JMIR Publications

ABSTRACT

Background:

Premature birth poses significant health challenges globally, impacting infants, families, and society. Despite recognition of its contributing factors, efforts to reduce its incidence have seen limited success. A notable gap exists in the awareness among women of childbearing age (WCA) regarding both the risks of premature birth and the preventative measures they can take. Research suggests that enhancing health beliefs and self-management efficacy in WCA could foster preventive health behaviors. Interactive webtoons offer an innovative, cost-effective avenue for delivering engaging, accessible health education aimed at preventing premature birth.

Objective:

This protocol describes a randomized controlled trial to assess the effectiveness and feasibility of a novel, self-guided, web-based intervention—Pregnancy Story I Didn't Know in Interactive Webtoon Series (PSIDK-iWebtoons)—designed to enhance self-management efficacy and promote behaviors preventing premature birth in WCA.

Methods:

Employing an explanatory sequential mixed-methods design, this study first conducts a quantitative analysis followed by a qualitative inquiry to evaluate outcomes and feasibility. Participants are randomly assigned to two groups: one accessing the PSIDK-iWebtoons and the other receiving text-based information (PSIDK-Texts) over three weeks. We measure primary efficacy through the self-management self-efficacy scale for premature birth prevention, alongside secondary outcomes including perceptions of susceptibility, severity, benefits, and barriers based on the health belief model for premature birth prevention, and premature birth prevention intention. Additional participant-reported outcomes are assessed at baseline, the postintervention time point, and 4-weeks follow-up. The feasibility of the intervention is assessed after the end of the 3-week intervention period. Outcome analysis employs t-tests for quantitative data, while qualitative data are explored through content analysis of interviews with 30 participants.

Results:

Both the PSIDK-iWebtoons and PSIDK-Texts interventions have been developed and pilot-tested from July to November 2023, with the main phase of data collection running until March 2024. Ongoing analyses include process evaluation and data interpretation.

Conclusions:

This trial will lay foundational insights into the nexus of interactive web-based interventions and the improvement of knowledge and practices related to premature birth prevention among WCA. By demonstrating the efficacy and feasibility of a web-based, interactive educational tool, this study will contribute essential evidence to the discourse on accessible and scientifically robust digital platforms. Positive findings will underscore the importance of such interventions in fostering preventive health behaviors, thereby supporting community-wide efforts to mitigate the risk of premature births through informed self-management practices. Clinical Trial: The trial was pre-registered with the Clinical Research Information Service, established at the Korea Disease Control and Prevention Agency (KDCA), under registration number KCT0008824, on September 25, 2023.