JMIR Publications

ABSTRACT

Background:

The use of mobile technologies in fostering health promotion and healthy behaviours is becoming an increasingly common phenomenon in global health programmes. While mobile technologies have been effective in health promotion initiatives and follow-up research in higher-income countries and concerns have been raised within clinical practice and research in low-and-middle income settings, scanty literature in South Africa exists that has qualitatively explored challenges that participants experience in terms of being contactable through mobile technologies.

Objective:

This study aimed to explore challenges that participants experience in terms of being contactable through mobile technologies in a trial conducted in Soweto, South Africa.

Methods:

A convergent parallel mixed-methods research design was employed. In the quantitative phase, approximately 363 young women in the age cohorts 18-28 were contacted telephonically between August 2019 and January 2022 to have a session delivered to them or to be booked for a session. Call attempts initiated by the study team were restricted to only one call attempt and participants who were reached at the first call attempt were classified as contactable (n = 189) while those whom the study team failed to contact were classified as hard to reach (n = 174). Two outcomes of interest in the quantitative phase were ‘contactability of the participants’ and ‘participants’ mobile number changes’ and these outcomes were analysed at a univariate and bivariate level using descriptive statistics and a two-way contingency table. In the qualitative phase, a subsample of young women (n = 20) who were part of the trial for 12 months or more participated in in-depth interviews and were recruited using a convenience sampling method. A reflexive thematic analysis approach was employed to analyse the data using MAXQDA software, version 20.

Results:

Of the 363 trial participants, 47.9% (n=174) were hard to reach telephonically while approximately 52.1% (n=189) were easy to reach telephonically. Most participants (55%) who were contactable did not change their mobile number. The highest percentage of mobile number changes was observed among participants who were hard to reach, with three-quarters (75%) of the participants being reported to have changed their mobile number two or more times. Eight (8) themes were generated following analysis of the transcripts which provided an in-depth account into reasons why some participants were hard to reach. These included (1) Mobile technical issues; (2) Coverage issues; (3) Lack of ownership of personal cell phone; (4) Unregistered number, among others.

Conclusions:

Remote data collection remains an important tool in public health research and could thus serve as a hugely beneficial mechanism in connecting with participants, while actively using established relationships with participants or community-based organisations to deliver health promotion and practice.