A Comprehensive App That Improves Tuberculosis Treatment Management Through Video-Observed Therapy: Usability Study

Guo, Xujun; Yang, Yarui; Takiff, Howard; Zhu, Manlu; Ma, Jianping; Zhong, Tao; Fan, Yuzheng; Wang, Jian; Liu, Shengyuan

doi:10.2196/17658

Cited by 25 publications

(38 citation statements)

References 24 publications

(23 reference statements)

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“…There were mixed perceptions about the impact of VDOT on privacy and confidentiality, particularly with unintended disease closure, potentially resulting in stigma. Similar perceptions of structural and privacy- and patient-related barriers to VDOT implementation have been previously reported [ 24 , 36 , 37 ]. For example, some studies have reported that video recordings and repeated text reminders are perceived as being overly intrusive [ 37 , 38 ].…”

Section: Discussionsupporting

confidence: 75%

Stakeholders’ Perceptions of Benefits of and Barriers to Using Video-Observed Treatment for Monitoring Patients With Tuberculosis in Uganda: Exploratory Qualitative Study

Sekandi¹,

Kasiita²,

Onuoha³

et al. 2021

JMIR Mhealth Uhealth

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Background Nonadherence to treatment remains a barrier to tuberculosis (TB) control. Directly observed therapy (DOT) is the standard for monitoring adherence to TB treatment worldwide, but its implementation is challenging, especially in resource-limited settings. DOT is labor-intensive and inconvenient to both patients and health care workers. Video DOT (VDOT) is a novel patient-centered alternative that uses mobile technology to observe patients taking medication remotely. However, the perceptions and acceptability of potential end users have not been evaluated in Africa. Objective This study explores stakeholders’ acceptability of, as well as perceptions of potential benefits of and barriers to, using VDOT to inform a pilot study for monitoring patients with TB in urban Uganda. Methods An exploratory, qualitative, cross-sectional study with an exit survey was conducted in Kampala, Uganda, from April to May 2018. We conducted 5 focus group discussions, each comprising 6 participants. Groups included patients with TB (n=2 groups; male and female), health care providers (n=1), caregivers (n=1), and community DOT volunteer workers (n=1). The questions that captured perceived benefits and barriers were guided by domains adopted from the Technology Acceptance Model. These included perceived usefulness, ease of use, and intent to use technology. Eligible participants were aged ≥18 years and provided written informed consent. For patients with TB, we included only those who had completed at least 2 months of treatment to minimize the likelihood of infection. A purposive sample of patients, caregivers, health care providers, and community DOT workers was recruited at 4 TB clinics in Kampala. Trained interviewers conducted unstructured interviews that were audio-recorded, transcribed, and analyzed using inductive content analysis to generate emerging themes. Results The average age of participants was 34.5 (SD 10.7) years. VDOT was acceptable to most participants on a scale of 1 to 10. Of the participants, 70% (21/30) perceived it as highly acceptable, with scores ≥8, whereas 30% (9/30) scored between 5 and 7. Emergent themes on perceived benefits of VDOT were facilitation of easy adherence monitoring, timely follow-up on missed doses, patient-provider communication, and saving time and money because of minimal travel to meet in person. Perceived barriers included limited technology usability skills, inadequate cellular connectivity, internet access, availability of electricity, cost of the smartphone, and use of the internet. Some female patients raised concerns about the disruption of their domestic work routines to record videos. The impact of VDOT on privacy and confidentiality emerged as both a perceived benefit and barrier. Conclusions VDOT was acceptable and perceived as beneficial by most study participants, despite potential technical and cost barriers. Mixed perceptions emerged about the impact of VDOT on privacy and confidentiality. Future efforts should focus on training users, ensuring adequate technical infrastructure, assuring privacy, and performing comparative cost analyses in the local context.

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Section: Discussionsupporting

confidence: 75%

Stakeholders’ Perceptions of Benefits of and Barriers to Using Video-Observed Treatment for Monitoring Patients With Tuberculosis in Uganda: Exploratory Qualitative Study

Sekandi¹,

Kasiita²,

Onuoha³

et al. 2021

JMIR Mhealth Uhealth

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“…While many rapid pathogen detection technologies have undergone validity analyses, there is a literature gap of usability analyses for such technologies [14][15][16][17][18]. Many usability studies instead evaluate technologies that aid interventions such as behavioral change, treatment adherence, or clinical decision making [23][24][25][26]. Thus, this study can serve as a model of iterative convergent mixed methods research design for device development to further promote usability analysis of rapid pathogen detection technologies and produce rapid detection devices that better fit into user workflows for increased uptake.…”

Section: Principal Findingsmentioning

confidence: 99%

“…While the field of mHealth and rapid diagnostic testing for infectious disease is fast-growing, few rapid pathogen detection technologies have been developed for environmental surveillance [12,22]. Moreover, many mHealth usability studies have evaluated interventions such as behavioral change, medication adherence, or clinical decision-making technologies, but there is a literature gap for usability studies evaluating rapid pathogen detection technology [23][24][25][26]. By providing input in the device development process, end users can become cocreators and feel ownership in the device design, enabling greater uptake and integration into workflows.…”

Section: Introductionmentioning

confidence: 99%

Usability of Rapid Cholera Detection Device (OmniVis) for Water Quality Workers in Bangladesh: Iterative Convergent Mixed Methods Study

Rager¹,

Koepfli²,

Khan³

et al. 2021

J Med Internet Res

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Background Cholera poses a significant global health burden. In Bangladesh, cholera is endemic and causes more than 100,000 cases each year. Established environmental reservoirs leave millions at risk of infection through the consumption of contaminated water. The Global Task Force for Cholera Control has called for increased environmental surveillance to detect contaminated water sources prior to human infection in an effort to reduce cases and deaths. The OmniVis rapid cholera detection device uses loop-mediated isothermal amplification and particle diffusometry detection methods integrated into a handheld hardware device that attaches to an iPhone 6 to identify and map contaminated water sources. Objective The aim of this study was to evaluate the usability of the OmniVis device with targeted end users to advance the iterative prototyping process and ultimately design a device that easily integrates into users’ workflow. Methods Water quality workers were trained to use the device and subsequently completed an independent device trial and usability questionnaire. Pretraining and posttraining knowledge assessments were administered to ensure training quality did not confound trial and questionnaire Results Device trials identified common user errors and device malfunctions including incorrect test kit insertion and device powering issues. We did not observe meaningful differences in user errors or device malfunctions accumulated per participant across demographic groups. Over 25 trials, the mean time to complete a test was 47 minutes, a significant reduction compared with laboratory protocols, which take approximately 3 days. Overall, participants found the device easy to use and expressed confidence and comfort in using the device independently. Conclusions These results are used to advance the iterative prototyping process of the OmniVis rapid cholera detection device so it can achieve user uptake, workflow integration, and scale to ultimately impact cholera control and elimination strategies. We hope this methodology will promote robust usability evaluations of rapid pathogen detection technologies in device development.

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“…Due to the long process of treatment in patients with TB, the need for treatment adherence especially when the initial signs of improvement appear, and information about the continued use and consequences of arbitrary discontinuation of the drug, customized messages are sent to patients according to the treatment schedule (54). In addition, to achieve better results and measure the actual effectiveness of the program, evaluation of the program by patients with TB is recommended, which requires shortterm education of patients and the inclusion of the needs of such users.…”

Section: Clinical Implications: Mobile Self-care System For Tuberculosis Controlmentioning

confidence: 99%

Intelligent Alarm System-Based Devices Designed for People with Disabilities, Caused by Various Chronic Diseases

Tirdad

Nami

Samieyan

et al. 2021

Jundishapur J Chronic Dis Care

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Context: Chronic diseases (CD) are defined as symptoms or disabilities, caused by diseases, genetic factors, and injury requiring long-term treatment. Intelligent alarm systems, which collect patient health data and transfer it to a medical server, help track and avoid future incidents. Method: The search terms were “computer network” OR “information systems” OR “wireless technology” OR “decision support systems” AND “chronic disease” OR “chronic disease” in major electronic databases, including Pubmed/Medline, Scopus, Embase, ISI Web of Science, and Cochrane Central. Results: The search resulted in 1275 articles with 11 specific to intelligence-based systems in chronic medical conditions until 08 June 2021. The creation of different access levels for care providers in the system and application customization according to CD conditions were the goals that can be achieved in future research. The human-computer interface (HCI) systems, smart home, and software, such as Fitbit using IoMT to monitor health metrics in people with different CDs, are introduced so far. Conclusions: These systems, if provided on the web and mobile platform, can be accessed at any time and place and are more efficient. Finally, the combination of clinical decision support systems with artificial intelligence has beneficial effects on physician's systems, increases the accuracy in CD diagnosis, and improves the pain management. This intelligent system demonstrates factors influencing back to work and allows identifying high-risk patients and their potential to handle activities of daily living.

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A Comprehensive App That Improves Tuberculosis Treatment Management Through Video-Observed Therapy: Usability Study

Cited by 25 publications

References 24 publications

Stakeholders’ Perceptions of Benefits of and Barriers to Using Video-Observed Treatment for Monitoring Patients With Tuberculosis in Uganda: Exploratory Qualitative Study

Stakeholders’ Perceptions of Benefits of and Barriers to Using Video-Observed Treatment for Monitoring Patients With Tuberculosis in Uganda: Exploratory Qualitative Study

Usability of Rapid Cholera Detection Device (OmniVis) for Water Quality Workers in Bangladesh: Iterative Convergent Mixed Methods Study

Intelligent Alarm System-Based Devices Designed for People with Disabilities, Caused by Various Chronic Diseases

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