen","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3884-6592","authenticated-orcid":false,"given":"Sarah","family":"Munro","sequence":"additional","affiliation":[{"name":"Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8928-7647","authenticated-orcid":false,"given":"Justine","family":"Dol","sequence":"additional","affiliation":[{"name":"Women's and Newborn Health Program, IWK Health Centre, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026100710202211000_bmjsrh-2026-203281v1.1","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jogc.2021.02.077","article-title":"Abortion utilisation and safety when mifepristone is available without regulations restricting practice? A population-based study using linked health administrative data from Ontario","volume":"43","author":"Schummers","year":"2021","journal-title":"J Obstet Gynaecol Canada"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1056\/NEJMsa2109779","article-title":"Abortion Safety and Use with Normally Prescribed Mifepristone in Canada","volume":"386","author":"Schummers","year":"2022","journal-title":"N Engl J Med"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.3","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.contraception.2020.04.012","article-title":"Trends in medication abortion provision before and after the introduction of mifepristone: A study of the National Abortion Federation\u2019s Canadian member services","volume":"102","author":"Yalahow","year":"2020","journal-title":"Contraception"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.contraception.2020.04.007","article-title":"\u201cIt gives you autonomy over your own choices\u201d: A qualitative study of Canadian abortion patients\u2019 experiences with mifepristone and misoprostol","volume":"102","author":"LaRoche","year":"2020","journal-title":"Contraception"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.5","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.contraception.2022.01.014","article-title":"\u201cI just was really scared, because it\u2019s already such an uncertain time\u201d: Exploring women\u2019s abortion experiences during the COVID-19 pandemic in Canada","volume":"110","author":"Hukku","year":"2022","journal-title":"Contraception"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.6","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1139\/facets-2017-0059","article-title":"\u201cI kind of feel like sometimes I am shoving it under the carpet\u201d: Documenting women\u2019s experiences with post-abortion support in Ontario","volume":"2","author":"LaRoche","year":"2017","journal-title":"FACETS"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0240664","article-title":"Quality of top webpages providing abortion pill information for Google searches in the USA: An evidence-based webpage quality assessment","volume":"16","author":"Pleasants","year":"2021","journal-title":"PLoS One"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.8","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.contraception.2014.07.003","article-title":"Crisis pregnancy center websites: Information, misinformation and disinformation","volume":"90","author":"Bryant","year":"2014","journal-title":"Contraception"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pdig.0000277","article-title":"There\u2019s an App for it: A systematic review of mobile apps providing information about abortion using a revised MARS scale","volume":"2","author":"Stifani","year":"2023","journal-title":"PLOS Digit Health"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.10","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1055\/s-0042-1760213","article-title":"Advancing Reproductive Health through Policy-Engaged Research in Abortion Care","volume":"40","author":"Munro","year":"2022","journal-title":"Semin Reprod Med"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.11","doi-asserted-by":"crossref","unstructured":"Dol J , Aston M , Grant A , et al . Effectiveness of the \u201cEssential Coaching for Every Mother\u201d postpartum text message program on maternal psychosocial outcomes: A randomized controlled trial. Digit Health 2022;8. doi:10.1177\/20552076221107886","DOI":"10.1177\/20552076221107886"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.12","doi-asserted-by":"crossref","DOI":"10.2196\/44661","article-title":"Expectant Parents\u2019 Preferences for Teaching by Texting: Development and Usability Study of SmartMom","volume":"7","author":"Murray","year":"2023","journal-title":"JMIR Form Res"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.13","article-title":"Targeted client communication via mobile devices for improving sexual and reproductive health","volume":"8","author":"Palmer","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.contraception.2021.12.003","article-title":"Integrating self-managed medication abortion with medical care","volume":"108","author":"Dragoman","year":"2022","journal-title":"Contraception"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.15","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031914-122855"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.16","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/joim.12687","article-title":"Should there be an app for that? The case for text messaging in mHealth interventions","volume":"283","author":"Mayberry","year":"2018","journal-title":"J Intern Med"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.17","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.contraception.2014.03.016","article-title":"RU OK? The acceptability and feasibility of remote technologies for follow-up after early medical abortion","volume":"90","author":"Bracken","year":"2014","journal-title":"Contraception"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1244"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2014.04.009"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.20","doi-asserted-by":"crossref","DOI":"10.2196\/13387","article-title":"Feasibility and Acceptability of a Mobile Technology Intervention to Support Postabortion Care in British Columbia: Phase I","volume":"21","author":"Gill","year":"2019","journal-title":"J Med Internet Res"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.21","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X20984134"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.22","doi-asserted-by":"crossref","unstructured":"Ames HM , Glenton C , Lewin S , et al . Clients\u2019 perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis. Cochrane Database Syst Rev 1996;2019. doi:10.1002\/14651858.CD013447","DOI":"10.1002\/14651858.CD013447"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.23","doi-asserted-by":"crossref","first-page":"100582","DOI":"10.1016\/j.srhc.2020.100582","article-title":"Women\u2019s experiences with information before medication abortion at home, support during the process and follow-up procedures \u2013 A qualitative study","volume":"27","author":"Aamlid","year":"2021","journal-title":"Sexual Reprod Healthcare"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.24","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1097\/AOG.0000000000005192","article-title":"Patient Perspectives Regarding Clinician Communication During Telemedicine Compared With In-Clinic Abortion","volume":"141","author":"Godfrey","year":"2023","journal-title":"Obstet Gynecol"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.25","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-021-01270-0","article-title":"It\u2019s a small bit of advice, but actually on the day, made such a difference\u2026: perceptions of quality in abortion care in England and Wales","volume":"18","author":"Whitehouse","year":"2021","journal-title":"Reprod Health"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.26","unstructured":"Costescu D , Guilbert E , Wagner MS , et al . Induced abortion: updated guidance during pandemics and periods of social disruption. Society of Obstetricians and Gynaecologists of Canada; 2020."},{"key":"2026100710202211000_bmjsrh-2026-203281v1.27","unstructured":"Statistics Canada . Literacy, numeracy and adaptive problem-solving skills of the population aged 16 to 65. Statistics Canada; 2024. Available: https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/241210\/dq241210a-eng.htm"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.28","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2345\/0899-8205-46.s2.49","article-title":"mHealth Consumer Apps: The Case for User-Centered Design","volume":"46","author":"McCurdie","year":"2012","journal-title":"Biomed Instrum Technol"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.29","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.jbi.2016.02.002","article-title":"A user-centered model for designing consumer mobile health (mHealth) applications (apps)","volume":"60","author":"Schnall","year":"2016","journal-title":"J Biomed Inform"},{"key":"2026100710202211000_bmjsrh-2026-203281v1.30","doi-asserted-by":"crossref","DOI":"10.2196\/resprot.2908","article-title":"Development and content validation of the information assessment method for patients and consumers","volume":"3","author":"Pluye","year":"2014","journal-title":"JMIR Res Protoc"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2026-203281","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:20:32Z","timestamp":1791393632000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2026-203281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":30,"alternative-id":["10.1136\/bmjsrh-2026-203281"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2026-203281","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}