Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 5, 2025
Date Accepted: Apr 2, 2026
Feasibility and acceptability of mPallCare, a digital health intervention for people living with advanced cancer in a refugee settlement in Uganda: a mixed-method study
ABSTRACT
Background:
Palliative care is a key component of comprehensive humanitarian health, yet there is often limited availability and capacity within humanitarian settings, where fragile health systems struggle to meet the complex needs of people living with advanced illness. Digital health technologies have the potential to enhance the reach and delivery of palliative care, yet their feasibility and acceptability in humanitarian settings remain underexplored.
Objective:
To evaluate mPallCare, a mobile health intervention integrating patient-reported symptom and outcome monitoring with a clinician dashboard, to support palliative care delivery in the Bidibidi Refugee Settlement, Uganda.
Methods:
A six-week, uncontrolled, mixed-methods feasibility study was conducted, involving 32 participants receiving palliative care. Community health workers (i.e., village health teams) used the mobile application to document patient-reported symptoms and multidimensional outcomes, which were accessible to clinical teams via a dashboard. Following the use of mPallCare, patient and clinical team participants participated in face-to-face interviews. Data collected via mPallCare were analysed using descriptive statistics to assess feasibility (compliance with reporting), and interview data were analysed using framework analysis to assess acceptability (user experiences).
Results:
Participants completed 84.9% of symptom reports (163/192) and 59.4% of outcome reports (266/448), demonstrating feasibility. Commonly reported symptoms included headache (84.4%), muscle pain (84.4%), and dizziness (81.3%). Patients and clinical staff found the intervention acceptable, citing improved patient-provider communication, enhanced symptom management, and increased care coordination. Challenges included initial navigation difficulties, translation limitations, and intermittent technical issues. Clinical teams highlighted the potential for integrating mPallCare with national health information systems.
Conclusions:
mPallCare is a feasible and acceptable digital health intervention for palliative care in a humanitarian setting. While it facilitates real-time symptom monitoring and patient engagement, enhancing language accessibility and overcoming technical challenges will be crucial for sustainable implementation. Future research will explore scale-up potential, integration with existing health information
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.