SMS text messaging to measure working time: the design of a time use study among general practitioners

Background Antenatal care (ANC) has the potential to improve maternal health, but it remains underutilized and unevenly implemented in many low- and middle-income countries. Increasingly, text messaging programs for pregnant women show evidence that they can improve the utilization of ANC during pregnancy; however, gaps remain regarding how implementation affects outcomes. Objective This study aimed to assess facilitators and barriers to implementation of an SMS text messaging intervention for pregnant women in Samoa and to assess its impact on ANC attendance. Methods This study took place in Upolu, Samoa, from March to August 2014 and employed a quasi-experimental design. Half (n=3) of the public antenatal clinics on the island offered adult pregnant women the SMS text messaging intervention, with 552 women registering for the messages. At the comparison clinics (n=3), 255 women registered and received usual care. The intervention consisted of unidirectional text messages containing health tips and appointment reminders. The outcome of interest was the number of attended antenatal visits. Implementation data were also collected through a survey of the participating midwives (n=7) and implementation notes. Data analysis included a comparison of women’s baseline characteristics between the two groups, followed by the use of negative binomial regressions to test for associations between participation in the intervention and increased ANC attendance, controlling for individual characteristics and accounting for the clustering of women within clinics. Results The comparison of ANC attendance rates found that women receiving the SMS text messaging intervention attended 15% fewer ANC visits than the comparison group (P=.004), controlling for individual characteristics and clustering. Data analysis of the implementation process suggests that barriers to successful implementation include women registering very late in pregnancy, sharing their phone with others, and inconsistent explanation of the intervention to women. Conclusions These results suggest that unidirectional text messages do not encourage, and might even discourage, ANC attendance in Samoa. Interpreted with other evidence in the literature, these results suggest that SMS text messaging interventions are more effective when they facilitate better communication between patients and health workers. This study is an important contribution to our understanding of when SMS text messaging interventions are and are not effective in improving maternal health care utilization.

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The Use of Text Messaging to Improve Clinical Engagement for Individuals With Psychosis: Systematic Review (Preprint)

10.2196/preprints.16993 ◽

2019 ◽

Author(s):

Jessica D'Arcey ◽

Joanna Collaton ◽

Nicole Kozloff ◽

Aristotle N Voineskos ◽

Sean A Kidd ◽

...

Keyword(s):

Text Messaging ◽

English Language ◽

Low Cost ◽

Personal Characteristics ◽

Practical Method ◽

Positive Effects ◽

Clinical Engagement ◽

Safety Considerations ◽

Year 2000 ◽

Sms Text Messaging

BACKGROUND Individuals experiencing psychosis are at a disproportionate risk for premature disengagement from clinical treatment. Barriers to clinical engagement typically result from funding constraints causing limited access to and flexibility in services. Digital strategies, such as SMS text messaging, offer a low-cost alternative to potentially improve engagement. However, little is known about the efficacy of SMS text messaging in psychosis. OBJECTIVE This review aimed to address this gap, providing insights into the relationship between SMS text messaging and clinical engagement in the treatment of psychosis. METHODS Studies examining SMS text messaging as an engagement strategy in the treatment of psychosis were reviewed. Included studies were published from the year 2000 onward in the English language, with no methodological restrictions, and were identified using 3 core databases and gray literature sources. RESULTS Of the 233 studies extracted, 15 were eligible for inclusion. Most studies demonstrated the positive effects of SMS text messaging on dimensions of engagement such as medication adherence, clinic attendance, and therapeutic alliance. Studies examining the feasibility of SMS text messaging interventions found that they are safe, easy to use, and positively received. CONCLUSIONS Overall, SMS text messaging is a low-cost, practical method of improving engagement in the treatment of psychosis, although efficacy may vary by symptomology and personal characteristics. Cost-effectiveness and safety considerations were not adequately examined in the studies included. Future studies should consider personalizing SMS text messaging interventions and include cost and safety analyses to appraise readiness for implementation. CLINICALTRIAL

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Out-of-hours workload among Norwegian general practitioners – an observational study

10.21203/rs.2.19580/v2 ◽

2020 ◽

Author(s):

Ingrid Keilegavlen Rebnord ◽

Tone Morken ◽

Kjell Maartmann-Moe ◽

Steinar Hunskaar

Keyword(s):

General Practitioners ◽

Rural Areas ◽

Linear Regression Analysis ◽

Working Hours ◽

Clinical Work ◽

Working Time ◽

Medical Work ◽

Out Of Hours ◽

Electronic Survey ◽

Regular Work

Abstract Background: Repeated studies of working hours among Norwegian regular general practitioners (RGPs) have shown that the average total number of weekly working hours has remained unchanged since 1994 and up until 2014. For both male and female RGPs, the mean total weekly working hours amounted to almost 50 hours in 2014. In recent years, Norwegian RGPs have become increasingly dissatisfied. They experience significantly increased workload without compensation in the form of more doctors or better payment. A study from the Norwegian Directorate of Health in 2018 (the RGP study) showed that Norwegian RGPs worked 55.6 hours weekly (median 52.5). 25% of the respondents worked more than 62.2 hours weekly. Based on data from the RGP study we investigated Norwegian RGP’s out-of-hours (OOH) work, how the working time was distributed, and to what extent the OOH work affected the regular working hours.Methods: In early 2018, an electronic survey was sent to all 4640 RGPs in Norway. Each RGP reported how many minutes that were spent that particular day on various tasks during seven consecutive days. Working time also included additional tasks in the municipality, other professional medical work and OOH primary health care. Differences were analysed by independent t-tests, and regression analyses. Results: 1876 RGPs (40.4%) responded, 640 (34.1%) had registered OOH work. Male RGPs worked on average 1.5 hours more doing regular work than did females (p=0.001) and on average 2.3 hours more OOH work than females (p=0.079). RGPs with no OOH work registered a mean of 1.0 hours more clinical work than RGPs working OOH (p=0.043). There was a large variation in OOH working hours. A linear regression analysis showed that male RGPs and RGPs in rural areas had the heaviest OOH workload. Conclusions: One in three Norwegian RGPs undertook OOH work during the registration week in the RGP study. OOH work was done in addition to a sizeable regular workload as an RGP. We found small gender differences. OOH work was not compensated with reduced regular RGP work.

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Use of SMS text messaging to improve outpatient attendance

The Medical Journal of Australia ◽

10.5694/j.1326-5377.2005.tb07085.x ◽

2005 ◽

Vol 183 (7) ◽

pp. 366-368 ◽

Cited By ~ 128

Author(s):

Sean R Downer ◽

John G Meara ◽

Annette C Da Costa

Keyword(s):

Text Messaging ◽

Sms Text Messaging

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Sa2055 SMS TEXT MESSAGING AND VIDEO INSTRUCTIONS FOR PEDIATRIC ENDOSCOPY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.348 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB288

Author(s):

Douglas S. Fishman ◽

Ryan Himes ◽

Karina Canadas

Keyword(s):

Text Messaging ◽

Pediatric Endoscopy ◽

Sms Text Messaging

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Injury reporting via SMS text messaging and online survey in community sport: A feasibility study

Translational Sports Medicine ◽

10.1002/tsm2.101 ◽

2019 ◽

Vol 2 (6) ◽

pp. 351-357

Author(s):

Laura M. Schwab ◽

Melinda M. Franettovich Smith ◽

M. Dilani Mendis ◽

Deirdre McGhee ◽

Julie Hides

Keyword(s):

Feasibility Study ◽

Text Messaging ◽

Online Survey ◽

Community Sport ◽

Injury Reporting ◽

Sms Text Messaging

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Identifying differences in GPs’ working hours according to gender and employment position: A time sampling study using SMS text messaging

International Journal of Healthcare ◽

10.5430/ijh.v4n2p64 ◽

2018 ◽

Vol 4 (2) ◽

pp. 64

Author(s):

Daniel Van Hassel ◽

Lud Van der Velden ◽

Ronald Batenburg

Keyword(s):

Text Messaging ◽

Workforce Planning ◽

Sampling Technique ◽

Working Hours ◽

Multiple Time ◽

Time Sampling ◽

Validity And Reliability ◽

Hours Worked ◽

Female Self ◽

Sms Text Messaging

In order to aid health workforce planning, we measured the number of hours worked by general practitioners (GPs). The twofold aim of this study consisted of assessing the feasibility, validity and reliability of an innovative method to measure working time and, second, to analyse differences in hours worked between six types of GPs divided by the combination of their gender and employment position. Our method was based on multiple time point observations using SMS text messaging. On average 19 GPs participated every week for 57 weeks. In total 1,051 GPs participated resulting in 61,320 valid measurements of time use. On average, GPs worked 44 hours per week. About 56% of this time was spent on direct patient-related activities, 26% to indirect patient-related activities, and 18% to activities not related to patients. There were substantial differences in working hours between male and female self-employed, those drawing a salary from a duo or group practice and locum GPs. For example, male self-employed GPs worked 51.6 hours per week, whereas male locum GPs worked 26.7 hours per week. Generally, differences in hours worked with regard to gender and employment position are smaller if we relate these hours to the number of FTE they worked. Furthermore, we conclude that the method of SMS text messaging based on the time sampling technique presents a limited degree of interference to the participants’ work and achieved reliable and valid results.

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