Use of m-Health Technology for Preventive Interventions to Tackle Cardiometabolic Conditions and Other Non-Communicable Diseases in Latin America- Challenges and Opportunities

Abstract

In Latin America, cardiovascular disease (CVD) mortality rates will increase by an estimated 145% from 1990 to 2020. Several challenges related to social strains, inadequate public health infrastructure, and underfinanced healthcare systems make cardiometabolic conditions and non-communicable diseases (NCDs) difficult to prevent and control. On the other hand, the region has high mobile phone coverage, making mobile health (mHealth) particularly attractive to complement and improve strategies toward prevention and control of these conditions in low- and middle-income countries. In this article, we describe the experiences of three Centers of Excellence for prevention and control of NCDs sponsored by the National Heart, Lung, and Blood Institute with mHealth interventions to address cardiometabolic conditions and other NCDs in Argentina, Guatemala, and Peru. The nine studies described involved the design and implementation of complex interventions targeting providers, patients and the public. The rationale, design of the interventions, and evaluation of processes and outcomes of each of these studies are described, together with barriers and enabling factors associated with their implementation.

Review of patients perspective’s of m-health adoption factors in the developing world. Development of a framework

“…Research methods used in the 54 reviewed resources were: 25 qualitative papers , 9 surveys [42][43][44][45][46][47][48][49][50], 7 mixed methods [51][52][53][54][55][56][57], 4 experimental [52,[58][59][60], 3 usability assessments [8,61,62], 2 cohort studies [63,64], and 4 cross sectional studies [65][66][67][68]. Collectively they reported the spectrum of factors that affect patient adoption.…”

“…Another issue was the ability to keep a mobile phone charged and connected, and the associated costs. In many developing countries power was described as irregular with rural areas being most affected [53,70]. Keeping a mobile phone charged was problematic [33,36,43] and it was common to nd people paying to charge their phones at street side vendors [33,37].…”

“…Keeping a mobile phone charged was problematic [33,36,43] and it was common to nd people paying to charge their phones at street side vendors [33,37]. Likewise, phone maintenance in the event of a fault was an equally important factor that might jeopardise adoption [50,53,76].…”

“…Studies reported participants from adolescents to the aged, of both genders, and broad levels of education [21,28,37,53,66]. Some studies suggested that age and gender of patients should be considered when implementing m-health systems, with different age groups having preferences for certain multimedia elements [48,66], and women given less priority in male dominated communities [37,42].…”

“…Reasons included the gatekeeper effect, but also the lack of primary or higher education for women [8,33]. It was suggested that an appropriate age target for minimally educated women to use m-health would be 17 to 63 years [8,22,25] but in certain parts of the developing world older women were more likely to own and use a mobile phone for m-health than younger women [53], and in South Africa women are the dominant users [37]. Urban women found evening m-health services more convenient and rural women preferred daytime services [19,28,57].…”