Impact of a mHealth Intervention for Peer Health Workers on AIDS Care in Rural Uganda: A Mixed Methods Evaluation of a Cluster-Randomized Trial
Impact of a mHealth Intervention for Peer Health Workers on AIDS Care in Rural Uganda: A Mixed Methods Evaluation of a Cluster-Randomized Trial
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DOI：
10.1007/s10461-011-9995-x
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发表时间：
2011-11-01
影响因子：
4.4
通讯作者：
Reynolds, Steven J.
中科院分区：
文献类型：
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作者：
Chang, Larry W.;Kagaayi, Joseph;Reynolds, Steven J.
低收入和中等收入国家的移动电话普及率正在迅速扩大，并提供了利用有限的卫生人力资源的机会。我们对一项整群随机试验探索性子研究进行了混合方法评估，该研究涉及社区同伴卫生工作者 (PHW) 使用的移动医疗（手机）支持干预措施对乌干达农村地区艾滋病护理的影响。 10 家诊所的 29 名公共卫生工作者按诊所随机分组接受或不接受干预。 PHW 使用电话给更高级别的医疗服务提供者打电话和发短信，提供患者特定的临床信息。对 970 名由 PHW 照顾的患者进行了为期 26 个月的随访。患者病毒学失败的风险没有发现显着差异。定性分析发现，患者护理和后勤工作有所改善，患者、诊所工作人员和公共卫生人员对移动健康干预措施也得到了广泛支持。确定的主要挑战包括可变的患者电话访问、隐私问题和电话维护。
Mobile phone access in low and middle-income countries is rapidly expanding and offers an opportunity to leverage limited human resources for health. We conducted a mixed methods evaluation of a cluster-randomized trial exploratory substudy on the impact of a mHealth (mobile phone) support intervention used by community-based peer health workers (PHW) on AIDS care in rural Uganda. 29 PHWs at 10 clinics were randomized by clinic to receive the intervention or not. PHWs used phones to call and text higher level providers with patient-specific clinical information. 970 patients cared for by the PHWs were followed over a 26 month period. No significant differences were found in patients' risk of virologic failure. Qualitative analyses found improvements in patient care and logistics and broad support for the mHealth intervention among patients, clinic staff, and PHWs. Key challenges identified included variable patient phone access, privacy concerns, and phone maintenance.