BACKGROUND The benefits of clouds to biomedical and health researchers especially consortia are tremendous spanning sequencing of instruments for health monitoring, image collection and archival, and analyses among others. The cloud enables On-demand access to researcher resources so that researchers can automatically consume them with minimal management effort. However, its wide adoption is staggeringly slow despite all these benefits due to a variety of challenges related to the availability and reliability of researcher applications, interoperability, ownership, security and privacy, and non-compliance to existing research regulations and laws. OBJECTIVE The main goal of this paper is to survey and map literature objectively to learn and discern what actually happens when biomedical and health research consortia activities and data are migrated onto the cloud. METHODS We investigate through literature, the application of Cloud computing paradigm within biomedical and health research, using publications from journals and scientific databases. RESULTS Findings indicate (a) a variety of biomedical and health research applications that we categorize as tools, platforms and storage archives, used for storing, enabling robust access and sharing, querying, and analyzing biomedical and health research data; (b)the paradigm’s adoption is extensive to include assistive care for elderly and the chronic, real time ECG monitoring and analysis, data management, picture archiving, and telemedicine; (c) that researchers need guidance on when to shift their endeavors to the cloud; (d) most applications are specific and limited in regards to flexibility and usability, confidentiality preservation, ownership, likelihood for collusion; (e)Data sharing and security models used by these applications have varied limitations, and their implementation requires that privacy and compliance to existing data protection regulations are observed. While resource sharing may be pivotal to biomedical consortia, utilizing the cloud for collaboration as a service requires that the service provision and consumption is complaint to the SLAs and related data protection regulations. The service is hoped that it is of high availability, scalable, secure and privacy-aware, yet biomedical and health research applications hosted for research consortia activities don’t entirely meet similar requirements CONCLUSIONS Therefore, the biomedical and health research cloud is complex with varied requirements for security and privacy, availability, scalability and trust. An attempt is proposed, “The Collab”, as a secure and a privacy-aware biomedical and health research collaboration cloud application. The Collab ensures that data under collaboration is secure, and infrastructure too, is privacy-aware, avails efficient and effective data auditing, and extended control beyond consortia boundary using a proxy-re- encryption and a 2-factor authentication. CLINICALTRIAL MUST/20/07-16
The use of the unified identification system (UIDS) can undoubtedly result in increased effectiveness and efficiency, improvement in the quality of life, reduction of crime, enhanced transparency, and good government. This study examined the dimensions of environmental factors in explaining the adoption of a unified identification system (UIDS). Dynamic capability theory (DCT), technology- organisation-environment (TOE) framework, and diffusion of innovation (DOI) were used as grounding theories. The study opted for a concurrent triangulation research design. The results revealed that government support, competitive pressure, and perceived trust are significant and support the adoption of a unified identification system. However, user readiness was insignificant in explaining the use of UIDS in the Ugandan context. This study recommends that policymakers focus on government support as it is a symbol of leadership in IS innovation adoption.
Background The expansion of cellular phones in sub-Saharan Africa spurred the development of SMS text message–based mobile health (mHealth) technology. Numerous SMS text message–based interventions have attempted to increase retention in care for people living with HIV in sub-Saharan Africa. Many of these interventions have failed to scale. Understanding theory-grounded factors leading to mHealth acceptability is needed to create scalable, contextually appropriate, and user-focused interventions to improve longitudinal HIV care for people living with HIV in sub-Saharan Africa. Objective In this study, we aimed to understand the relationship between constructs from the Unified Theory of Acceptance and Use of Technology (UTAUT), constructs identified in previous qualitative research, and behavioral intention to use a novel SMS text message–based mHealth intervention designed to improve care retention among people living with HIV initiating treatment in rural Uganda. Methods We conducted a survey of people living with HIV who were newly initiating HIV care in Mbarara, Uganda, and had agreed to use a novel SMS text message–based system that notified them of abnormal laboratory results and reminded them to return to the clinic. Survey items assessed behavioral intention to use the SMS text messaging system; constructs from UTAUT; and demographics, literacy, SMS text messaging experience, HIV status disclosure, and social support. We used factor analysis and logistic regression to estimate the relationships between UTAUT constructs and the behavioral intention to use the SMS text messaging system. Results A total of 249 participants completed the surveys, of whom 115 (46.2%) expressed high behavioral intention to use the SMS text messaging intervention. In a multivariable analysis, we found that performance expectancy (adjusted odds ratio [aOR] of the scaled factor score 5.69, 95% CI 2.64-12.25; P<.001), effort expectancy (aOR of the scaled factor score 4.87, 95% CI 1.75-13.51; P=.002), and social influence (measured as a 1-unit Likert score increase in the perception that clinical staff have been helpful in the use of the SMS text messaging program; aOR 3.03, 95% CI 1.21-7.54; P=.02) were significantly associated with high behavioral intention to use the SMS text messaging program. SMS text messaging experience (aOR/1-unit increase 1.48, 95% CI 1.11-1.96; P=.008) and age (aOR/1-year increase 1.07, 95% CI 1.03-1.13; P=.003) were also significantly associated with increased odds of high intention to use the system. Conclusions Performance expectancy, effort expectancy, and social influence, as well as age and SMS experience, were drivers of high behavioral intention to use an SMS text messaging reminder system among people living with HIV initiating treatment in rural Uganda. These findings highlight salient factors associated with SMS intervention acceptability in this population and indicate attributes that are likely to be key to the successful development and scaling of novel mHealth interventions.
BACKGROUND The expansion of cellular phones in sub-Saharan Africa spurred the development of SMS text message–based mobile health (mHealth) technology. Numerous SMS text message–based interventions have attempted to increase retention in care for people living with HIV in sub-Saharan Africa. Many of these interventions have failed to scale. Understanding theory-grounded factors leading to mHealth acceptability is needed to create scalable, contextually appropriate, and user-focused interventions to improve longitudinal HIV care for people living with HIV in sub-Saharan Africa. OBJECTIVE In this study, we aimed to understand the relationship between constructs from the Unified Theory of Acceptance and Use of Technology (UTAUT), constructs identified in previous qualitative research, and behavioral intention to use a novel SMS text message–based mHealth intervention designed to improve care retention among people living with HIV initiating treatment in rural Uganda. METHODS We conducted a survey of people living with HIV who were newly initiating HIV care in Mbarara, Uganda, and had agreed to use a novel SMS text message–based system that notified them of abnormal laboratory results and reminded them to return to the clinic. Survey items assessed behavioral intention to use the SMS text messaging system; constructs from UTAUT; and demographics, literacy, SMS text messaging experience, HIV status disclosure, and social support. We used factor analysis and logistic regression to estimate the relationships between UTAUT constructs and the behavioral intention to use the SMS text messaging system. RESULTS A total of 249 participants completed the surveys, of whom 115 (46.2%) expressed high behavioral intention to use the SMS text messaging intervention. In a multivariable analysis, we found that performance expectancy (adjusted odds ratio [aOR] of the scaled factor score 5.69, 95% CI 2.64-12.25; <i>P</i><.001), effort expectancy (aOR of the scaled factor score 4.87, 95% CI 1.75-13.51; <i>P</i>=.002), and social influence (measured as a 1-unit Likert score increase in the perception that clinical staff have been helpful in the use of the SMS text messaging program; aOR 3.03, 95% CI 1.21-7.54; <i>P</i>=.02) were significantly associated with high behavioral intention to use the SMS text messaging program. SMS text messaging experience (aOR/1-unit increase 1.48, 95% CI 1.11-1.96; <i>P</i>=.008) and age (aOR/1-year increase 1.07, 95% CI 1.03-1.13; <i>P</i>=.003) were also significantly associated with increased odds of high intention to use the system. CONCLUSIONS Performance expectancy, effort expectancy, and social influence, as well as age and SMS experience, were drivers of high behavioral intention to use an SMS text messaging reminder system among people living with HIV initiating treatment in rural Uganda. These findings highlight salient factors associated with SMS intervention acceptability in this population and indicate attributes that are likely to be key to the successful development and scaling of novel mHealth interventions.
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