Feasibility and acceptability of mobile phone short message service as a support for patients receiving antiretroviral therapy in rural Uganda: a cross‐sectional study

Abstract

IntroductionMobile phone technologies have been promoted to improve adherence to antiretroviral therapy (ART). We studied the receptiveness of patients in a rural Ugandan setting to the use of short messaging service (SMS) communication for such purposes.MethodsWe performed a cross-sectional analysis measuring mobile phone ownership and literacy amongst patients of The AIDS Support Organisation (TASO) in Jinja, Uganda. We performed bivariate and multivariate logistic regression analyses to examine associations between explanatory variables and a composite outcome of being literate and having a mobile phone.ResultsFrom June 2012 to August 2013, we enrolled 895 participants, of whom 684 (76%) were female. The median age was 44 years. A total of 576 (63%) were both literate and mobile phone users. Of these, 91% (527/ 576) responded favourably to the potential use of SMS for health communication, while only 38.9% (124/319) of others were favourable to the idea (p<0.001). A lower proportion of literate mobile phone users reported optimal adherence to ART (86.4% vs. 90.6%; p=0.007). Male participants (AOR=2.81; 95% CI 1.83–4.30), sub-optimal adherence (AOR=1.76; 95% CI 1.12–2.77), those with waged or salaried employment (AOR=2.35; 95% CI 1.23–4.49), crafts/trade work (AOR=2.38; 95% CI 1.11–5.12), or involved in petty trade (AOR=1.85; 95% CI 1.09–3.13) (in comparison to those with no income) were more likely to report mobile phone ownership and literacy.ConclusionsIn a rural Ugandan setting, we found that over 60% of patients could potentially benefit from a mobile phone-based ART adherence support. However, support for such an intervention was lower for other patients.

eHealth Literacy in People Living with HIV: Systematic Review (Preprint)

“…[28,29] Potential confounding factors were not identified in these two studies. Two of the seven studies did not use a validated standard measure of eHealth literacy but collected participants' basic literacy skills.…”

“…Four studies were conducted in the U.S., [24][25][26][27] two in Uganda, [23,28] and one in Peru. [29] Various study designs were used: cross-sectional, [27][28][29] quasi-experimental, [24][25][26] and a RCT. [23] Two studies identified a theoretical or conceptual framework used in their research.…”

“…One study simply defined health literacy as the ability to read and write. [28] Three studies conducted in the U.S. [26,27] measured eHealth literacy using the eHealth Literacy Scale (eHEALS), a self-evaluation tool comprised of 8 items with a 5-point Likert scale.…”

“…[23] Two studies identified a theoretical or conceptual framework used in their research. [23,25] Study participants were recruited from a variety of settings: community-based HIV/AIDS organizations, [25,[27][28][29] HIV hospital settings, [23,26] and both community-based and hospital settings. [24] Overall, HIV-infected adults older than 18 years were included; one study included only people who had advanced immunosuppression (CD4+ T cell count < 350 cells/mm 3 and taking ARTs for at least four years), [28] one included women only, [27] and one involved men who have sex with men (MSM) and/or transgender women (TGW).…”

“…Two of the seven studies did not use a validated standard measure of eHealth literacy but collected participants' basic literacy skills. [23,28] Further, an inter-rater reliability analysis using kappa statistic was performed to determine consistency between raters. [30] The resulting kappa indicated substantial agreement with k=0.692 as analyzed by SPSS version 24.…”