@Article{info:doi/10.2196/17328，作者=“Demirci, Jill R和Suffoletto, Brian和Doman, Jack和Glasser, Melissa和Chang, Judy C和Sereika, Susan M和Bogen, Debra L”，标题=“短信程序的开发和评估预防第一次母亲感知的母乳不足:一项随机对照试验的回顾性分析”，期刊=“JMIR Mhealth Uhealth”，年=“2020”，月=“4”，日=“29”，卷=“8”，数=“4”，页=“e17328”，关键词=“母乳喂养;感觉到奶量不足;短信;短消息服务;手机;移动电话;远程医疗;移动健康;背景:最近的几项试验研究了自动短信发送为母亲提供远程母乳喂养支持的可行性和有效性，但这些短信系统在设计特征和检测结果方面各不相同。目的:本研究调查了用户对基于理论的短信干预的参与度和反馈，该干预旨在防止感知到的奶量不足(PIM)——意外减少母乳喂养和停止母乳喂养的单一、主要可修改原因。 Methods: We recruited 250 nulliparous individuals intending to breastfeed between 13 and 25 weeks of pregnancy in southwestern Pennsylvania. Participants were randomly assigned with equal allocation to either an SMS intervention to prevent PIM and unintended breastfeeding reduction or cessation (MILK, a Mobile, semiautomated text message--based Intervention to prevent perceived Low or insufficient milK supply; n=126) or a control group receiving general perinatal SMS text messaging--based support via the national, free Text4Baby system (n=124). Participants in both groups received SMS text messages 3 to 7 times per week from 25 weeks of pregnancy to 8 weeks postpartum. The MILK intervention incorporated several automated interactivity and personalization features (eg, keyword texting for more detailed information on topics and branched response logic) as well as an option to receive one-on-one assistance from an on-call study lactation consultant. We examined participant interactions with the MILK system, including response rates to SMS text messaging queries. We also sought participant feedback on MILK content, delivery preferences, and overall satisfaction with the system via interviews and a remote survey at 8 weeks postpartum. Results: Participants randomized to MILK (87/124, 70.2{\%} white and 84/124, 67.7{\%} college educated) reported that MILK texts increased their breastfeeding confidence and helped them persevere through breastfeeding problems. Of 124 participants, 9 (7.3{\%}) elected to stop MILK messages, and 3 (2.4{\%}) opted to reduce message frequency during the course of the study. There were 46 texts through the MILK system for individualized assistance from the study lactation consultant (25/46, 54{\%} on weekends or after-hours). The most commonly texted keywords for more detailed information occurred during weeks 4 to 6 postpartum and addressed milk volume intake and breastfeeding and sleep patterns. MILK participants stated a preference for anticipatory guidance on potential breastfeeding issues and less content addressing the benefits of breastfeeding. Suggested improvements included extending messaging past 8 weeks, providing access to messaging for partners, and tailoring content based on participants' pre-existing breastfeeding knowledge and unique breastfeeding trajectory. Conclusions: Prenatal and postpartum evidence--based breastfeeding support delivered via semiautomated SMS text messaging is a feasible and an acceptable intervention for first-time mothers. To optimize engagement with digital breastfeeding interventions, enhanced customization features should be considered. Trial Registration: ClinicalTrials.gov NCT02724969; https://clinicaltrials.gov/ct2/show/NCT02724969 ", issn="2291-5222", doi="10.2196/17328", url="https://mhealth.www.mybigtv.com/2020/4/e17328", url="https://doi.org/10.2196/17328", url="http://www.ncbi.nlm.nih.gov/pubmed/32347815" }