The Portable Eye Examination Kit: Mobile phones can screen for eye disease in low-resource settings.

BACKGROUND The reach of internet and mobile phone coverage has grown rapidly in low- and middle-income countries (LMICs). The potential for sharing knowledge with health care workers in low-resource settings to improve working practice is real, but barriers exist that limit access to online information. Burns affect more than 11 million people each year, but health care workers in low-resource settings receive little or no training in treating burn patients. Interburns' training programs are tailor-made to improve the quality of burn care in Asia, Africa, and the Middle East; the challenge is to understand the best way of delivering these resources digitally toward improved treatment and care of burn patients. OBJECTIVE The aim of the study, funded by the National Institute for Health Research (NIHR), was to understand issues and barriers that affect health care worker access to online learning in low-resource settings in order to broaden access to Interburns' training materials and improve burn-patient care. METHODS A total of 546 participants of Interburns' Essential Burn Care (EBC) course held in Bangladesh, Nepal, Ethiopia, and the West Bank, the occupied Palestinian Territories, between January 2016 and June 2018 were sent an online survey. EBC participants represent the wide range of health care professionals involved with the burn-injured patient. A literature review was carried out as well as research into online platforms. RESULTS A total of 207 of 546 (37.9%) participants of the EBC course did not provide an email address. Of the 339 email addresses provided, 81 (23.9%) “bounced” back. Surgeons and doctors were more likely to provide an email address than nurses, intern doctors, or auxiliary health care workers. A total of 258 participants received the survey and 70 responded, giving a response rate of 27.1%. Poor internet connection, lack of time, and limited access to computers were the main reasons for not engaging with online learning, along with lack of relevant materials. Computers were seen as more useful for <i>holding information</i>, while mobile phones were better for communicating and <i>sharing knowledge</i>. Health care workers in LMICs use mobile phones professionally on a daily basis. A total of 80% (56/70) felt that educational content on burns should be available through mobile apps. CONCLUSIONS Health care workers in low-resource settings face a variety of barriers to accessing educational content online. The reliance on email for sign-up to learning management systems is a significant barrier. Materials need to be relevant, localized, and easy to consume offline if necessary, to avoid costs of mobile phone data. Smartphones are increasingly used professionally every day for communication and searching for information, pointing toward the need for tailored educational content to be more available through mobile- and web-based apps.

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Finding the Best Way to Deliver Online Educational Content in Low-Resource Settings: Qualitative Survey Study

JMIR Medical Education ◽

10.2196/16946 ◽

2020 ◽

Vol 6 (1) ◽

pp. e16946

Author(s):

Lucy Kynge

Keyword(s):

Health Care ◽

Mobile Phones ◽

Health Care Workers ◽

Burn Patients ◽

Educational Content ◽

Low Resource Settings ◽

Low Resource ◽

Burn Care ◽

Email Address ◽

Care Workers

Background The reach of internet and mobile phone coverage has grown rapidly in low- and middle-income countries (LMICs). The potential for sharing knowledge with health care workers in low-resource settings to improve working practice is real, but barriers exist that limit access to online information. Burns affect more than 11 million people each year, but health care workers in low-resource settings receive little or no training in treating burn patients. Interburns' training programs are tailor-made to improve the quality of burn care in Asia, Africa, and the Middle East; the challenge is to understand the best way of delivering these resources digitally toward improved treatment and care of burn patients. Objective The aim of the study, funded by the National Institute for Health Research (NIHR), was to understand issues and barriers that affect health care worker access to online learning in low-resource settings in order to broaden access to Interburns' training materials and improve burn-patient care. Methods A total of 546 participants of Interburns' Essential Burn Care (EBC) course held in Bangladesh, Nepal, Ethiopia, and the West Bank, the occupied Palestinian Territories, between January 2016 and June 2018 were sent an online survey. EBC participants represent the wide range of health care professionals involved with the burn-injured patient. A literature review was carried out as well as research into online platforms. Results A total of 207 of 546 (37.9%) participants of the EBC course did not provide an email address. Of the 339 email addresses provided, 81 (23.9%) “bounced” back. Surgeons and doctors were more likely to provide an email address than nurses, intern doctors, or auxiliary health care workers. A total of 258 participants received the survey and 70 responded, giving a response rate of 27.1%. Poor internet connection, lack of time, and limited access to computers were the main reasons for not engaging with online learning, along with lack of relevant materials. Computers were seen as more useful for holding information, while mobile phones were better for communicating and sharing knowledge. Health care workers in LMICs use mobile phones professionally on a daily basis. A total of 80% (56/70) felt that educational content on burns should be available through mobile apps. Conclusions Health care workers in low-resource settings face a variety of barriers to accessing educational content online. The reliance on email for sign-up to learning management systems is a significant barrier. Materials need to be relevant, localized, and easy to consume offline if necessary, to avoid costs of mobile phone data. Smartphones are increasingly used professionally every day for communication and searching for information, pointing toward the need for tailored educational content to be more available through mobile- and web-based apps.

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Passive sensing on mobile devices to improve mental health services with adolescent and young mothers in low-resource settings: the role of families in feasibility and acceptability

10.21203/rs.3.rs-22755/v2 ◽

2020 ◽

Author(s):

Sujen Man Maharjan ◽

Anubhuti Poudyal ◽

Alastair van Heerden ◽

Prabin Byanjankar ◽

Ada Thapa ◽

...

Keyword(s):

Data Collection ◽

Health Services ◽

Mobile Devices ◽

Family Involvement ◽

Mobile Phones ◽

Young Mothers ◽

Low Resource Settings ◽

Low Resource ◽

Passive Sensing ◽

Passive Data

Abstract Background: Passive sensor data from mobile devices can shed light on daily activities, social behavior, and maternal-child interactions to improve maternal and child health services including mental healthcare. We assessed feasibility and acceptability of the Sensing Technologies for Maternal Depression Treatment in Low Resource Settings (StandStrong) platform. The StandStrong passive data collection was piloted with adolescent and young mothers, including mothers experiencing postpartum depression, in Nepal.Methods: Mothers (15-25 years old) with infants (<12 months old) were recruited in person from vaccination clinics in rural Nepal. They were provided with an Android smartphone and a Bluetooth beacon to collect data in four domains: the mother’s location using the Global Positioning System (GPS), physical activity using the phone’s accelerometer, auditory environment using episodic audio recording on the phone, and mother-infant proximity measured with the Bluetooth beacon attached to the infant’s clothing. Feasibility and acceptability were evaluated based on the amount of passive sensing data collected compared to the total amount that could be collected in a 2-week period. Endline qualitative interviews (n=31) were conducted to understand mothers’ experiences and perceptions of passive data collection. Results: 782 women were approached and 320 met eligibility criteria. 38 mothers (11 depressed, 27 non-depressed) were enrolled. Of 9,605 possible readings per sensor, 5,579 audio recordings [mean (M)=57.4%; median (Mdn)=62.6%], 5,001 activity readings (M=50.6%; Mdn=63.2%), 4,168 proximity readings (M=41.1%; Mdn=47.6%), and 3,482 GPS readings (M=35.4%; Mdn=39.2%) were obtained. Feasibility challenges were phone battery charging, data usage exceeding pre-paid limits, and burden of carrying mobile phones. Acceptability challenges were privacy concerns and lack of family involvement. Overall, families’ understanding of passive sensing and families’ awareness of potential benefits to mothers and infants were the major modifiable factors to increase acceptability and reduce gaps in data collection. Conclusion: Approximately half of all possible passive data readings were collected. Feasibility challenges can be addressed by providing alternative phone charging options, setting up reverse billing for the app, and exploring smartwatches as a replacement for mobile phones. Enhancing acceptability will require greater family involvement and improved communication regarding benefits of passive sensing for psychological interventions and other health services. Registration: International Registered Report Identifier (IRRID): DERR1-10.2196/14734

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