Effectiveness of SMS messaging for diarrhoea measurement: a factorial cross-over randomised controlled trial

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background Text messaging systems are used to collect data on symptom prevalence. Using a text messaging system, we evaluated the effects of question load, question frequency, and financial incentive on response rates and reported infant diarrhoea rates in an infant diarrhoea survey. Methods We performed a factorial cross-over randomised controlled trial of an SMS surveying system for infant diarrhoea surveillance with treatments: financial incentive (yes/no), question load (1-question/3-question), and questioning frequency (daily/fortnightly). Participants progressed through all treatment combinations over eight two-week rounds. Data were analysed using multivariable logistic regressions to determine the impacts of the treatments on the response rates and reported diarrhoea rates. Attitudes were explored through qualitative interviews. Results For the 141 participants, the mean response rate was 47%. In terms of percentage point differences (ppd), daily questioning was associated with a lower response rate than fortnightly (-1·2[95%CI:-4·9,2·5]); high (3-question) question loads were associated with a lower response rate than low (1-question) question loads (-7·0[95%CI:-10·8,-3·1]); and financial incentivisation was associated with a higher response rate than no financial incentivisation (6·4[95%CI:2·6,10·2]). The mean two-week diarrhoea rate was 36·4%. Daily questioning was associated with a higher reported diarrhoea rate than fortnightly (29·9[95%CI:22·8,36·9]); with little evidence for impact by incentivisation or question load. Conclusions Close to half of all participants responded to the SMS survey. Daily questioning evoked a statistically higher rate of reported diarrhoea, while financial incentivisation and low (1-question) question loads evoked higher response rates than no incentive and high (3-question) question loads respectively. Trial Registration The protocol was registered on ISRCTN on the 20 th of March 2019 under number ISRCTN11410773 .</jats:p>

COVID-19 vaccination refusal trends in Kenya over 2021

“…[1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] .…”

The impact of diarrhoea measurement methods for under 5s in low‐ and middle‐income countries on estimated diarrhoea rates at the population level: A systematic review and meta‐analysis of methodological and primary empirical studies

“…We would expect a lower reported number of diarrhoea episodes with longer recall periods and this was borne out by our analysis including two of the three head‐to‐head comparisons – the exception examined a much smaller gap between questions than the other two [10, 22]. This finding was corroborated by a more recent head‐to‐head comparison where daily recall was associated with a 30 percentage point higher estimated diarrhoea rate than fortnightly recall during a text message survey of under 5 diarrhoea in urban Tanzania [24]. While not examined in our review, it has also been reported that the effect of recall bias is more apparent for moderate diarrhoea compared to severe diarrhoea.…”

Evaluating Self-Reported Vaccination Hesitancy in Mobile Phone Surveys Performed in LMICs: Learned Lessons from Data in Four Low and Middle Income Countries

“…When surveying on health topics, social desirability bias is o en of concern when there is a response which is clearly socially desirable 16,17 . While one may expect assurance of confiden ality (compounded by the inherent privacy of phone interviews) to counteract this, we have demonstrated that this may not be the case 18 . Indeed, Wolter et al (2022) found in Germany that direct ques oning on COVID-19 vaccina on led to a 10pp higher reported vaccina on rate than indirect ques oning using the item count technique 19 .…”