scholarly journals Improving Retention in Care and Promoting Adherence to HIV Treatment: Protocol for a Multisite Randomized Controlled Trial of Mobile Phone Text Messaging (Preprint)

2019 ◽  
Author(s):  
Elvis Asangbeng Tanue ◽  
Dickson Shey Nsagha ◽  
Nana Njamen Theophile ◽  
Jules Clement Nguedia Assob
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Mobile Phones ◽  
Text Messaging ◽  
Care Delivery ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Text Messages ◽  
Adherence To Treatment ◽  
Randomized Controlled

BACKGROUND The World Health Organization has prioritized the use of new technologies to assist in health care delivery in resource-limited settings. Findings suggest that the use of SMS on mobile phones is an advantageous application in health care delivery, especially in communities with an increasing use of this device. OBJECTIVE The main aim of this trial is to assess whether sending weekly motivational text messages (SMS) through mobile phones versus no text messaging will improve retention in care and promote adherence to treatment and health outcomes among patients receiving HIV treatment in Fako Division of Cameroon. METHODS This is a multisite randomized controlled single-blinded trial. Computer-generated random block sizes shall be used to produce a randomization list. Participants shall be randomly allocated into the intervention and control groups determined by serially numbered sealed opaque envelopes. The 156 participants will either receive the mobile phone text message or usual standard of care. We hypothesize that sending weekly motivational SMS reminders will produce a change in behavior to enhance retention; treatment adherence; and, hence, health outcomes. Participants shall be evaluated and data collected at baseline and then at 2, 4, and 6 months after the launch of the intervention. Text messages shall be sent out, and the delivery will be recorded. Primary outcome measures are retention in care and adherence to treatment. Secondary outcomes are clinical (weight, body mass index), biological (virologic suppression, tuberculosis coinfection), quality of life, treatment discontinuation, and mortality. The analysis shall be by intention-to-treat. Analysis of covariates shall be performed to determine factors influencing outcomes. RESULTS Recruitment and random allocation are complete; 160 participants were allocated into 3 groups (52 in the single SMS, 55 in the double SMS, and 53 in the control). Data collection and analysis are ongoing, and statistical results will be available by the end of August 2019. CONCLUSIONS The interventions will contribute to an improved understanding of which intervention types can be feasible in improving retention in care and promoting adherence to antiretroviral therapy. CLINICALTRIAL Pan African Clinical Trial Registry in South Africa PACTR201802003035922; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3035 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15680

scholarly journals Improving Retention in Care and Promoting Adherence to HIV Treatment: Protocol for a Multisite Randomized Controlled Trial of Mobile Phone Text Messaging

10.2196/15680 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e15680
Author(s):  
Elvis Asangbeng Tanue ◽  
Dickson Shey Nsagha ◽  
Nana Njamen Theophile ◽  
Jules Clement Nguedia Assob
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Mobile Phones ◽  
Text Messaging ◽  
Care Delivery ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Text Messages ◽  
Adherence To Treatment ◽  
Randomized Controlled

Background The World Health Organization has prioritized the use of new technologies to assist in health care delivery in resource-limited settings. Findings suggest that the use of SMS on mobile phones is an advantageous application in health care delivery, especially in communities with an increasing use of this device. Objective The main aim of this trial is to assess whether sending weekly motivational text messages (SMS) through mobile phones versus no text messaging will improve retention in care and promote adherence to treatment and health outcomes among patients receiving HIV treatment in Fako Division of Cameroon. Methods This is a multisite randomized controlled single-blinded trial. Computer-generated random block sizes shall be used to produce a randomization list. Participants shall be randomly allocated into the intervention and control groups determined by serially numbered sealed opaque envelopes. The 156 participants will either receive the mobile phone text message or usual standard of care. We hypothesize that sending weekly motivational SMS reminders will produce a change in behavior to enhance retention; treatment adherence; and, hence, health outcomes. Participants shall be evaluated and data collected at baseline and then at 2, 4, and 6 months after the launch of the intervention. Text messages shall be sent out, and the delivery will be recorded. Primary outcome measures are retention in care and adherence to treatment. Secondary outcomes are clinical (weight, body mass index), biological (virologic suppression, tuberculosis coinfection), quality of life, treatment discontinuation, and mortality. The analysis shall be by intention-to-treat. Analysis of covariates shall be performed to determine factors influencing outcomes. Results Recruitment and random allocation are complete; 160 participants were allocated into 3 groups (52 in the single SMS, 55 in the double SMS, and 53 in the control). Data collection and analysis are ongoing, and statistical results will be available by the end of August 2019. Conclusions The interventions will contribute to an improved understanding of which intervention types can be feasible in improving retention in care and promoting adherence to antiretroviral therapy. Trial Registration Pan African Clinical Trial Registry in South Africa PACTR201802003035922; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3035 International Registered Report Identifier (IRRID) DERR1-10.2196/15680

scholarly journals Assessing the Effectiveness and Acceptability of a Personalized Mobile Phone App in Improving Adherence to Oral Hygiene Advice in Orthodontic Patients: Protocol for a Feasibility Study and a Randomized Controlled Trial

10.2196/18021 ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. e18021
Author(s):  
Mohammad Owaise Sharif ◽  
Jonathon Timothy Newton ◽  
Susan J Cunningham
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Orthodontic Treatment ◽  
Controlled Trial ◽  
Phase 1 ◽  
Adherence To Treatment ◽  
Randomized Controlled

Background Orthodontic treatment is a common health care intervention; treatment duration can be lengthy (2-3 years on average), and adherence to treatment advice is therefore essential for successful outcomes. It has been reported that up to 43% of patients fail to complete treatment, and there are currently no useful predictors of noncompletion. Given that the National Health Service England annual expenditure on primary-care orthodontic treatment is in excess of £200 million (US $267 million), noncompletion of treatment represents a significant inefficient use of public resources. Improving adherence to treatment is therefore essential. This necessitates behavior change, and interventions that improve adherence and are designed to elicit behavioral change must address an individual’s capability, opportunity, and motivation. Mobile phones are potentially an invaluable tool in this regard, as they are readily available and can be used in a number of ways to address an individual’s capability, opportunity, and motivation. Objective This study will assess the effectiveness and acceptability of a personalized mobile phone app in improving adherence to orthodontic treatment advice by way of a randomized controlled trial. Methods This study will be conducted in 2 phases at the Eastman Dental Hospital, University College London Hospitals Foundation Trust. Phase 1 is feasibility testing of the My Braces app. Participants will be asked to complete the user version of the Mobile Application Rating Scale. The app will be amended following analysis of the responses, if appropriate. Phase 2 is a randomized controlled trial to test the effectiveness and acceptability of the My Braces app. Results This study was approved by the London – Bloomsbury Research Ethics Committee on November 5, 2019 (reference 19/LO/1555). No patients have been recruited to date. The anticipated start date for recruitment to phase 1 is October 2020. Conclusions Given the availability, affordability, and versatility of mobile phones, it is proposed that they will aid in improving adherence to treatment advice and hence improve treatment completion rates. If effective, the applicability of this methodology to developing behavior change/modification interventions and improving adherence to treatment across health care provides an exciting opportunity. Trial Registration ClinicalTrials.gov NCT04184739; https://clinicaltrials.gov/ct2/show/NCT04184739 International Registered Report Identifier (IRRID) PRR1-10.2196/18021

scholarly journals Assessing the Effectiveness and Acceptability of a Personalized Mobile Phone App in Improving Adherence to Oral Hygiene Advice in Orthodontic Patients: Protocol for a Feasibility Study and a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Mohammad Owaise Sharif ◽  
Jonathon Timothy Newton ◽  
Susan J Cunningham
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Orthodontic Treatment ◽  
Controlled Trial ◽  
Phase 1 ◽  
Adherence To Treatment ◽  
Randomized Controlled

BACKGROUND Orthodontic treatment is a common health care intervention; treatment duration can be lengthy (2-3 years on average), and adherence to treatment advice is therefore essential for successful outcomes. It has been reported that up to 43% of patients fail to complete treatment, and there are currently no useful predictors of noncompletion. Given that the National Health Service England annual expenditure on primary-care orthodontic treatment is in excess of £200 million (US $267 million), noncompletion of treatment represents a significant inefficient use of public resources. Improving adherence to treatment is therefore essential. This necessitates behavior change, and interventions that improve adherence and are designed to elicit behavioral change must address an individual’s capability, opportunity, and motivation. Mobile phones are potentially an invaluable tool in this regard, as they are readily available and can be used in a number of ways to address an individual’s capability, opportunity, and motivation. OBJECTIVE This study will assess the effectiveness and acceptability of a personalized mobile phone app in improving adherence to orthodontic treatment advice by way of a randomized controlled trial. METHODS This study will be conducted in 2 phases at the Eastman Dental Hospital, University College London Hospitals Foundation Trust. Phase 1 is feasibility testing of the My Braces app. Participants will be asked to complete the user version of the Mobile Application Rating Scale. The app will be amended following analysis of the responses, if appropriate. Phase 2 is a randomized controlled trial to test the effectiveness and acceptability of the My Braces app. RESULTS This study was approved by the London – Bloomsbury Research Ethics Committee on November 5, 2019 (reference 19/LO/1555). No patients have been recruited to date. The anticipated start date for recruitment to phase 1 is October 2020. CONCLUSIONS Given the availability, affordability, and versatility of mobile phones, it is proposed that they will aid in improving adherence to treatment advice and hence improve treatment completion rates. If effective, the applicability of this methodology to developing behavior change/modification interventions and improving adherence to treatment across health care provides an exciting opportunity. CLINICALTRIAL ClinicalTrials.gov NCT04184739; https://clinicaltrials.gov/ct2/show/NCT04184739 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/18021

scholarly journals mHealth and Health Care Service Delivery in Africa: A Systematic Review

2021 ◽  
Vol 13 (2) ◽  
pp. 123
Author(s):  
Austin Eze Egede ◽  
Cajetan Ikechukwu Ilo ◽  
Maryjane Ikechukwu-Nwobodo ◽  
Tessy Amaka Nnaji ◽  
Rita Ihuoma Anaba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Science Citation Index ◽  
Citation Index ◽  
Care Delivery ◽  
Care Service ◽  
Health Care Service ◽  
Text Messages ◽  
Science Citation ◽  
Services Delivery

We conducted a systematic review of studies on mHealth and health care services delivery that were carried out within Africa. Our search process was through MEDLINE, and then on PubMed, we searched key terms based on various keywords: “Whatsapp, health, Africa, Text messages, health impact, Africa, mHealth tools, Africa”. This was done in December of 2018. Only English written articles from journals indexed in Science Citation Index Expanded and Social Science Citation Index were incorporated in this review. In line with our inclusion criteria, only a total of 19 out of 155 studies were relevant. Inferences from these studies showed that mHealth tools are speedy and quality means for health care delivery in Africa. We also found out that there is less usage of internet devices in Africa as suspected. There is a serious need for improvement in the use of other online based mHealth tools as it was found that the use of Short Messaging Service (SMS) has been the nearly the sole mHealth intervention utilized in Africa. This, it is believed would foster better wider intervention and implementation of quality health outcomes in Africa, and other low and middle-income regions of the world.

scholarly journals An Interactive Parent-Targeted Text Messaging Intervention to Improve Oral Health in Children Attending Urban Pediatric Clinics: Feasibility Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Belinda Borrelli ◽  
Michelle Henshaw ◽  
Romano Endrighi ◽  
William G Adams ◽  
Timothy Heeren ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Behaviors ◽  
Self Efficacy ◽  
Text Messaging ◽  
Text Messages ◽  
Feasibility Trial ◽  
Randomized Controlled ◽  
Oral Health Behaviors ◽  
Scale Range

BACKGROUND Effective preventive treatments for dental decay exist, but caries experience among preschoolers has not changed, with marked disparities in untreated decay. Despite near-universal use of SMS text messaging, there are no studies using text messages to improve the oral health of vulnerable children. OBJECTIVE This randomized controlled feasibility trial aimed to test the effects of oral health text messages (OHT) versus a control (child wellness text messages or CWT). OHT was hypothesized to outperform CWT on improving pediatric oral health behaviors and parent attitudes. METHODS Parents with a child aged &lt;7 years were recruited at urban clinics during pediatric appointments (79% [41/52] below poverty line; 66% [36/55] black) and randomized to OHT (text messages on brushing, dental visits, bottle and sippy cups, healthy eating and sugary beverages, and fluoride) or CWT (text messages on reading, safety, physical activity and development, secondhand smoke, and stress) groups. Automated text messages based on Social Cognitive Theory were sent twice each day for 8-weeks. Groups were equivalent on the basis of the number of text messages sent, personalization, interactivity, and opportunity to earn electronic badges and unlock animated characters. Assessments were conducted at baseline and 8 weeks later. Data were analyzed with linear mixed–effects models. RESULTS A total of 55 participants were randomized (28 OHT and 27 CWT). Only one participant dropped out during the text message program and 47 (24 OHT and 23 CWT) completed follow up surveys. Response rates exceeded 68.78% (1040/1512) and overall program satisfaction was high (OHT mean 6.3; CWT mean 6.2; 1-7 scale range). Of the OHT group participants, 84% (21/25) would recommend the program to others. Overall program likeability scores were high (OHT mean 5.90; CWT mean 6.0; 1-7 scale range). Participants reported high perceived impact of the OHT program on brushing their child’s teeth, motivation to address their child's oral health, and knowledge of their child's oral health needs (mean 4.7, 4.6, and 4.6, respectively; 1-5 scale range). At follow up, compared with CWT, OHT group participants were more likely to brush their children’s teeth twice per day (odds ratio [OR] 1.37, 95% CI 0.28-6.50) and demonstrated improved attitudes regarding the use of fluoride (OR 3.82, 95% CI 0.9-16.8) and toward getting regular dental checkups for their child (OR 4.68, 95% CI 0.24-91.4). There were modest, but not significant, changes in motivation (F1,53=0.60; <italic>P</italic>=.45) and self–efficacy (F1,53=0.24; <italic>P</italic>=.63) to engage in oral health behaviors, favoring OHT (<italic>d</italic>=0.28 and <italic>d</italic>=0.16 for motivation and self–efficacy, respectively). CONCLUSIONS The OHT program demonstrated feasibility was well utilized and appealing to the target population and showed promise for efficacy.

Recovery Following Peer and Text Messaging Support after Discharge from Acute Psychiatric Care: A Randomized Controlled Pilot Trial (Preprint)

2021 ◽  
Author(s):  
Reham Shalaby ◽  
Marianne Hrabok ◽  
Pamela Spurvey ◽  
Rabab M. Abou El-Magd ◽  
Michelle Knox ◽  
...  
Keyword(s):  
Peer Support ◽  
Text Messaging ◽  
Psychiatric Care ◽  
Text Message ◽  
Text Messages ◽  
Treatment As Usual ◽  
Usual Condition ◽  
Randomized Controlled ◽  
Acute Psychiatric Care

BACKGROUND Peer support (PS) is emotional, social, and practical help that is provided by non-professionals to assist others in sustaining health behaviours. PS is valued in recovery-oriented models of mental health and is becoming implemented increasingly at the organizational level. Text messaging is a relatively low cost, high impact, and easily scalable program that uses existing technology, is devoid of geographic barriers, and is easily accessible to end users. OBJECTIVE This study aims to evaluate the effect of an innovative peer support system plus supportive text messaging program on the recovery of discharged patients from acute psychiatric care. METHODS This is a prospective, rater-blinded, pilot randomized controlled trial, including 180 patients discharged from acute psychiatric care. Patients were randomized to one of four conditions: treatment as usual (follow-up care), daily supportive text messages, peer-support only, or peer-support plus daily supportive text messages. A standardized self-report measure of recovery (Recovery Assessment Scale; RAS) was completed at baseline, six weeks, three months, and six months. Descriptive analysis, One-Way ANOVA, and repeated measures MANCOVA were deployed to examine the changes in RAS among the study groups and over the follow-up time points. RESULTS Sixty-five patients completed assessments at each time-point. For the overall sample, higher scores were found for the peer-support plus text message condition compared to the text message only and treatment as usual condition on several scales (i.e., Willingness to ask for help and Personal Confidence and Hope) and total score on the RAS. CONCLUSIONS Peer support plus supportive text messaging results in improved recovery compared to other interventions. It is advisable to incorporate the two interventions as a part of routine practice for patients with psychiatric disorders upon their hospital discharge. CLINICALTRIAL The study received ethical approval from the Health Ethics Research Board of the University of Alberta (Ref # Pro00078427) and operational approval from the Alberta Health Services regional health authority. All patients provided written informed consent. The study was registered with clinicaltrials.gov (Trial registration number NCT03404882).

Text-Messaging in Africa

2017 ◽  
Author(s):  
Ana Deumert
Keyword(s):  
Mobile Phones ◽  
Technology Use ◽  
Text Messaging ◽  
Social Inequalities ◽  
Instant Messaging ◽  
Text Messages ◽  
African Languages ◽  
Pan African ◽  
Message Service ◽  
Local Meaning

The concept of Africa requires reflection: what does it mean to study a social phenomenon “in Africa”? Technology use in Africa is complex and diverse, showing various degrees of access across the continent (and in the Diaspora, and digital social inequalities—which are part and parcel of the political economy of communication—shape digital engagement. The rise of mobile phones, in particular, has enabled the emergence of technologically mediated literacies, text-messaging among them. Text-messaging is defined not only by a particular mode of communication (typically written on mobile phones, visual, digital), but it also favors particular topics (intimate, relational, sociable, ludic) and ways of writing (short, non-standard texts that are creative as well as multilingual). The genre of text-messaging thus includes not only short message service (SMS) and (mobile) instant-messaging (which one might call prototypical one-to-one text messages), but also Twitter, an application that, like texting, favors brevity of expression and allows for one-to-many conversations. Access to Twitter is still limited for many Africans, but as ownership of smartphones is growing, so is Twitter use, and the African “Twittersphere” is emerging as an important pan-African space. At times, discussions are very local (as on Ghanaian Twitter), at other times regional (East African Twitter) or global (African Twitter and Black Twitter); all these are emic, folksonomic terms, assigned and discussed by users. Although former colonial languages, especially English, dominate in many prototypical text messages and on Twitter, the genre also provides important opportunities for writing in African languages. The choices made in the digital space echo the well-known debate between Chinua Achebe and Ngũgĩ wa Thiong’o: the Africanization of the former colonial languages versus writing in African languages. In addition, digital writers engage in multilingual writing, combining diverse languages in one text, and thus offer new ways of writing locally as well as shaping a digitally-mediated pan-African voice that draws on global strategies as well as local meaning.

scholarly journals Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery

2018 ◽  
Vol 36 (20) ◽  
pp. 2088-2100 ◽  
Author(s):  
Paul B. Jacobsen ◽  
Antonio P. DeRosa ◽  
Tara O. Henderson ◽  
Deborah K. Mayer ◽  
Chaya S. Moskowitz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Cochrane Library ◽  
Survivorship Care Plan ◽  
Satisfaction With Care ◽  
Survivorship Care ◽  
Care Plans

Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers’ concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.

Experimental Evidence on the Long-Run Impact of Community-Based Monitoring

2017 ◽  
Vol 9 (1) ◽  
pp. 33-69 ◽  
Author(s):  
Martina Björkman Nyqvist ◽  
Damien de Walque ◽  
Jakob Svensson
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Lower Cost ◽  
Care Delivery ◽  
Care Provision ◽  
Community Based ◽  
Long Run ◽  
Short Run

We evaluate the longer run impact of a local accountability intervention in primary health care provision in Uganda. Short-run improvements in health care delivery and health outcomes remained in the longer run despite minimal follow-up. We find no impact on the quality of care or health outcomes of a lower cost intervention that focused on encouraging participation but did not provide information on staff performance. We provide suggestive evidence that informed beneficiaries are more likely to identify and challenge (mis)behavior by providers and, as a result, turn their focus to issues that they can manage locally. (JEL H75, I11, I18, O15, O18)

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