Woodman, BenjaminChatterji, MinkiFriedman, WillaRiley, PamelaMacDonald, Vicki2015-11-102015-11-102015Woodman Benjamin, Chatterji Minki, Friedman Willa, Riley Pamela, MacDonald Vicki. Reinforcing Provider Training with Mobile Phone Text Messages in Ghana: Results from a Randomized Controlled Trial. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 852-853.2347-5641http://imsear.searo.who.int/handle/123456789/165432Objectives: To describe the findings of an RCT to evaluate the impact of mobile phone text (SMS) messaging in encouraging providers to recommend ORS and zinc instead of antibiotics for the management of uncomplicated childhood diarrhea. Methods: The intervention consisted of SMS messaging to licensed chemical sellers (LCS) to reinforce training, detailing, and media interventions promoting new diarrhea management protocols. We trained 1800 LCS, 900 of whom opted into the study; half (450) were randomly selected for the SMS intervention (receiving informational messages and interactive quizzes over an eight-week period). We measured the impact of SMS messages on reported and actual behavior through mystery client surveys and interviews with 354 LCS in the intervention group and 345 LCS in the control group. Results: Over 80 percent of both groups knew that zinc and ORS were the appropriate treatment. Most (66 percent) respondents in both groups correctly dispensed zinc and ORS to the mystery client. The intervention had a statistically significant impact on providers' knowledge of appropriate diarrhea management, but not actual behaviors when dispensing treatments to mystery clients. There was a sizable difference between knowing appropriate treatments, and actually providing those treatments--only 12 percent of the control LCS reported recommending antimicrobials for uncomplicated diarrhea, but the mystery client survey showed that 50 percent actually provided antimicrobials. Conclusions: While training, detailing, and media campaigns significantly improved overall provider behaviors in diarrhea management, and SMS messages for 8 weeks significantly improved provider knowledge, the SMS campaign did not substantially improve actual behaviors of front-line providers.enArticle