A Qualitative Study Investigating the Use of a Mobile Phone Short Message Service Designed to Improve HIV Adherence and Retention in Care in Canada (WelTel BC1)☆

Smillie, Kirsten; Borek, Natasha Van; Abaki, Joshua; Pick, Neora; Maan, Evelyn J.; Friesen, Karen; Graham, Rebecca; Levine, Sarah; Kop, Mia L. van der; Lester, Richard; Murray, Melanie

doi:10.1016/j.jana.2014.01.008

Cited by 65 publications

(133 citation statements)

References 6 publications

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“…23,30,31,33,35,36,38,41,45,47,[49][50][51][52][53][54][55][56][57][58][59] Table 1 illustrates and rank orders the themes from analysis of the facilitators of adoption based on frequency of their occurrence in the literature.…”

Section: Facilitatorsmentioning

confidence: 99%

“…Effective, outcomes, and communicative were mentioned in 6/60 occurrences (10%). 27,28,30,[37][38][39][40]45,46,48,53,[54][55][56]58 mHealth can change behaviour through feedback. It can mentally stimulate patients to delay the advance of dementia, improve triage decisions and arrangement of transportation through communication channels, increase self-efficacy augmenting existing interventions and thereby outcomes.…”

Section: Facilitatorsmentioning

confidence: 99%

“…23,25,52 The improvement of access included technology to enhance coordination of care without the limitations of proximity or mobility. 40,46,55 The theme of convenient was only mentioned once (2%). The authors pointed out that elderly with dementia are willing to wear mobile technology, they willingly accept it, and they feel that it is convenient to use for multiple purposes.…”

Section: Facilitatorsmentioning

confidence: 99%

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Mobile health solutions for the aging population: A systematic narrative analysis

2016

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Introduction: The ubiquitous nature of mobile technology coupled with the acceptance of mobile health (mHealth) among the elderly offers an opportunity to augment the existing medical workforce in long-term care. The objective of this review and narrative analysis is to identify and analyse facilitators and barriers to adoption of mHealth for the elderly. Methods: Studies over the last year were identified in multiple database indices, and three reviewers examined abstracts (k ¼ 0.82) and analysed articles for themes which were tallied in affinity diagrams to identify frequency of occurrence in the literature (n ¼ 36). Results: The three facilitators mentioned most often were independence (18%), understanding (13%), and visibility (13%). The three barriers mentioned most often were complexity (21%), limited by users (12%) and ineffective (12%). Discussion and conclusions: The reviewers concluded that the work done so far illustrates that mHealth enables a perception of independence. Future research should focus on the barriers of complexity of technology and improving existing medical literacy in order to facilitate further adoption.

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Section: Facilitatorsmentioning

confidence: 99%

Section: Facilitatorsmentioning

confidence: 99%

Section: Facilitatorsmentioning

confidence: 99%

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Mobile health solutions for the aging population: A systematic narrative analysis

2016

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“…Since the original RCT, the WelTel mobile health program has expanded in Africa and North America in the area of HIV/AIDS [9]-13], Tuberculosis [14], Maternal and Child Care, Asthma and recently in primary care settings. The WelTel program is a patient-centered form of digital outreach communications designed to support engagement in care and treatment adherence.…”

Section: Methodsmentioning

confidence: 99%

Identifying Barriers and Facilitators of 13 mHealth Projects in North America and Africa: Protocol for a 5-Year Implementation Science Study (Preprint)

Tilahun¹,

Smillie²,

Bardosh³

et al. 2017

Preprint

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BACKGROUND Although many mHealth interventions have shown efficacy in research, few have been effectively implemented and sustained in real-world health system settings. Despite this programmatic gap, there is limited conclusive evidence identifying the factors that affect the implementation and successful integration of mHealth into a health system. OBJECTIVE The aim of this study is to examine the individual, organizational, and external level factors associated with the effective implementation of WelTel, an mHealth intervention designed to support outpatient medication adherence and engagement in care in Africa and North America. METHODS We will adopt the Consolidated Framework for Implementation Research (CFIR) constructs for evaluation of mHealth implementation including a scoring and monitoring system. We will apply the adapted tool to identify facilitators and barriers to implementation of the WelTel mHealth intervention in order to determine how the technology platform is perceived, diffused, adapted, and used by different mHealth project teams and health system actors in Africa and North America. We will use a mixed-methods approach to quantitatively test whether the factors identified in the CFIR framework are associated with the successful uptake of the mHealth intervention toward implementation goals. We will triangulate these data through interviews and focus group discussion with project stakeholders, exploring factors associated with successful implementation and sustainment of these interventions. RESULTS The development of the customized CFIR is finalized and currently is in pilot testing. The initial results of the use of the tool in those 13 implementations will be available in 2019. Continuous conference and peer- reviewed publications will be published in the coming years. CONCLUSIONS The results of this study will provide an in-depth understanding of individual, organizational, and external level factors that influence the successful implementation of mHealth in different health systems and geographic contexts over time. Via the tool’s unique scoring system connected to qualitative descriptors, these data will inform the most critical implementation targets and contribute to the tailoring of strategies that will assist the health system in overcoming barriers to implementation, and ultimately, improve treatment adherence and engagement in care. REGISTERED REPORT IDENTIFIER RR1-10.2196/9633

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“…When sensitive information was exchanged, a phone call or in-person visit was always offered first. These measures ensured respect of each participant's wishes to guarantee confidentiality and security in the program [4].…”

mentioning

confidence: 99%

Author�s Response to Letter to the Editor for �Health Care Provider Utilization and Cost of an mHealth Intervention in Vulnerable People Living With HIV in Vancouver, Canada: Prospective Study� (Preprint)

Campbell¹,

Murray²

2018

Preprint

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A main concern was that the cost to provide the WelTel program would be too high in many low income countries. However, the cost presented here is specific to our Canadian setting, and would likely be much less in low income nations. Our cost assessment is based on the salaries of Canadian health care providers (HCPs) and the cost of cell phones and plans in Canada. Cost of HCP services were calculated by the amount of time spent on problem solving, and this time is detailed in the paper so that costs can be estimated in other settings. In a low income nation where the HCP wage is lower, the cost of running the program would be decreased. In addition, the cost of phones and plans in Canada is quite expensive, and in countries where this is reduced, program costs would again be lower. For instance, WelTel was previously conducted in Kenya in the WelTelKenya1 study, and phones were affordable there [3].

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A Qualitative Study Investigating the Use of a Mobile Phone Short Message Service Designed to Improve HIV Adherence and Retention in Care in Canada (WelTel BC1)☆

Cited by 65 publications

References 6 publications

Mobile health solutions for the aging population: A systematic narrative analysis

Mobile health solutions for the aging population: A systematic narrative analysis

Identifying Barriers and Facilitators of 13 mHealth Projects in North America and Africa: Protocol for a 5-Year Implementation Science Study (Preprint)

Author�s Response to Letter to the Editor for �Health Care Provider Utilization and Cost of an mHealth Intervention in Vulnerable People Living With HIV in Vancouver, Canada: Prospective Study� (Preprint)

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