The intervention consists of a series of e-messages and a chatbot menu, made available via WhatsApp, with information, resources and nudges that support and educate expecting parents throughout pregnancy and the first months after birth. The messages are sent to the pregnant woman and her partner (if any) four times a week from the moment the woman is recruited at gestation week 12 up to 6 months after birth. The messages are personalized with the name of the pregnant woman, her partner's, and the child's (after birth), and are adapted to the pregnancy's gestational age at recruitment (if after week 12), the pregnant woman’s marital status (alone or with a partner), the pregnant woman's emotional state, baseline information on support networks and enjoyable activities, and whether the child is delivered prematurely.
The content of the pregnancy chatbot menu and messages is based on three pillars: (i) promoting healthy habits (physical activity, healthy eating, avoiding psychoactive substances), (ii) maintaining a healthy mental and emotional state, and (iii) promoting support networks. The chatbot also includes information about available health care resources (health clinics, pregnancy workshops, sequence of normal check-ups, ecosounds and diagnostic tests) and useful telephone numbers and hotlines. The program is, in addition, used to screen mental health problems and refer women to treatment if needed. At baseline, women are screened for domestic violence, food insecurity, and mental health problems and derived to social workers or mental health specialists accordingly. Then, every two weeks, women receive a "mood-checker" message inquiring about her emotional status. If she indicates not feeling well for two consecutive mood-checking messages, the program activates a protocol in which the woman has to complete a depression screener and is eventually derived to a mental health specialist.
Once the child is born, a new menu is displayed in the chatbot and caregivers begin to receive a new set of messages and alerts, based on four parenting competencies: (i) affection and good treatment; (ii) protection, including routines and a safe environment; (iii) stimulation, including playing with the child, talking to the child, reading and telling stories; and (iv) parental self-care and reflection. This stage is implemented for 24 weeks after delivery.
The contents of the chatbot and messages are aligned with information and resources currently delivered to pregnant women, and caregivers through different programs at the national and international level (WHO, UNICEF, Ministry of Health, Ministry of Social Development).
The structure of the messages addresses behavioral biases that play against an optimal pregnancy and parenthood, including negative identities, status quo bias, present bias, and cognitive inattention.The first message is an infograph with information on child development at the woman's age of gestation. The second message provides information on the future benefits of certain behaviors or attitudes, the third message suggests specific tips or activities to implement during the week associated to that topic, and the last one encourages reflection or motivates the participant to complete the previous activity.