High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study

Abstract

BackgroundPatient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region.MethodsWe performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to notify patients of abnormal test results.ResultsParticipants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information.ConclusionsCell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied.

Cell Phone-Based and Adherence Device Technologies for HIV Care and Treatment in Resource-Limited Settings: Recent Advances

“…Specifically, studies have found high rates of acceptability for laboratory notification and adherence and appointment reminders. A study from Uganda evaluated individuals' interest in an SMS-based laboratory notification system and found that all 50 participants would like to receive such notifications; the majority cited expectations for improved communication and improved clinical care [38]. Similarly, in a pre-rollout qualitative acceptability study of WelTel Retain, both HIV-infected individuals and clinicians felt that the SMS intervention would improve communication and lead to early identification of clinical problems, resulting in improved retention [40].…”

“…One recent study estimated that after accounting for system development and fixed and marginal costs, rollout of a cell phone-based adherence intervention among the 600,000 PLWHA in India on first-line ART would cost between $1.27 and $1.77 per individual per year [37]. After start-up costs, the cost of most individual-centered cell phone-based interventions (excluding the cost of the phone itself, which most individuals own), is quite low (e.g., each SMS in Uganda is approximately $0.04 [38]). Some evidence also suggests that individuals would be willing to pay for cell phone-based adherence support.…”

Drop-out from the tuberculosis contact investigation cascade in a routine public health setting in urban Uganda: A prospective, multi-center study

“…[19] Our findings are also consistent with previous work demonstrating that even members of vulnerable populations in Uganda have access to mobile phones. [20][21][22] Only 5% of index patients and 1% of contacts reported that they did not have access to a mobile phone, a functional precondition of household contact investigation in lowincome, urban settings where street addresses are uncommon.…”

Analysis of Interventions for Improving Cervical-Cancer Screening Uptake among Nigerian Women

“…The graphics quality, reliability and speed of short message service (SMS) data transfer, confidentiality and the use of varieties of language tailored to the target audience, based on unique characteristics and the outcome of interest or untailored to address the overall target population are acceptable by women across all culture, ethnicity, religion and social divide [2,49,[55][56][57][58].…”