JMIR Publications

ABSTRACT

Background:

Many individuals in urban low-income settings face barriers to engaging in primary care. The advancement of mobile health (mHealth) expands options for facilitating communication between primary care providers and clients.

Objective:

We conducted a pilot project that provided primary care clients in a low-income neighbourhood in Vancouver, Canada with a mobile phone and access to WelTel, an mHealth tool that uses a two-way texting approach and sends weekly automated check-in messages asking clients “Are you okay? If clients respond that they are not okay, clinic staff call them back to try to sort out their problem. Our study measured phone retention over a six-month period and explored the acceptability and feasibility of WelTel among a cohort of clients with complex health challenges.

Methods:

Participants completed three surveys over a six-month period, and clients who had access to a functional mobile phone at the end of the follow-up period were invited to complete a qualitative interview.

Results:

We enrolled 49 clients (median age of 48, 53% women) and interviewed 16 participants. The WelTel intervention was well-received by participants and was found to strengthen client-provider relationships, create opportunities for self-reflection, and promoted pathways for receiving care. Some participants reported that the WelTel intervention made them feel cared for. Approximately 1% of weekly messages received an “I am not okay” reply and participants reported that 75% of these problems were fully addressed by clinic staff. However, only 14 (29%) retained the mobile device supplied by the study at the end of six months.

Conclusions:

Overall, the pilot study found this intervention feasible and acceptable to clients. Expanded enrollment in the WelTel service will allow us to examine whether it also facilitates engagement in primary care among marginalized urban populations. Clinical Trial: This is not a clinical trial.