Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 27, 2022
Open Peer Review Period: Jan 26, 2022 - Mar 23, 2022
Date Accepted: Jul 28, 2022
(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Warning: This is an author submission that is not peer-reviewed or edited.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.
Perceptions and Attitudes Towards an Interactive Voice Response Tool (Call for Life Uganda) Providing Adherence support and Health Information to HIV Positive Ugandans: A Qualitative study
ABSTRACT
Background:
The continuing decline in AIDS-related deaths in the African Region is largely driven by the steady scale-up of antiretroviral therapy (ART). However, there are challenges to retaining People Living with HIV (PLHIV) on treatment. Call for Life Uganda (CFLU), is an Interactive Voice Response (IVR) tool using simple analogue phones. CFLU supports patients with daily pill reminders, pre-appointment reminders, symptom reporting and management, and weekly health promotion tips. Mobile Health (mHealth) tools are being increasingly used in resource limited settings, but are often adopted without rigorous evaluation.
Objective:
This qualitative study conducted at 12 months’ post enrollment assessed patients’ experiences, perceptions and attitudes towards the Call for Life Uganda.
Methods:
We conducted a qualitative sub-study within an open label randomized controlled trial (RCT) titled ‘Improving outcomes in HIV patients using mobile phone based interactive software support’. Data were collected through six focus group discussions with participants sampled based on proportion of calls responded to: <25%; between 25%-50%; and >50% categories, conducted at the Infectious Diseases Institute, Mulago and Kasangati Health Centre IV. NVivo version 11 was used in the management of the data and in the coding of the emerging themes. The data were then analyzed using content thematic analysis.
Results:
There was consensus across all groups that they had more positive than negative experiences with the CFLU system. Participants who responded to calls >50% reported more frequent use of the specific elements of the CFLU tool and consequently experienced more benefits from the system than those who responded to calls less frequently. Irrespective of calls responded to, participants identified pill reminders as the most important aspect in improved quality of life followed by health promotion tips. The most common challenge faced was difficulty with the secret pin code.
Conclusions:
Findings showed participants’ appreciation, high willingness and interest in the intervention, CFLU, that demonstrated great perceived potential to improve their access to healthcare: adherence to treatment, health awareness and consequently quality of life. Clinical Trial: ClinicalTrials.gov NCT02953080; https://clinicaltrials.gov/ct2/show/NCT02953080
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