Perceptions and acceptability of mHealth interventions for improving patient care at a community-based HIV/AIDS clinic in Uganda: A mixed methods study

Abstract

mHealth (mobile technologies for health) represents a growing array of tools being applied in diverse health care settings. mHealth interventions for improving HIV/AIDS care is a promising strategy, but its evidence-base is limited. We conducted a formative research evaluation to inform the development of novel, mHealth HIV/AIDS care interventions to be used by community health workers (CHWs) in Kampala, Uganda. A mixed methods formative research approach was utilized. Qualitative methods included 20 in-depth interviews and 6 focus groups with CHWs, clinic staff, and patients. Thematic analysis was performed and selected quotations used to illustrate themes. Quantitative methods consisted of a survey administered to CHWs and clinic staff using categorical and Likert scale questions regarding current mobile phone and internet access and perceptions on the potential use of smartphones by CHWs. Qualitative results included themes on significant current care challenges, multiple perceived mHealth benefits, and general intervention acceptability. Key mHealth features desired included tools to verify CHW task completions, clinical decision support tools, and simple access to voice calling. Inhibiting factors identified included concerns about CHW job security and unrealistic expectations of mHealth capabilities. Quantitative results from 27 staff participants found that 26 (96%) did not have internet access at home; yet, only 2 (7.4%) did not own a mobile phone. Likert scale survey responses (1–5, 1=Strongly Disagree, 5=Strongly Agree) indicated general agreement that smartphones would improve efficiency (Mean=4.35) and patient care (4.31) but might be harmful to patient confidentiality (3.88) and training was needed (4.63). Qualitative and quantitative results were generally consistent, and, overall, there was enthusiasm for mHealth technology. However, a number of potential inhibiting factors were also discovered. Findings from this study may help guide future design and implementation of mHealth interventions in this setting, optimizing their chances for success.

Beyond acceptability and feasibility: moving mHealth into impact

“…The findings from Jenkins et al (1) are consistent with the other ample literature that considers acceptability of using mobile phones and other digital solutions for health promotion and disease self-management (8,9), including those that use sensors to monitor activity (10), those that consider acceptability for mHealth in low and middle income settings (11) and those that consider acceptability for low income (12) and elderly (13).…”

Identifying Grassroots Opportunities and Barriers to mHealth Design for HIV/AIDS Using a Communicative Ecologies Framework

“…Rather, this study should be considered alongside larger-scale quantitative reports such as the eHealth surveys conducted by the WHO Global Observatory for eHealth (WHO, 2016). However, our findings do confirm that multiple soft organisational and cultural barriers to adoption can be expected by any media technology-oriented project (Chang et al, 2013) and as a consequence, the adoption of formal or informal mHealth tools, methods or systems by CHWs and/or smaller scale NGOs should not be assumed by policymakers or system designers.…”

Determinants of readiness to adopt mHealth in a rural community of Bangladesh

“…mHealth, using mobile phone and multimedia technologies, has been successfully used, particularly in resource-poor settings, to increase access to primary healthcare, real time diagnosis and treathttp://dx.doi.org/10.1016/j.ijmedinf.2015.06.008 1386-5056/© 2015 Published by Elsevier Ireland Ltd. ment, health education, emergency medical response, and data collection in disease surveillance [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Evidence in favor of its usefulness is accumulating.…”