Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Apr 8, 2021
Date Accepted: Dec 31, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Reaching patients with noncommunicable diseases in rural Tanzania using mobile devices and community trust
ABSTRACT
Background:
A health service utilizing mobile devices, mHealth, has been widely applied to programs focusing on maternal and child health and communicable diseases in Sub-Saharan African countries. However, mHealth applications for noncommunicable disease (NCD) services remain limited.
Objective:
This study aimed to explore the acceptability and potential usability of text messaging for patients and health-care providers for the management of NCDs as a part of implementation research in rural Tanzania.
Methods:
Nine focus group discussions (FGDs) were conducted with 56 participants (21 community health workers [CHWs], 17 patients, and 18 health-care professionals [HPs]) in three districts in the Dodoma region in Tanzania. The interview guides were prepared in Swahili and each session was recorded, transcribed, and translated into English. The FGDs focused on the following topics: [a] perceptions of the participants about the possible use of mobile devices and short message service text messages as an mHealth platform in community health services; and [b] experiences of mobile device use in health activities or receiving health services via a mobile phone in the past.
Results:
CHWs and HPs reported having familiarity with using mobile devices to provide health services, especially for reaching or tracing patients in remote settings; however, patients with NCDs were less familiar with the use of mobile devices compared with the other groups. Hesitation to receive health services via text messaging was seen in the patient group, as they wondered who would send health advice to them. Some patients expected services beyond what mHealth could do, such as aiding in recovery from a disease or sending notifications about the availability of prescription medications. CHWs showed interest in utilizing text messaging to provide health services in the community, however the concerns raised by CHWs included the cost of using their own mobile devices, and also they demanded training about NCD management before involving such an activity.
Conclusions:
This study explored views and experiences regarding the possible installation of a mobile health intervention for managing NCDs in rural Tanzania. Although HPs and CHWs had experience using mobile devices to provide health services in non-NCD projects, only a few patients (3/17) had heard about the use of mobile devices to receive health services. To improve the suitability and acceptability of the intervention design for patients with NCDs, their trust must be earned. Involving CHWs in the intervention is recommended because they have already been appointed in the community and already know how to communicate effectively with patients in the area.
Citation
