Digital Adherence Technologies and Mobile Money Incentives for Management of Tuberculosis Medication Among People Living With Tuberculosis: Mixed Methods Formative Study.
Digital Adherence Technologies and Mobile Money Incentives for Management of Tuberculosis Medication Among People Living With Tuberculosis: Mixed Methods Formative Study.
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DOI：
10.2196/45301
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发表时间：
2023-04-12
影响因子：
2.2
通讯作者：
Haberer, Jessica
中科院分区：
文献类型：
--
作者：
Musiimenta, Angella;Tumuhimbise, Wilson;Atukunda, Esther;Mugaba, Aaron;Linnemayr, Sebastian;Haberer, Jessica
关键词：
尽管数字依从性技术(DAT)的使用越来越多，例如在结核病用药依从性方面的实时监测和短信提醒，但有报道称，患者与各种DAT的接触不是最理想的。此外，财务限制可能会限制DAT的效用。与用于结核病药物管理的移动货币财政奖励挂钩的DAT的感知有用性和设计机制仍不清楚。这项研究的目的是描述被称为我的移动钱包的DAT干预的感知有用性和设计机制，该干预由实时依从性监测、短信提醒和移动货币激励组成，以支持低收入环境下的结核病用药依从性。这项研究在姆巴拉拉地区转诊医院结核病诊所招募的结核病患者中使用了混合方法。我们有目的地抽样了21名年龄在18岁及以上的结核病患者，他们拥有手机，并能够使用短信干预。我们还招募了9名在之前的研究中使用DAT的参与者。我们使用与30名参与者的焦点小组讨论来征求对My Mobile Wallet干预的初始版本的看法，然后按照以用户为中心的设计方法迭代地改进干预的后续版本，直到开发出适合他们需求的干预的测试版。还进行了调查，了解参与者的手机使用情况和对干预措施的看法。内容分析用于归纳分析定性数据，以得出描述干预措施、关注事项和设计机制的感知有用性的类别。使用STATA(版本13；StataCorp)分析调查数据。与会者表示，我的移动钱包干预措施在以下方面被认为是有用的：被提醒服用药物，并得到前往诊所的交通支持，以及支付其他与结核病药物相关的费用，所有这些都被认为意味着护理，这可以为医护人员创造一种连接感。因此，这可能会导致参与者产生一种自我感觉到的需要，以证明他们对护理他们的卫生保健人员的承诺，从而激励他们坚持用药。由于担心意外泄露结核病状况，20名(67%)参与者建议使用保密的短信语言--不易与结核病相关。为了减少将钱用于其他相互竞争的要求的可能性，25名(83%)的参与者倾向于在预约前1-2天将钱寄出，以限制收到钱和去诊所之间的时间间隔。DATS与移动货币财务激励相结合，可能会提供可接受的方法来提醒、支持和激励患者坚持服用结核病药物。ClinicalTrials.gov NCT05656287；https://clinicaltrials.gov/ct2/show/NCT05656287
Although there is an increasing use of digital adherence technologies (DATs), such as real-time monitors and SMS reminders in tuberculosis medication adherence, suboptimal patient engagement with various DATs has been reported. Additionally, financial constraints can limit DAT’s utility. The perceived usefulness and the design mechanisms of DATs linked to mobile money financial incentives for tuberculosis medication management remain unclear. The aim of this study is to describe the perceived usefulness and design mechanisms for a DAT intervention called My Mobile Wallet, which is composed of real-time adherence monitors, SMS reminders, and mobile money incentives to support tuberculosis medication adherence in a low-income setting. This study used mixed methods approaches among persons with tuberculosis recruited from the Tuberculosis Clinic in the Mbarara Regional Referral Hospital. We purposively sampled 21 persons with tuberculosis aged 18 years and older, who owned cell phones and were able to use SMS text messaging interventions. We also enrolled 9 participants who used DATs in our previous study. We used focus group discussions with the 30 participants to solicit perceptions about the initial version of the My Mobile Wallet intervention, and then iteratively refined subsequent versions of the intervention following a user-centered design approach until the beta version of the intervention that suited their needs was developed. Surveys eliciting information about participants’ cell phone use and perceptions of the intervention were also administered. Content analysis was used to inductively analyze qualitative data to derive categories describing the perceived usefulness of the intervention, concerns, and design mechanisms. Stata (version 13; StataCorp) was used to analyze survey data. Participants expressed the perceived usefulness of the My Mobile Wallet intervention in terms of being reminded to take medication, supported with transport to the clinic, and money to meet other tuberculosis medication–related costs, all of which were perceived to imply care, which could create a sense of connectedness to health care workers. This could consequently cause participants to develop a self-perceived need to prove their commitment to adherence to health care workers who care for them, thereby motivating medication adherence. For fear of unintended tuberculosis status disclosure, 20 (67%) participants suggested using SMS language that is confidential—not easily related to tuberculosis. To reduce the possibilities of using the money for other competing demands, 25 (83%) participants preferred sending the money 1-2 days before the appointment to limit the time lag between receiving the money and visiting the clinic. DATs complemented with mobile money financial incentives could potentially provide acceptable approaches to remind, support, and motivate patients to adhere to taking their tuberculosis medication. ClinicalTrials.gov NCT05656287; https://clinicaltrials.gov/ct2/show/NCT05656287
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影响因子：
1.9
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
5
作者：
Musiimenta A;Atukunda EC;Tumuhimbise W;Pisarski EE;Tam M;Wyatt MA;Ware NC;Haberer JE
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影响因子：
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作者：
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通讯作者：
Haberer JE
DOI：
10.1016/j.jctube.2019.100119
发表时间：
2019-12-01
影响因子：
2
作者：
Musiimenta, Angella;Tumuhimbise, Wilson;Haberer, Jessica E.
通讯作者：
Haberer, Jessica E.