Acceptability and Use of Interactive Voice Response Mobile Phone Surveys for Noncommunicable Disease Behavioral Risk Factor Surveillance in Rural Uganda: Qualitative Study

Abstract

BackgroundThere is need for more timely data to inform interventions that address the growing noncommunicable disease (NCD) epidemic. With a global increase in mobile phone ownership, mobile phone surveys can bridge this gap.ObjectiveThis study aimed to explore the acceptability and use of interactive voice response (IVR) surveys for surveillance of NCD behavioral risk factors in rural Uganda.MethodsThis qualitative study employed user group testing (UGT) with community members. The study was conducted at the Iganga-Mayuge Health and Demographic Surveillance Site (IM-HDSS) in Eastern Uganda. We conducted four UGTs which consisted of different categories of HDSS members: females living in urban areas, males living in urban areas, females living in rural areas, and males living in rural areas. Participants were individually sent an IVR survey, then were brought in for a group discussion using a semistructured guide. Data were analyzed thematically using directed content analysis.ResultsParticipants perceived that IVR surveys may be useful in promoting confidentiality, saving costs, and raising awareness on NCD behavioral risk factors. Due to the clarity and delivery of questions in the local language, the IVR survey was perceived as easy to use. Community members suggested scheduling surveys on specific days and sending reminders as ways to improve their use for surveillance. Social issues such as domestic violence and perceptions toward unknown calls, technological factors including poor network connections and inability to use phones, and personal issues such as lack of access to phones and use of multiple networks were identified as barriers to the acceptability and use of mobile phone surveys. However, incentives were reported to motivate people to complete the survey.ConclusionsCommunity members reflected on contextual and sociological implications of using mobile phones for surveillance of NCD behavioral risk factors. The opportunities and challenges that affect acceptability and use of IVR surveys should be considered in designing and implementing surveillance programs for NCD risk factors.

Adaptation of a mobile phone health survey for risk factors for noncommunicable diseases in Colombia: a qualitative study

“…Intensive information dissemination to generate trust in the survey through other media channels was frequently mentioned by participants including the provision of a contact number and website link to confirm the information provided, learn more about the study or even complain about the survey's experience. Using additional media platforms (television, radio, newspapers) leading up the IVR launch or providing a contact number for the user was also proposed in several studies in Uganda aiming to adequately sensitize communities and mitigate distrust caused by phone calls from unknown numbers [3,11,12]. Other research has identified Colombia as one of the countries where more women than men have reported apprehension towards harassment and security issues (theft or fraud) as principal barriers to mobile phone ownership and usage.…”

“…Previous research has assessed the development of health surveys through interactive voice response (IVR), where participants select responses to prerecorded questions via keypad or voice recognition software [ 9 ] and short message service (SMS; text message) technology to determine effectiveness for surveillance of NCD [ 4 , 10 , 11 ]. These surveys constitute a potential effective monitoring mechanism to assess NCD risk factors in the context of policy change, the implementation of programs, or the surveillance of secular trends [ 6 , 10 , 12 ].…”

Women’s perceptions of telephone interviews about their experiences with childbirth care in Nigeria: A qualitative study

“…Being habitual mobile phone users, even among those who relied on their spouses, relatives or friend’s phones, participants found the interview easy to participate in. Participant’s perceived ease to use a technology has been associated with increased acceptability [ 41 , 42 ]. The study participants highlighted the ability to schedule the interview at a time convenient to both the interviewer and the interviewee as an advantage of the telephone interview, and enabler of acceptability.…”

“…An earlier study has pointed to a direct relationship between convenience and increased acceptability especially by older adults [ 43 ]. In few studies there are divergent findings regarding time and day preferences for phone-based surveys [ 41 , 44 ], but the option of data collectors speaking to interviewees to schedule convenient interview times appears to offer a favourable approach. Many participants stated their appreciation for the perceived privacy offered by the telephone interview, in relation to being able to speak when they were alone or with minimal intrusion.…”

“…Perception of privacy and confidentiality was not related to whether the phone used for the interview belonged to the respondents or not, contrary to our expectations. There is currently limited evidence in the literature about perceptions or expectation of privacy and confidentiality during telephone interviews, or on the effects of approaches to improve phone interview privacy and confidentiality in LMICs [ 6 , 41 ].…”