Cell phones to collect pregnancy data from remote areas in Liberia.

PURPOSE To report findings on knowledge and skill acquisition following a 3-day training session in the use of short message service (SMS) texting with non- and low-literacy traditional midwives. DESIGN A pre- and post-test study design was used to assess knowledge and skill acquisition with 99 traditional midwives on the use of SMS texting for real-time, remote data collection in rural Liberia, West Africa. METHODS Paired sample t-tests were conducted to establish if overall mean scores varied significantly from pre-test to immediate post-test. Analysis of variance was used to compare means across groups. The nonparametric McNemar's test was used to determine significant differences between the pre-test and post-test values of each individual step involved in SMS texting. Pearson's chi-square test of independence was used to examine the association between ownership of cell phones within a family and achievement of the seven tasks. FINDINGS The mean increase in cell phone knowledge scores was 3.67, with a 95% confidence interval ranging from 3.39 to 3.95. Participants with a cell phone in the family did significantly better on three of the seven tasks in the pre-test: "turns cell on without help" (χ(2) (1) = 9.15, p= .003); "identifies cell phone coverage" (χ(2) (1) = 5.37, p= .024); and "identifies cell phone is charged" (χ(2) (1) = 4.40, p= .042). CONCLUSIONS A 3-day cell phone training session with low- and nonliterate traditional midwives in rural Liberia improved their ability to use mobile technology for SMS texting. CLINICAL RELEVANCE Mobile technology can improve data collection accessibility and be used for numerous health care and public health issues. Cell phone accessibility holds great promise for collecting health data in low-resource areas of the world.