Clients’ perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis

Abstract

BackgroundGovernments and health systems are increasingly using mobile devices to communicate with patients and the public. Targeted digital client communication is when the health system transmits information to particular individuals or groups of people, based on their health or demographic status. Common types of targeted client communication are text messages that remind people to go to appointments or take their medicines. Other types include phone calls, interactive voice response, or multimedia messages that offer healthcare information, advice, monitoring, and support.ObjectivesTo explore clients' perceptions and experiences of targeted digital communication via mobile devices on topics related to reproductive, maternal, newborn, child, or adolescent health (RMNCAH).Search methodsWe searched MEDLINE (OvidSP), MEDLINE In‐Process & Other Non‐Indexed Citations (OvidSP), Embase (Ovid), World Health Organization Global Health Library, and POPLINE databases for eligible studies from inception to 3‐6 July 2017 dependant on the database (See appendix 2).Selection criteriaWe included studies that used qualitative methods for data collection and analysis; that explored clients' perceptions and experiences of targeted digital communication via mobile device in the areas of RMNCAH; and were from any setting globally.Data collection and analysisWe used maximum variation purposive sampling for data synthesis, employing a three‐step sampling frame. We conducted a framework thematic analysis using the Supporting the Use of Research Evidence (SURE) framework as our starting point. We assessed our confidence in the findings using the GRADE‐CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. We used a matrix approach to explore whether potential implementation barriers identified in our synthesis had been addressed in the trials included in the related Cochrane Reviews of effectiveness.Main resultsWe included 35 studies, from a wide range of countries on six continents. Nineteen studies were conducted in low‐ and middle‐income settings and sixteen in high‐income settings. Some of the studies explored the views of people who had experienced the interventions, whereas others were hypothetical in nature, asking what people felt they would like from a digital health intervention. The studies covered a range of digital targeted client communication, for example medication or appointment reminders, prenatal health information, support for smoking cessation while pregnant, or general sexual health information.Our synthesis showed that clients' experiences of these types of programmes were mixed. Some felt that these programmes provided them with feelings of support and connectedness, as they felt that someone was taking the time to send them messages (moderate confidence in the evidence). They also described sharing the messages with their friends and family (moderate confidence).However, clients also pointed to problems when using these programmes. Some clients had poor access to cell networks and t...

Using a mHealth system to recall and refer existing clients and refer community members with health concerns to primary healthcare facilities in South Africa: a feasibility study

“…Although this paper does not report on client perspectives regarding the mHealth system (these findings will be reported separately), client-related factors, including how far from the facility they live, and their values and preferences regarding their health, are also likely to impact on the success of recalls and referrals [47]. This makes it difficult to predict how clients will respond to health workers' encouragement to seek healthcare [48].…”

Mobile Phone Access and Implications for Digital Health Interventions Among Adolescents and Young Adults in Zimbabwe: Cross-Sectional Survey

“…Recording whether participants have multiple phones or phone numbers may improve follow-up [ 34 ]. Phone sharing is relatively common and YP’s access to phones may be controlled by someone else which may limit their access and raises the issue of confidentiality [ 22 , 35 ]. In this study females were most likely to share phones with their mothers and boyfriends/partners, and boys with their siblings.…”

Understanding the Highly Sensitive Health Communication Behavior in Social Media from the Perspective of the Risk Perception Attitude Framework and Perceived Interactivity

“…Such sites are often the first choice for adolescents seeking RH information [2]. At the same time, social media has become an important tool for healthcare providers to implement targeted digital communication and interventions for RH [4,5]. Social media is characterized by high levels of interactivity and sociality, which greatly benefit RH communication [6][7][8][9].…”

“…Privacy concerns are a key factor in RH communication among social media users, especially when for highly sensitive information [20][21][22]. In addition, the feedback interaction mechanism of social media can raise concerns among users that their own communications will be misunderstood by others and even lead to discrimination, hostility, or aggression from others; these concerns can create anxiety and tension [4,5,22,23]. Therefore, the impacts of the social media interaction environment on users' intention to RH communication are very complex.…”

“…Users are willing to be involved in health communication only when perceived benefits exceed perceived risk [15]. Perceived risk may be an especially key factor for highly sensitive RH topics, influencing people's participation in RH communication [4,5,29]. However, few studies have focused on the influential factors of RH communication, especially on the impact of the social media interaction environment on users' perceived risk and RH communication intentions.…”