Mobile Phone Access and Implications for Digital Health Interventions Among Adolescents and Young Adults in Zimbabwe: Cross-Sectional Survey.
Mobile Phone Access and Implications for Digital Health Interventions Among Adolescents and Young Adults in Zimbabwe: Cross-Sectional Survey.
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DOI：
10.2196/21244
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发表时间：
2021-01-13
影响因子：
5
通讯作者：
Ferrand RA
中科院分区：
文献类型：
--
作者：
Doyle AM;Bandason T;Dauya E;McHugh G;Grundy C;Dringus S;Dziva Chikwari C;Ferrand RA
移动的电话可以帮助年轻人（YP）获取健康信息和支持健康服务参与。然而，在低收入环境中，对YP的电话和互联网接入的了解有限，无法告知实施数字健康干预措施的可行性。我们调查了津巴布韦青少年和年轻人获得信息和通信技术的情况。2018年10月至12月，在津巴布韦哈拉雷和东马绍纳兰的城市和城郊5个社区的13-24岁的YP中进行了一项基于人口的横断面调查。YP完成了一份关于移动的手机拥有和使用以及互联网使用的自我完成的平板电脑问卷。主要结果是报告拥有移动的手机的比例。次要结果包括电话和互联网接入和使用行为，以及其他技术设备的所有权和使用。多变量逻辑回归被用来调查与移动的手机拥有量和互联网接入相关的因素，并对一阶段整群抽样设计进行调整。先验探索变量包括年龄、性别、婚姻状况和城市/城郊居住地。共有634/719（88.2%）名合格的YP参与，平均年龄18.0岁（SD 3.3），62.6%（397/634）为女性。在接受采访的YP中，62.6%（396/633; 95% CI 58.5-66.5）报告拥有手机，另有4.3%（27/633）报告可以使用共享手机。手机拥有率随着年龄的增长而增加：13-15奥尔兹27.0%（43/159），16-17奥尔兹61.0%（72/118），18-19奥尔兹71.5%（103/144），20-24奥尔兹84.7%（171/202）（比值比[OR] 1.4，95% CI 1.3-1.5）。女性和男性的所有权相似：61.0%（236/387; 95% CI 55.6-66.1）vs 64.8%（153/236; 95% CI 57.8-71.2），年龄校正OR 0.7（95% CI 0.5-1.1）;受过中等教育的人高于小学或未受过教育的人：67.1%（346/516; 95% CI 62.6-71.2）对比26%（21/82; 95% CI 16.4-37.7），年龄校正OR 2.3（95% CI 1.1-4.8）;其他社会人口统计学因素相似。YP报告称，85.3%（361/423）的自有或共享手机是智能手机。在手机用户中，最常用的手机应用程序是WhatsApp（71.2%，282/396），16.4%（65/396）的人表示曾使用手机跟踪自己的健康状况。共有407/631（64.5%; 95% CI 60.3-68.5）目前可以访问互联网（在过去3个月内使用任何设备），访问随着年龄的增长而增加（OR 1.2，95% CI每年增加1.2-1.3）。在年龄调整分析中，男性，未婚，教育水平较高的人，手机所有者和在社区居住超过1年的人的互联网接入率较高。YP最不喜欢的互联网内容是不受欢迎的性（29.2%，136/465）和暴力（13.1%，61/465）内容。基于移动的电话的干预措施在这一人群中可能是可行的;然而，这种干预措施可能会增加不平等，特别是如果他们需要访问互联网。基于互联网的干预措施应考虑参与者的潜在风险，并纳入安全使用互联网和电话的技能建设课程。
Mobile phones may help young people (YP) access health information and support health service engagement. However, in low-income settings there is limited knowledge on YP’s phone and internet access to inform the feasibility of implementing digital health interventions. We investigated access to information and communication technologies among adolescents and young adults in Zimbabwe. A cross-sectional population-based survey was conducted from October to December 2018 among YP aged 13-24 years in 5 communities in urban and peri-urban Harare and Mashonaland East, Zimbabwe. Consenting YP completed a self-completed tablet-based questionnaire on mobile phone ownership and use, and use of the internet. The primary outcome was the proportion who reported owning a mobile phone. Secondary outcomes included phone and internet access and use behavior, and ownership and use of other technological devices. Multivariable logistic regression was used to investigate factors associated with mobile phone ownership and with internet access, with adjustment for the one-stage cluster sampling design. A priori exploratory variables were age, sex, marital status, and urban/peri-urban residence. A total of 634/719 (88.2%) eligible YP, mean age 18.0 years (SD 3.3) and 62.6% (397/634) females, participated. Of the YP interviewed, 62.6% (396/633; 95% CI 58.5-66.5) reported owning a phone and a further 4.3% (27/633) reported having access to a shared phone. Phone ownership increased with age: 27.0% (43/159) of 13-15-year olds, 61.0% (72/118) of 16-17-year olds, 71.5% (103/144) of 18-19-year olds, and 84.7% (171/202) of 20-24-year olds (odds ratio [OR] 1.4, 95% CI 1.3-1.5) per year increase. Ownership was similar among females and males: 61.0% (236/387; 95% CI 55.6-66.1) versus 64.8% (153/236; 95% CI 57.8-71.2), age-adjusted OR 0.7 (95% CI 0.5-1.1); higher in those with secondary level education compared to primary or no education: 67.1% (346/516; 95% CI 62.6-71.2) versus 26% (21/82; 95% CI 16.4-37.7), age-adjusted OR 2.3 (95% CI 1.1-4.8); and similar across other sociodemographic factors. YP reported that 85.3% (361/423) of phones, either owned or shared, were smartphones. Among phone owners, the most commonly used phone app was WhatsApp (71.2%, 282/396), and 16.4% (65/396) reported having ever used their phone to track their health. A total of 407/631 (64.5%; 95% CI 60.3-68.5) currently had access to the internet (used in last 3 months on any device) with access increasing with age (OR 1.2, 95% CI 1.2-1.3 per year increase). In age-adjusted analysis, internet access was higher among males, the unmarried, those with a higher level of education, phone owners, and those who had lived in the community for more than 1 year. The aspect of the internet that YP most disliked was unwanted sexual (29.2%, 136/465) and violent (13.1%, 61/465) content. Mobile phone–based interventions may be feasible in this population; however, such interventions could increase inequity, especially if they require access to the internet. Internet-based interventions should consider potential risks for participants and incorporate skill-building sessions on safe internet and phone use.
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影响因子：
4.8
作者：
Porter, Gina;Hampshire, Kate;Tanle, Augustine
通讯作者：
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DOI：
10.1097/qai.0000000000002198
发表时间：
2020-01-01
影响因子：
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作者：
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通讯作者：
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