Evidence map›Paper›PMID 27496227›Full record

Observational studyBMJ open2016

Usage, adherence and attrition: how new mothers engage with a nurse-moderated web-based intervention to support maternal and infant health. A 9-month observational study.

Michael G Sawyer, Christy E Reece, Kerrie Bowering, Debra Jeffs, Alyssa C P Sawyer, Jacqueline D Peters, Christine Mpundu-Kaambwa, Jennifer J Clark, Denise McDonald, Murthy N Mittinty and 1 more

Abstract readMulticenter StudyObservational Study

PubMed Full text at PMC Publisher

In one paragraph

Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it

0cells of the map it votes in

8citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

The MyCancerGene study: a hybrid type 1 effectiveness-implementation randomized study comparing a patient-centered digital genetic health portal to usual care after receipt of cancer genetic testing.BMC cancer · 2025
Trial
The Effectiveness of an App-Based Nurse-Moderated Program for New Mothers With Depression and Parenting Problems (eMums Plus): Pragmatic Randomized Controlled Trial.Journal of medical Internet research · 2019
Trial
Nurse-Moderated Internet-Based Support for New Mothers: Non-Inferiority, Randomized Controlled Trial.Journal of medical Internet research · 2017
Trial
An eHealth Delivery Alternative for Cancer Genetic Testing for Hereditary Predisposition in Patients With Metastatic Cancers: Protocol for a Randomized Trial.JMIR research protocols · 2025
Article
Healthy Moms and Babies Preventive Psychological Intervention Application: A Study Protocol.International journal of environmental research and public health · 2021
Article
Evaluating the Effectiveness of an App-Based Nurse-Moderated Program for New Mothers With Depression and Parenting Problems (eMums Plus): Protocol for a Pragmatic Randomized Controlled Trial.JMIR research protocols · 2019
Article
A Mixed Methods Study to Explore the Effects of Program Design Elements and Participant Characteristics on Parents' Engagement With an mHealth Program to Promote Healthy Infant Feeding: The Growing Healthy Program.Frontiers in endocrinology · 2019
Article
Users' Intrinsic Goals Linked to Alcohol Dependence Risk Level and Engagement With a Health Promotion Website (Hello Sunday Morning): Observational Study.JMIR mental health · 2018
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Michael G SawyerSchool of Medicine, University of Adelaide, Adelaide, South Australia, Australia Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Christy E ReeceSchool of Medicine, University of Adelaide, Adelaide, South Australia, Australia Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Kerrie BoweringChild and Family Health Service, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Debra JeffsChild and Family Health Service, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Alyssa C P SawyerSchool of Public Health, University of Adelaide, Adelaide, South Australia, Australia.

Jacqueline D PetersSchool of Medicine, University of Adelaide, Adelaide, South Australia, Australia Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Christine Mpundu-KaambwaSchool of Medicine, University of Adelaide, Adelaide, South Australia, Australia Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Jennifer J ClarkResearch and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Denise McDonaldChild and Family Health Service, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Murthy N MittintySchool of Public Health, University of Adelaide, Adelaide, South Australia, Australia.

John W LynchSchool of Public Health, University of Adelaide, Adelaide, South Australia, Australia School of Social and Community Medicine, University of Bristol, Bristol, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo identify factors predicting use, adherence and attrition with a nurse-moderated web-based group intervention designed to support mothers of infants aged 0-6 months.

design9-Month observational study.

settingCommunity maternal and child health service.

participants240 mothers attending initial postnatal health checks at community clinics who were randomly assigned to the intervention arm of a pragmatic preference randomised trial (total randomised controlled trial, n=819; response rate=45%).

interventionIn the first week (phase I), mothers were assisted with their first website login by a research assistant. In weeks 2-7 (phase II), mothers participated in the web-based intervention with an expectation of weekly logins. The web-based intervention was comparable to traditional face-to-face new mothers' groups. During weeks 8-26 (phase III), mothers participated in an extended programme at a frequency of their choosing. PRIMARY OUTCOME MEASURES: Number of logins and posted messages. Standard self-report measures assessed maternal demographic and psychosocial characteristics.

resultsIn phase II, the median number of logins was 9 logins (IQR=1-25), and in phase III, it was 10 logins (IQR=0-39). Incident risk ratios from multivariable analyses indicated that compared to mothers with the lowest third of logins in phase I, those with the highest third had 6.43 times as many logins in phase II and 7.14 times in phase III. Fifty per cent of mothers logged-in at least once every 30 days for 147 days after phase I and 44% logged-in at least once in the last 30 days of the intervention. Frequency of logins during phase I was a stronger predictor of mothers' level of engagement with the intervention than their demographic and psychosocial characteristics.

conclusionsMothers' early use of web-based interventions could be employed to customise engagement protocols to the circumstances of individual mothers with the aim of improving adherence and reducing attrition with web-based interventions. TRIAL REGISTRATION NUMBER: ACTRN12613000204741; Results.

Indexed as

Maternal-Child Health ServicesAdultAustraliaFemaleHumansInfantInfant HealthInfant, NewbornInternetKaplan-Meier EstimateMaleMaternal-Child NursingMaternal HealthMultivariate AnalysisPatient CompliancePragmatic Clinical Trials as TopicPAEDIATRICS

Identifiers

PMID27496227

DOI10.1136/bmjopen-2015-009967

PMCPMC4985835

What OpenQuestion holds

Textmetadata

LicenceCC BY-NC

Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.