Patterns of usage and preferences of users for tuberculosis-related text messages and voice calls in Uganda

Ggita, Joseph; Ojok, Christopher; Meyer, Amanda; Farr, Katherine; Shete, Priya B.; Ochom, Emmanuel; Turimumahoro, Patricia; Babirye, Diana; Mark, David H.; Dowdy, David W.; Ackerman, Sara; Armstrong-Hough, Mari; Nalugwa, Talemwa; Ayakaka, Irene; Moore, David; Haberer, Jessica; Cattamanchi, Adithya; Katamba, Achilles; Davis, J. Lucian

doi:10.5588/ijtld.17.0521

Cited by 22 publications

(38 citation statements)

References 27 publications

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“…Second, we applied innovative techniques to determine message receipt using SMS reply messages, although uptake of this method of message verification was extremely low. Finally, our study population included young residents of a crowded urban area with high rates of access to mobile phones [21], making our findings likely generalizable to many urban settings in sub-Saharan Africa where health-related SMS interventions are being evaluated and implemented.…”

Section: Discussionmentioning

confidence: 99%

“…Including quizzes or trivia may also improve participant response rates [31]. These strategies, along with more personalized SMS content [21], may increase participant engagement.…”

Section: Discussionmentioning

confidence: 99%

“…We then programmed the mobile survey application to deliver a category-specific SMS message of 145 characters or less (Online Supplement, Table S1) at 7:00 am the following day, via integrated textmessaging software (CommCare Messaging, Dimagi, Boston, MA, USA). The content of the messages was developed through household focus groups and interviews, as previously described [21]. Each message addressed the participant by name in English or Luganda according to his or her preference and provided the results of TB screening and testing with instructions for follow-up.…”

Section: Procedures For Sms Messaging Within the Parent Studymentioning

confidence: 99%

“…Median age among adult participants was 27 years of age (interquartile range (IQR) [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Step 2: SMS Received…”

Section: Study Population Of the Process Evaluationmentioning

confidence: 99%

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Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

Gupta¹,

Babirye²,

Armstrong-Hough³

et al. 2018

Preprint

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Including quizzes or trivia may also improve participant response rates [31]. These strategies, along with more personalized SMS content [21], may increase participant engagement.…”

Section: Discussionmentioning

confidence: 99%

Section: Procedures For Sms Messaging Within the Parent Studymentioning

confidence: 99%

“…Median age among adult participants was 27 years of age (interquartile range (IQR) [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Step 2: SMS Received…”

Section: Study Population Of the Process Evaluationmentioning

confidence: 99%

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Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

Gupta¹,

Babirye²,

Armstrong-Hough³

et al. 2018

Preprint

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“…Given the widespread adoption of wireless technologies, such as mobile phones in sub-Saharan Africa (76% ownership in 2015; [12]), these technologies can provide accessible and potentially affordable means of providing social support. In a recent study carried out in central Uganda, 75% of TB patients reported owning mobile phones and being willing to receive TBrelated communication via their phones [13]. Mobile phones are thus a promising alternative approach for providing social support to TB patients.…”

Section: Introductionmentioning

confidence: 99%

Mobile Health Technologies May Be Acceptable Tools for Providing Social Support to Tuberculosis Patients in Rural Uganda: A Parallel Mixed-Method Study

Musiimenta

Tumuhimbise

Atukunda

et al. 2020

Tuberculosis Research and Treatment

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Background. Social support has been shown to mitigate social barriers to medication adherence and improve tuberculosis (TB) treatment success rates. The use of mobile technology to activate social support systems among TB patients, however, has not been well explored. Moreover, studies that tie supportive SMS (Short Message Service) texts to electronic monitoring of TB medication adherence are lacking. Objective. To explore TB patients’ current access to social support and perceptions of utilizing real-time adherence monitoring interventions to support medication adherence. Methods. We purposively selected TB patients who owned phones, had been taking TB medications for ≥1 month, were receiving their treatment from Mbarara Regional Referral Hospital, and reported having ≥1 social supporter. We interviewed these patients and their social supporters about their access to and perceptions of social support. We used STATA 13 to describe participants’ sociodemographic and social support characteristics. Qualitative data were analyzed using content analysis to derive categories describing accessibility and perceptions. Results. TB patients report requesting and receiving a variety of different forms of social support, including instrumental (e.g., money for transport and other needs and medication reminders), emotional (e.g., adherence counselling), and informational (e.g., medication side effects) support through mobile phones. Participants felt that SMS notifications may motivate medication adherence by creating a personal sense of obligation to take medications regularly. Participants anticipated that limited financial resources and relationship dynamics could constrain the provision of social support especially when patients and social supporters are not oriented about their expectations. Conclusion. Mobile telephones could provide alternative approaches to providing social support for TB medication adherence especially where patients do not stay close to their social supporters. Further efforts should focus on optimized designs of mobile phone-based applications for providing social support to TB patients and training of TB patients and social supporters to match their expectations.

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Feasibility of a short message service (SMS) intervention to deliver tuberculosis testing results in peri-urban and rural Uganda

Babirye

Shete

Farr

et al. 2019

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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BackgroundPre-treatment loss to follow-up is common for patients diagnosed with tuberculosis (TB) in high-burden countries. Delivering test results by Short-Messaging-Service (SMS) is increasingly being considered as a solution, but there is limited information about its feasibility as a public health tool in low resourced settings.ObjectiveWe sought to assess the feasibility of utilizing SMS technology to deliver TB test results during routine TB diagnostic evaluation in Uganda.MethodsWe conducted a single arm interventional pilot study at four community health centers in Uganda that referred sputum samples to a district hospital for GeneXpert-MTB/RIF (Xpert) testing (Cepheid, USA). Using existing GxAlert-software (SystemOne,USA), we set up an automated SMS platform to send Xpert results to patients and referring health centers. We assessed each step of the SMS delivery cascade for consecutive patients who presented to these four community health centers between December 2015 and March 2016 and underwent Xpert testing.ResultsOf 233 patients enrolled, 161 (69%) had phone numbers recorded on individual Xpert referral forms. Phone numbers were entered into Xpert device software in the correct format for 152 (94%) patients. GxAlert-software generated an automated SMS reporting Xpert results for 151 (99%) patients and delivered it successfully to mobile phone service providers for 145/151 (96%). Of the 123 patients reached by phone to determine receipt of test results, 114 (93%) confirmed SMS receipt. SMS-based delivery of Xpert results was verified for 114/233 (49%) patients overall. In contrast, phone calls to health centers confirmed that health centers received messages for 222/233 (95%) patients.ConclusionReporting Xpert results via automated SMS is technically feasible and results in approximately half of patients receiving their test results immediately. Additional research should be done to address process inefficiencies in order to maximize impact of this technology and link its successful utilization to improved patient outcomes.

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Patterns of usage and preferences of users for tuberculosis-related text messages and voice calls in Uganda

Cited by 22 publications

References 27 publications

Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation (Preprint)

Mobile Health Technologies May Be Acceptable Tools for Providing Social Support to Tuberculosis Patients in Rural Uganda: A Parallel Mixed-Method Study

Feasibility of a short message service (SMS) intervention to deliver tuberculosis testing results in peri-urban and rural Uganda

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