Centering healthcare workers in developing digital health interventions: usability and acceptability of a two-way texting retention intervention in a public HIV clinic in Lilongwe, Malawi.
Centering healthcare workers in developing digital health interventions: usability and acceptability of a two-way texting retention intervention in a public HIV clinic in Lilongwe, Malawi.
复制标题
以医护人员为中心制定数字健康干预措施：马拉维利隆圭公共艾滋病毒诊所双向短信保留干预措施的可用性和可接受性。
DOI：
10.1101/2023.01.09.23284326
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Feldacker,Caryl
中科院分区：
文献类型：
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作者：
Mureithi,Maryanne;Ng'aari,Leah;Wasunna,Beatrice;Kiruthu-Kamamia,Christine;Sande,Odala;Chiwaya,GeldertDavie;Huwa,Jacqueline;Tweya,Hannock;Jafa,Krishna;Feldacker,Caryl
研究背景抗逆转录病毒治疗（ART）的新开始者有很高的风险停止治疗，使他们的健康处于危险之中。在马拉维这样的低资源环境中，适当的数字健康应用必须适应当地的连通性和资源限制。目标用户的观点对于应用程序的可用性、购买和优化至关重要。我们描述了一个双向的基于文本的（2wT）系统的设计的形成阶段，为新的ART启动量身定制的提醒和坚持消息，并分享结果，从关键线人采访HCWs专注于应用程序的可用性和acceptance.MethodsUsing一个共同创造的方法与客户端，临床，技术和评估团队和应用程序的开发，我们举行了四个非正式的用户反馈会议，一个小的试点与50个客户端，和10个关键线人（KII），以加深我们的理解，医护人员（HCWs）的需求，可接受性和usability.ResultsFormative研究通知交互式客户端的设计HCW通信，精炼的语言和时间每周的文本爆炸激励信息和量身定制的客户端特定的访问提醒。HCW利益相关者的非正式反馈也为教育材料提供了信息，以提高2wT客户对如何报告转移、请求访问日期更改和询问与访问相关的问题的理解。在KII中，HCW对共同创造过程表示赞赏，认为参与式HCD过程和响应式设计团队能够开发出高度可接受和可用的2wT数字工具。HCWs还建议未来的改进，以促进不同文化水平和经济背景的客户端的包容性，以及与其他健康平台的整合，以提高2wT.ConclusionsInclusion HCWs的摄取增加应用程序的可用性和HCWs之间的可接受性的看法。卫生保健工作者认为，2wT将提高及时的ART访问出席率，并提供宝贵的早期保留护理支持。共同创造的方法似乎成功地设计了一个应用程序，将满足HCW的需求，因此，支持客户坚持访问。
BackgroundNew initiates on antiretroviral therapy (ART) are at high risk of treatment discontinuation, putting their health at risk. In low-resource settings, like Malawi, appropriate digital health applications must fit into local connectivity and resource constraints. Target users’ perspectives are critical for app usability, buy-in and optimization. We describe the formative stages of the design of a two-way text-based (2wT) system of tailored reminders and adherence messages for new ART initiates and share results from key informant interviews with HCWs focused on app usability and acceptability.MethodsUsing a co-creation approach with clients, clinical, technical and evaluation teams and over app development, we held four informal user feedback sessions, a small pilot with 50 clients, and ten key informant (KIIs) to deepen our understanding of healthcare workers (HCWs) needs, acceptability and usability.ResultsFormative research informed the design of interactive client-to-HCW communication, refining of the language and timing of weekly text blast motivational messages and tailored client-specific visit reminders. Informal feedback from HCW stakeholders also informed educational materials to enhance 2wT client understanding of how to report transfers, request visit date changes and ask questions related to their visits. In KII, HCWs noted their appreciation for the co-creation process, believing that the participatory HCD process and responsive design team enabled the development of a highly acceptable and usable 2wT digital tool. HCWs also suggested future improvements to promote inclusion of clients of varying literacy levels and economic backgrounds as well as integrating with other health platforms to improve uptake of 2wT.ConclusionsInclusion of HCWs increased perceptions of app usability and acceptability among HCWs. HCWs believe that 2wT will improve on-time ART visit attendance and provide valuable early retention in care support. The co-creation approach appears successful in designing an app that will meet HCW needs and, therefore, support client adherence to visits.