Assessing the quality of quantitative research Question 1: Study purpose/question

(a) Did the study have a clearly stated purpose/research question?                                                    

Yes 

(b) Explain your response below: 

The study was designed to evaluate the feasibility of the mobile service so as to determine the most suitable sample size and to refine the study design prior to rolling out the randomized controlled study. The study also had the dual purpose of gathering feedback from parents on the SMS reminders after the intervention. 

Question 2: Relevance to nursing/midwifery practice

(a) Explain how this question was relevant to nursing/midwifery practice.

The research is extremely relevant in terms of achieving some of key objectives of nursing/ midwifery practice; the objective of reminding/ alerting parents about certain obligations they have to fulfil on a given date via mobile texts. The mobile phone has revolutionized many aspects of day-to-day life. The SMS (Short Message Service) technology has proven useful in the delivery of health care to the public. Feature phones and smartphones have become ubiquitous in our society. The fact that almost everyone has a phone that can receive and send text messages has enabled health care professionals to deliver important communication to members of the public especially in the area of disease prevention. Multiple studies have been done to investigate this usefulness of text messaging technology in disease prevention. Most of the studies have reported positive results. One of the most prominent uses of text messaging technology in health care is in helping remind parents about their children’s vaccination dates. This has helped to get more children fully immunized against different types of infections. However, there are still millions of infants around the globe who still do not complete their vaccination series putting them at risk of suffering serious but vaccine-preventable diseases. One of the barriers that is preventing these children from receiving immunization is the lack of proper communication between health care providers and parents with regards to the need for timely vaccination of children. It is thought that mobile telephony especially the use of text messages can help reverse this situation (Domek et al., 2016).

Question 3: Ethics

(a) What were the possible risks of participating in the study?

Possible disruption of network/ phone service

Software limitations

(b) Were these risks clearly identified by the authors?                                                                           Yes

(c) If risks were identified by the authors, how did they propose to minimise risk?

The possible disruption of network service was identified by the authors as a serious risk. To address the risk, the authors argued that there was a need to have more communication channels with the parents. The authors also argued that there was a need for back-up systems that could convert the SMSs to other media such as email, letters or voice messages so that the messages could still get to the parents in case of disruption of phone service.

The mobile telephony software used in the study was also thought to be a possible risk. This was because it was not integrated with electronic medical records meaning all the information that was entered into the system was keyed in manually and not automatically. There was also no automatic calendar functionality to enable the software to send the reminders automatically. They had to be sent on the actual day. Furthermore, there was no alert system to inform the health professionals that a mother or father had not received the text reminder that was intended for them. 

(d) Did the authors state that they had approval from an ethics committee to undertake the study?

Yes

(e) How did the authors obtain informed consent from participants?

The participants were asked for their consent through forms and text messages. 

(f) Did you identify and potential risks associated with the study that were not identified by the authors and if so, what were they? 

Some studies may cause inconvenience, discomforts or even harm on the participants. Some of the inconveniences include filling forms. 

There is also discomfort in the fact that one may feel hurried up by the text reminder to do something that he or she did not plan to do on that particular day. There is also anxiety that may be triggered by having to appear for an interview. 

The most serious risk however is the fact that researchers or their assistants may be involved in some form of misconduct. This could be...

Randomized controlled trials form an important part of evidence-based medicine and are important for investigating the usefulness of research data on the ground. In terms of the study design, RCTs are regarded by many to be the best tool for assessing effectiveness in clinical research. The data or conclusions from RCTs are usually adopted by many health care professionals for the delivery of evidence-based interventions. Unlike non-experimental research studies such as case reports and cross-sectional reviews, randomized controlled trials often lead to high-quality insights with causal inferential value and are therefore considered to be at the core of evidence-based medical care (Spieth et al., 2016).
 

(b) Was this a suitable study design for the given research question?

Yes

(c) Explain why the chosen study design was suitable.

Randomized controlled trials are considered to be the gold standard in the evaluation of effectiveness/ efficacy of medical interventions. There are most often used in assessing the efficacy of drugs but are also appropriate for looking into how well tools or interventions perform in real-world situations as opposed to control circumstances. Hence, the use of randomized controlled trials for this study was extremely suitable considering there was an intervention whose success could be influenced by several known and unknown factors. It also had to be randomized to remove bias (Houle, 2015). 

Question 5: Sample (Participants)

(a) How many participants were included in the study?

Ninety participants out of the 125 approached were accepted and participated in the study. Out of the ninety, 40 were control participants. 

(b) What were the inclusion and exclusion criteria?

The inclusion criteria was broad. Mothers of newborns who could speak either Spanish or English and had a phone with SMS functionality were eligible for the study. The study, however, excluded young mothers under the age of 18 years or did not want their children to be vaccinated for religious or personal beliefs. 

(c) Explain how the participants were recruited 

Mothers of newborns were enrolled from a local hospital by a research assistant. Only those mothers that wanted to seek paediatric care at the university health facility were recruited by the assistant. Mothers who agreed to be recruited were asked to confirm their recruitment by sending the word “TRICKS” to a specific mobile number that was designated for the research. Those who sent the SMS, received follow up messages asking them to send their children’s date of birth, name and sex. 

(d) Describe the setting in which the study took place (hospital, community, etc). 

The study took place in a mid-western metropolitan setting at the University Faculty and Resident Clinic for paediatric care. 

Question 6: Methods/Intervention/Data collection 

(a) Describe the intervention (eg. treatment, therapy etc)

The parents of the newborns were divided into two groups the control group and the intervention group. Those in the intervention group received appointment cards and SMSs on their phones a week before three vaccination dates; when the children turned 2, 4 and then 6 months old. The messages were sent using a computer software that was connected to the research mobile phone. 

(b) What was the comparator (eg. alternative treatment or therapy; placebo etc)

Mothers in the control group received regular communications on the vaccinations due. No text messages were sent to them.

(c) Was this intervention adequately described so that it could be replicated in practice?         

Yes

(d) Explain your response to (c)

One of the most important parts of scientific research is making sure that the research is replicable. This adds value to the study and enables other interested researchers to repeat the study to confirm the validity of the results. The process of making sure that research is replicable simple entails giving complete details and maintaining maximum transparency in the reports produced before and during the study (Douet et al., 2014). This particular research has implementation fidelity; the extent to which the intervention matches the intended purpose (Breitenstein et al., 2010). This is because the details given appear to be complete and show that the study can be successfully translated into real-world situations for evidence-based practice. 

(e) Describe the method/s used to collect data (you do not need to include basic demographic/sociographic data)

When recruited, each participant was required to fill in a baseline questionnaire including those demographic…