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Mobile phone access in low and middle-income countries is rapidly expanding and offers an opportunity to leverage limited human resources for health. We conducted a mixed methods evaluation of a cluster-randomized trial exploratory substudy on the impact of a mHealth (mobile phone) support intervention used by community-based peer health workers (PHW) on AIDS care in rural Uganda. 29 PHWs at 10 clinics were randomized by clinic to receive the intervention or not. PHWs used phones to call and text higher level providers with patient-specific clinical information. 970 patients cared for by the PHWs were followed over a 26 month period. No significant differences were found in patients’ risk of virologic failure. Qualitative analyses found improvements in patient care and logistics and broad support for the mHealth intervention among patients, clinic staff, and PHWs. Key challenges identified included variable patient phone access, privacy concerns, and phone maintenance.

Unprecedented obesity rates are changing the burden of disease worldwide and obesity-related health complications are increasing health care costs. In response, researchers, clinicians and public health practitioners are seeking new and effective tools such as the internet to effect weight loss. This review highlights peer-reviewed literature on randomized controlled trials that examine internet-delivered weight loss and maintenance programs. The scope of this review is broader than previous reviews, including more males and non-Hispanic white participants. The reviewed studies show intervention results ranging from no weight loss to an average loss of 7.6 kg. It is difficult to draw a definitive conclusion on the potential impact of internet-based weight loss as study methods are highly variable between papers, low adherence was recorded and not all studies include a control group. As the demand for low-cost, efficacious interventions that yield statistically significant and/or clinically relevant results grows, more rigorous, population-specific research is needed to determine if internet-delivered interventions may slow or reverse with weight gain and obesity and the associated health consequences.