OBJECTIVE: We aimed to evaluate the efficacy of text messaging interventions on breastfeeding outcomes and to identify the efficacy moderators of such interventions.
METHODS: Ten electronic databases were searched from the inception of the databases to 5 July 2023. Studies were included if they used randomized controlled trials or quasi-experimental designs to evaluate the effect of text messaging interventions on breastfeeding outcomes. Two reviewers screened the included studies, assessed the risk of bias, and extracted the data. Pooled results were obtained by the random-effects model, and subgroup analyses were conducted on intervention characteristics to identify potential moderators. The protocol of this study was registered on PROSPERO (ID: CRD42022371311).
RESULTS: Sixteen studies were included. Text messaging interventions could improve the exclusive breastfeeding rate (at <3 months: OR = 2.04; 95 % CI: 1.60-2.60, P < 0.001; at 3-6 months: OR = 1.66; 95 % CI: 1.18-2.33, P = 0.004; at ≥6 months: OR = 2.13; 95 % CI: 1.47-3.08, P < 0.001), and the breastfeeding self-efficacy (SMD = 0.30, 95 % CI: 0.14-0.45, P < 0.001). Text messaging interventions that covered antenatal and postnatal periods, delivered weekly were most effective in improving the exclusive breastfeeding rate.
CONCLUSIONS: Text messaging interventions may improve breastfeeding practice compared with no or general health information. We suggest text messaging conducted from the pre- to postnatal periods in a weekly manner can effectively increase exclusive breastfeeding rates and breastfeeding self-efficacy. Further studies should investigate the relation between new theories (such as the health action process approach and the theory of message-framing) and efficacy of breastfeeding interventions, using text components.
目的:我们的目的是评估短信干预措施对母乳喂养结局的效果,并确定此类干预措施的效果调节因素。
方法:从数据库开始到2023年7月5日检索了10个电子数据库。如果他们使用随机对照试验或准实验设计来评估短信干预对母乳喂养结果的影响,则包括研究。两名审稿人筛选了纳入的研究,评估了偏见的风险,并提取数据。通过随机效应模型获得集合结果,并对干预特征进行亚组分析,以确定潜在的调节者.本研究的方案在PROSPERO上注册(ID:CRD42022371311)。
结果:共纳入16项研究。短信干预可以提高纯母乳喂养率(<3个月时:OR=2.04;95%CI:1.60-2.60,P<0.001;3-6个月时:OR=1.66;95%CI:1.18-2.33,P=0.004;≥6个月时:OR=2.13;95%CI:1.47-3.08,P<0.001),母乳喂养自我效能感(SMD=0.30,95%CI:0.14~0.45,P<0.001)。涵盖产前和产后的短信干预措施,每周分娩在提高纯母乳喂养率方面最有效.
结论:与无健康信息或一般健康信息相比,短信干预可以改善母乳喂养行为。我们建议每周从产前到产后进行短信收发,可以有效提高纯母乳喂养率和母乳喂养自我效能。进一步的研究应该调查新理论(如健康行动过程方法和信息框架理论)与母乳喂养干预措施的功效之间的关系,使用文本组件。