2wT Procedures (Intervention Arm)
bleeding, redness, swelling, pain
BLEEDING
On day 0 (day of VMMC), a 2wT study team member registered all the intervention participants in the app. The 2wT arm participants received up to 10 minutes of enhanced postoperative counseling using the 2wT flip-book on how to respond to the daily SMS text message and reviewed photos that illustrated the terms in the daily SMS text message: “How are you? Are you experiencing any bleeding, swelling, pus, pain, redness or wound opening? Enter 1=Yes, 0=No and press send.” The 2wT participants received the automated daily SMS text message on days 1 to 13 in 1 of 3 predominant languages of the area, English, Setswana, or isiZulu. The participants could respond via an SMS text message in any language. The clients were expected to respond to the daily SMS text message with a single numeric (0 or 1) response; they could respond to any daily SMS text message at any time. They could also initiate an unrestricted, freely-worded text response at any time, instead of or in addition to the daily numeric response. A The 2-way texting (2wT) hybrid SMS text message flow (CC BY 4.0 [