Effectiveness of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda: A randomized controlled trial

Nuwamanya, Ephraim; Nalwanga, Robinah; Babigumira, Janet U.; Asiimwe, Francis T.; Babigumira, Joseph B.; Ngambouk, Vitalis P.

doi:10.21203/rs.3.rs-41027/v3

Cited by 2 publications

(8 citation statements)

References 16 publications

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“…This allowed access to information, goods, and services while assuring privacy and confidentiality, and enabling convenience by easing transportation and payment. For the section of the population with internet-enabled mobile phones that can download and use apps, our intervention has the potential to improve SRH care delivery in Uganda and other low-income settings [27].…”

Section: Discussionmentioning

confidence: 99%

“…This study demonstrates that university students in Uganda find a mobile phone application to increase access to SRH information, goods, and services acceptable and usable. Given the effectiveness of the MPA in increasing access to SRH information, goods, and services (27), this study provides the basis for further improvement of both the evidence base (economic efficiency and scalability) and technical features of the app for use in this population, and potentially, for scale up to other populations with access to internet-enabled mobile phones, to improve SRH in Uganda and other low-income settings.…”

Section: Discussionmentioning

confidence: 99%

“…The study was a one-year pilot project with two complementary sub-studies; (1) a randomized control trial (RCT) to evaluate the effectiveness of the MPA to increasing access to SRH information, goods, and services among KYU students [27], (2) a cross-sectional study to assess the acceptability and usability of MPA. The acceptability study was part of the baseline survey used during data collection.…”

Section: Methodsmentioning

confidence: 99%

“…The acceptability study was part of the baseline survey used during data collection. The inclusion criteria for the extensive study (RCT) were KYU students 18 to 30 years of age, self-reported sexual activity in the last six months, more than 12 months to graduation, consent, and access to an internet-enabled Android smartphone [27]. The utilization study used data collected from MPA users over the 6-month period of the RCT from in-app data collection and data provided by the healthcare providers.…”

Section: Methodsmentioning

confidence: 99%

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Utilization of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda

Nalwanga¹,

Nuwamanya

Babigumira³

et al. 2021

Reprod Health

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Background Innovations to increase access to sexual and reproductive health (SRH) information, goods, and services are needed, particularly in low-income settings. This study assessed the utilization of a mobile phone application (MPA) to increase access to SRH information, goods, and services among university students in Uganda. Methods We conducted a cross-sectional analysis of data from: (1) an endline survey performed as a consequence of a randomized controlled trial (RCT) of the effectiveness of the MPA, and (2) data from use of the MPA for accessing information, goods, and services over the 6-month time period of the RCT, obtained from in-MPA data collection service providers. We performed descriptive analysis of participant characteristics and their association with the utilization of the MPA using logistic regression; analyses of MPA use for accessing different types of information, goods, and services by gender; and analyses of functionality attributes of the MPA and related services. Results In the study population of young (median 22 years) predominantly female (61%) students, the utilization of the MPA by those who downloaded it was high (81% overall, 82% female, and 82% male). The most popular information portal was the frequently asked questions (71% utilization); the most popular goods were condoms for males (77% utilization) and sanitary pads for females (94% utilization); and the most popular service was HIV testing and counseling (60% utilization). The MPA demonstrated predominantly positive (responsiveness, non-distracting in-app advertisements, and ease of use) attributes. Conclusion A mobile phone app to increase access to SRH information, goods, and services among university students in Uganda demonstrated high utilization. The results of this study support ongoing and future technical improvement efforts and research on effectiveness, economic efficiency, and scalability, along the continuum of activities to scale this intervention in order to improve SRH in low-income settings. Trial Registration MUREC1/7 No. 07/05-18. Registered; June 29, 2018.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Utilization of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda

Nalwanga¹,

Nuwamanya

Babigumira³

et al. 2021

Reprod Health

Self Cite

View full text Add to dashboard Cite

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“…There were 39 RCTs that reported on the effect of digital interventions: 12 were video-or audio-based [54,81,[107][108][109][110][111][112][113][114][115][116], 8 used social media [51,52,59,64,75,[117][118][119], 5 used websites [54,55,94,120,121], 13 used SMS messaging [65,90,95,[122][123][124][125][126][127][128][129][130][131], and 1 used gamification [132].…”

Section: Digitalmentioning

confidence: 99%

Demand creation for HIV testing services: A systematic review and meta-analysis

et al. 2023

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Background HIV testing services (HTS) are the first steps in reaching the UNAIDS 95-95-95 goals to achieve and maintain low HIV incidence. Evaluating the effectiveness of different demand creation interventions to increase uptake of efficient and effective HTS is useful to prioritize limited programmatic resources. This review was undertaken to inform World Health Organization (WHO) 2019 HIV testing guidelines and assessed the research question, “Which demand creation strategies are effective for enhancing uptake of HTS?” focused on populations globally. Methods and findings The following electronic databases were searched through September 28, 2021: PubMed, PsycInfo, Cochrane CENTRAL, CINAHL Complete, Web of Science Core Collection, EMBASE, and Global Health Database; we searched IAS and AIDS conferences. We systematically searched for randomized controlled trials (RCTs) that compared any demand creation intervention (incentives, mobilization, counseling, tailoring, and digital interventions) to either a control or other demand creation intervention and reported HTS uptake. We pooled trials to evaluate categories of demand creation interventions using random-effects models for meta-analysis and assessed study quality with Cochrane’s risk of bias 1 tool. This study was funded by the WHO and registered in Prospero with ID CRD42022296947. We screened 10,583 records and 507 conference abstracts, reviewed 952 full texts, and included 124 RCTs for data extraction. The majority of studies were from the African (N = 53) and Americas (N = 54) regions. We found that mobilization (relative risk [RR]: 2.01, 95% confidence interval [CI]: [1.30, 3.09], p < 0.05; risk difference [RD]: 0.29, 95% CI [0.16, 0.43], p < 0.05, N = 4 RCTs), couple-oriented counseling (RR: 1.98, 95% CI [1.02, 3.86], p < 0.05; RD: 0.12, 95% CI [0.03, 0.21], p < 0.05, N = 4 RCTs), peer-led interventions (RR: 1.57, 95% CI [1.15, 2.15], p < 0.05; RD: 0.18, 95% CI [0.06, 0.31], p < 0.05, N = 10 RCTs), motivation-oriented counseling (RR: 1.53, 95% CI [1.07, 2.20], p < 0.05; RD: 0.17, 95% CI [0.00, 0.34], p < 0.05, N = 4 RCTs), short message service (SMS) (RR: 1.53, 95% CI [1.09, 2.16], p < 0.05; RD: 0.11, 95% CI [0.03, 0.19], p < 0.05, N = 5 RCTs), and conditional fixed value incentives (RR: 1.52, 95% CI [1.21, 1.91], p < 0.05; RD: 0.15, 95% CI [0.07, 0.22], p < 0.05, N = 11 RCTs) all significantly and importantly (≥50% relative increase) increased HTS uptake and had medium risk of bias. Lottery-based incentives and audio-based interventions less importantly (25% to 49% increase) but not significantly increased HTS uptake (medium risk of bias). Personal invitation letters and personalized message content significantly but not importantly (<25% increase) increased HTS uptake (medium risk of bias). Reduced duration counseling had comparable performance to standard duration counseling (low risk of bias) and video-based interventions were comparable or better than in-person counseling (medium risk of bias). Heterogeneity of effect among pooled studies was high. This study was limited in that we restricted to randomized trials, which may be systematically less readily available for key populations; additionally, we compare only pooled estimates for interventions with multiple studies rather than single study estimates, and there was evidence of publication bias for several interventions. Conclusions Mobilization, couple- and motivation-oriented counseling, peer-led interventions, conditional fixed value incentives, and SMS are high-impact demand creation interventions and should be prioritized for programmatic consideration. Reduced duration counseling and video-based interventions are an efficient and effective alternative to address staffing shortages. Investment in demand creation activities should prioritize those with undiagnosed HIV or ongoing HIV exposure. Selection of demand creation interventions must consider risks and benefits, context-specific factors, feasibility and sustainability, country ownership, and universal health coverage across disease areas.

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Effectiveness of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda: A randomized controlled trial

Cited by 2 publications

References 16 publications

Utilization of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda

Utilization of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda

Demand creation for HIV testing services: A systematic review and meta-analysis

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