{"doi":"10.1371/journal.pone.0300642","title":"Mobile solutions to Empower reproductive life planning for women living with HIV in Kenya (MWACh EMPOWER): Protocol for a cluster randomized controlled trial","abstract":"BACKGROUND: Women living with HIV (WLWH) face unique reproductive health (RH) barriers which increase their risks of unmet need for contraception, contraceptive failure, unintended pregnancy, and pregnancy-related morbidity and mortality and may prevent them from achieving their reproductive goals. Patient-centered counseling interventions that support health care workers (HCWs) in providing high-quality RH counseling, tailored to the needs of WLWH, may improve reproductive health outcomes. METHODS AND DESIGN: We are conducting a non-blinded cluster randomized controlled trial (cRCT) of a digital health intervention for WLWH (clinicaltrials.gov #NCT05285670). We will enroll 3,300 WLWH seeking care in 10 HIV care and treatment centers in Nairobi and Western Kenya. WLWH at intervention sites receive the Mobile WACh Empower intervention, a tablet-based RH decision-support counseling tool administered at baseline and SMS support during two years of follow-up. WLWH at control sites receive the standard of care FP counseling. The decision-support tool is a logic-based tool for family planning (FP) counseling that uses branching logic to guide RH questions based on participants' reproductive life plans, tailoring counseling based on the responses. Follow-up SMSs are based in the Information-Motivation-Behavioral (IMB) Skills model of behavioral change and are tailored to participant characteristics and reproductive needs through separate SMS \"tracks\". Follow-up visits are scheduled quarterly for 2 years to assess plans for pregnancy, pregnancy prevention, and contraceptive use. The primary outcome, FP discontinuation, will be compared using an intent-to-treat analysis. We will also assess the unmet need for FP, dual method use, viral load suppression at conception and unintended pregnancy. DISCUSSION: The Mobile WACh Empower intervention is innovative as it combines a patient-centered counseling tool to support initial reproductive life decisions with longitudinal SMS for continued RH support and may help provide RH care within the context of provision of HIV care.","journal":"PLoS ONE","year":2024,"id":440033,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":2,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9521,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT05285670"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":323805,"name":"Jennifer A. Unger","orcid":"0000-0002-6317-226X","position":1,"is_corresponding":false},{"id":820301,"name":"Brenda Wandika","orcid":null,"position":2,"is_corresponding":false},{"id":1252086,"name":"Celestine Atieno","orcid":null,"position":3,"is_corresponding":false},{"id":507127,"name":"Kristin Beima‐Sofie","orcid":"0000-0002-3408-7410","position":4,"is_corresponding":false},{"id":404956,"name":"Julia C. Dettinger","orcid":"0000-0002-9130-2666","position":5,"is_corresponding":false},{"id":1159009,"name":"Emmaculate Nzove","orcid":"0009-0001-1259-4884","position":6,"is_corresponding":false},{"id":1084641,"name":"Elizabeth K. Harrington","orcid":"0000-0002-8196-069X","position":7,"is_corresponding":false},{"id":1251682,"name":"Agnes Karingo Karume","orcid":"0000-0002-3425-2391","position":8,"is_corresponding":false},{"id":541204,"name":"Lusi Osborn","orcid":"0000-0002-7100-2666","position":9,"is_corresponding":false},{"id":289068,"name":"Monisha Sharma","orcid":"0000-0002-7599-1561","position":10,"is_corresponding":false},{"id":407491,"name":"Barbra A. Richardson","orcid":"0000-0001-9564-1828","position":11,"is_corresponding":false},{"id":1252087,"name":"Aparna Seth","orcid":null,"position":12,"is_corresponding":false},{"id":611917,"name":"Jenna Udren","orcid":"0000-0002-9523-1041","position":13,"is_corresponding":false},{"id":1252088,"name":"Noor Zanial","orcid":null,"position":14,"is_corresponding":false},{"id":299054,"name":"John Kinuthia","orcid":"0000-0001-6571-8927","position":15,"is_corresponding":false},{"id":315410,"name":"Alison L. Drake","orcid":"0000-0002-4178-7706","position":16,"is_corresponding":false},{"id":1060310,"name":"Nancy Ngumbau","orcid":"0000-0003-4176-5950","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-19T02:00:57.233748Z","pmid":"38557692","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}